Effect size based on study OR
HomVEE calculated the effect size based on the study-reported odds ratio.
Model effectiveness research report last updated: 2019
The Maternal Infant Health Program (MIHP) provides prenatal and postnatal home visiting to pregnant women and infants living in Michigan who are Medicaid beneficiaries. MIHP was designed to serve women and their children who receive Medicaid because they are more likely to experience adverse birth outcomes and higher rates of infant mortality and injury than families with private insurance. The model is based on the premise that early intervention can help mitigate the effects of delayed prenatal care, unintended pregnancy, and substance use during pregnancy.
MIHP offers home visiting by a team composed of a licensed social worker, a registered nurse, an infant mental health specialist, a lactation consultant, and a registered dietitian. MIHP services aim to supplement regular prenatal and infant care by offering tailored education and counseling, care coordination, and referrals. The model is designed to serve mothers during pregnancy and up to 60 days postpartum and infants before they reach 18 months of age; it serves mothers and infants separately based on their respective needs.
To initiate services, a licensed social worker or registered nurse conducts a risk assessment with the mother or infant. The assessments are designed to identify potential health risks and cover areas such as pregnancy and overall health history, basic needs, domestic violence, substance abuse, support systems, maternal mental health, and infant safety.
Based on findings from the risk assessment, the licensed social worker and registered nurse develop an individualized plan of care for the mother and/or infant. Registered dietitians, lactation consultants, and infant mental health specialists may contribute to the plan as needed. The plan of care identifies the needs of the mother and/or infant, outlines the desired outcomes, and describes the appropriate services to fulfill the family’s needs.
Based on the plan of care, either the licensed social worker or the registered nurse will serve as the primary home visitor, but each professional will visit the family at least once. Other MIHP team members may also conduct home visits. During the visits, the home visitor may provide the following services:
The home visitor uses motivational interviewing techniques and works with the family to develop goals and a plan for achieving them.
MDHHS requires providers to make every effort to visit the mother or infant at home. The mother has the right to request that some visits take place at the MIHP provider’s office or at a mutually agreed-upon community location. For maternal services, MDHHS requires at least one visit to the mother’s home during the prenatal period to assess the mother, and at least one other home visit postpartum to observe infant care and nutrition and discuss family planning. For infants, MDHHS requires that the assessment and 80 percent of other visits to be conducted at the infant’s home. Across the state, most MIHP providers serve clients exclusively or primarily in the home; there are a few clinic-based providers that include a higher complement of office visits.
MIHP uses standardized plans of care to guide service delivery. The plans of care are available on the MIHP website.
MIHP serves pregnant women and infants up to 18 months old who live in Michigan and receive Medicaid. A pregnant woman or infant does not need to be receiving Medicaid at the time of MIHP enrollment, but must apply in order to receive ongoing services. MIHP offers assistance with the application process. Women may enroll in MIHP at any time during their pregnancy and receive services until 60 days postpartum. Families may enroll infants, even if the mother was not enrolled in MIHP during pregnancy.
