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Table 15CHW maternal and child interventions and prenatal care and perinatal outcomes

Author, Year
Study Design
Population Setting
Sample Size
Intensity of CHW InterventionStudy GroupsResults
Graham et al., 199279


Pregnant inner-city African-American women

Cleveland, Ohio

N: 145

HighG1: Home visits with psychosocial support and encouragement, education, link to community resources, information on health risks; 4 visits of 1 hour each at 2–4 week intervals

G2: Routine prenatal obstetric care (control)
No statistically significant difference between groups in incidence of low birth weight: 12.9% intervention, 7.5% controls (P = 0.51)
Nacion et al., 200072



Low-income inner-city
African-American pregnant women and infants

Chicago, Illinois

N: 213

HighG1: Home visits by CHW

G2: Home visits by nurse (historic control)
G1 more likely than G2 to receive problem- solving services (P < 0.01) and to have problems identified in women’s health (P = 0.01), well-child health care deficits (P = 0.02), parenting (P = 0.02), and socioeconomic issues (P < 0.01)

G1 less likely than G2 to receive emotional support services (P < 0.01), to have referrals placed for women’s health (P = 0.01), well-woman (P = 0.02), emotional/interpersonal (P < 0.01), parental support (P < 0.01), or for socioeconomic issues (P < 0.01)
St. James et al., 199983


Mothers with PKU

New England

N: 69

HighG1: Historic control; women who completed pregnancy in the 5 years prior to project onset

G2: Resource mothers
Metabolic control achieved in 8.5 weeks for G2 vs. 16 weeks for G1 (P < 0.05)

Infant mental scale on Bayley Developmental Quotient was 108 for G2 vs. 95 for G1 (P < 0.05)

No difference in head circumference at birth (P = 0.08)
Barnes-Boyd et al., 200171



Low-income inner-city African-American pregnant women and infants

Chicago, Illinois

N: 1,922

HighG1: Monthly home visits over 1 year; visits at prenatal, 1, 6, and 12 months teamed with nurse

G2: Historic controls with nurse home visits
Proportion fully immunized at 12 months: CHW 77%, nurse 63% (P < 0.001)

No significant difference between groups in presence of neonatal or postneonatal health problems (27% CHW vs. 25% nurse)
Caulfield et al., 199877


African-American women receiving prenatal care

Baltimore, Maryland

N: 548

HighG1: Standard WIC services only

G2: WIC plus video and literature

G3: WIC plus peer counseling

G4: WIC plus peer counseling plus video and literature
Initiation of breastfeeding: G1: 26% (referent)
G2: 50% (OR, 1.36; 95% CI, 0.52–3.54)
G3: 62% (OR, 3.84; 95% CI, 1.44–10.21)
G4: 52% (OR, 1.92; 95% CI, 0.78–4.76)

Breastfeeding at 7–10 days: G1: 14% (referent)
G2: 30% (OR, 0.79; 95% CI, 0.25–2.52)
G3: 38% (OR, 1.11; 95% CI, 0.34–3.61)
G4: 38% (OR, 1.52; 95% CI, 0.50–4.59)
Tessaro et al., 199786,87


Maternal Outreach Workers

Medicaid-eligible pregnant women with 1 or more pregnancy risk factors

North Carolina

N: 705

HighG1: CHW intervention

G2: Matched controls, not otherwise defined
Maternal depression score increased by 2.1 in G1 vs. 5.1 in G2 (P = 0.01)

Prenatal care, African Americans: G1: 60.7% adequate, 32.6% intermediate, 6.7% inadequate
G2: 63.8% adequate, 31.5% intermediate, 4.7% inadequate

Prenatal care, Whites: G1: 77.4% adequate, 19.7% intermediate, 2.9% inadequate
G2: 75.1% adequate, 22.8% intermediate, 2.1% inadequate

No difference between groups in maternal self-esteem (P = 0.19) or perceived stress (P = 0.75)

No difference in observed vs. expected incidence of low birth weight or very low birth weight: African Americans −13 (P = 0.12), Whites +1 (P = 0.58)

CHW, community health worker; PKU, phenylketonuria; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children.

From: 3, Results

Cover of Outcomes of Community Health Worker Interventions
Outcomes of Community Health Worker Interventions.
Evidence Reports/Technology Assessments, No. 181.
Viswanathan M, Kraschnewski J, Nishikawa B, et al.

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