Maternal and Infant Health Program
Division of Maternal and Infant Health
Michigan Department of Health and Human Services
Phone: (833)-MI4-MIHP
Email: MIHP@michigan.gov
Website: https://www.michigan.gov/mihp/
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Adequate prenatal care | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2010 birth cohort | 32088 mothers | Unadjusted proportion = 0.65 | Unadjusted proportion = 0.63 | OR = 1.06 | HomVEE calculated = 0.04 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. |
Any prenatal care | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2010 birth cohort | 32088 mothers | Unadjusted proportion = 0.99 | Unadjusted proportion = 0.97 | OR = 2.94 | HomVEE calculated = 0.65 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. |
Appropriate postnatal visit | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2010 birth cohort | 32088 mothers | Unadjusted proportion = 0.50 | Unadjusted proportion = 0.41 | OR = 1.50 | HomVEE calculated = 0.25 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Infant death < 1 year |
FavorableUnfavorable or ambiguousNo Effect |
One year following birth | Full sample; Michigan Medicaid 2009-2012 birth cohort | 126880 infants | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.01 | OR = 0.73 | HomVEE calculated = -0.19 | Statistically significant, p < 0.01 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.010. HomVEE calculated the effect size based on the study-reported odds ratio. |
Infant death < 28 days | FavorableUnfavorable or ambiguousNo Effect |
28 days following birth | Full sample; Michigan Medicaid 2009-2012 birth cohort | 126880 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | OR = 0.70 | HomVEE calculated = -0.22 | Statistically significant, p < 0.01 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. HomVEE calculated the effect size based on the study-reported odds ratio. |
Infant death 28-365 days | FavorableUnfavorable or ambiguousNo Effect |
One year following birth | Full sample; Michigan Medicaid 2009-2012 birth cohort | 126880 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | OR = 0.78 | HomVEE calculated = -0.15 | Statistically significant, p = 0.02 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. HomVEE calculated the effect size based on the study-reported odds ratio. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Low birth weight (<2500g) | FavorableUnfavorable or ambiguousNo Effect |
Immediately post-intervention | Full sample; Michigan Medicaid 2010 birth cohort | 32088 infants | Unadjusted proportion = 0.08 | Unadjusted proportion = 0.09 | OR = 0.91 | HomVEE calculated = -0.06 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorableNegative effect is favorable to the intervention. |
Preterm birth (<37 weeks) | FavorableUnfavorable or ambiguousNo Effect |
Immediately post-intervention | Full sample; Michigan Medicaid 2010 birth cohort | 32088 infants | Unadjusted proportion = 0.11 | Unadjusted proportion = 0.12 | OR = 0.91 | HomVEE calculated = -0.06 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorableNegative effect is favorable to the intervention. |
Very low birth weight (<1500g) | FavorableUnfavorable or ambiguousNo Effect |
Immediately post-intervention | Full sample; Michigan Medicaid 2010 birth cohort | 32088 infants | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.02 | OR = 0.71 | HomVEE calculated = -0.21 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorableNegative effect is favorable to the intervention. |
Very preterm birth (<32 weeks) | FavorableUnfavorable or ambiguousNo Effect |
Immediately post-intervention | Full sample; Michigan Medicaid 2010 birth cohort | 32088 infants | Unadjusted proportion = 0.02 | Unadjusted proportion = 0.03 | OR = 0.80 | HomVEE calculated = -0.14 | Statistically significant, p < 0.05 | Effect size based on study ORHomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorableNegative effect is favorable to the intervention. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
Burns | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.01 | MD = 0.00 | HomVEE calculated = 0.11 | Not statistically significant, p = 0.16 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.010. Group differences are very small. |
Crush injury | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.81 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Dislocations and strains and sprains | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.01 | MD = 0.00 | HomVEE calculated = 0.08 | Not statistically significant, p = 0.62 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.010. Group differences are very small. |
Foreign body | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.01 | MD = 0.00 | HomVEE calculated = 0.21 | Statistically significant, p = 0.01 | Negative effect is favorableNegative effect is favorable to the intervention. Group differences are very small. |
Fracture lower limb | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.33 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Fracture neck and trunk | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.42 | Not statistically significant, p = 0.48 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Fracture skull that apart from vault or base | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.51 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Fracture skull vault or base | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.68 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Fracture upper limb | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = -0.17 | Not statistically significant, p = 0.32 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Internal trauma | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.56 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Intracranial Injury | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.01 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.25 | Statistically significant, p = 0.04 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.010. Group differences are very small. |
Multiple fractures of limbs | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.56 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Nerve and spinal cord | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p = 0.81 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Open wounds | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.02 | Unadjusted proportion = 0.01 | MD = 0.00 | HomVEE calculated = 0.17 | Statistically significant, p = 0.02 | Negative effect is favorableNegative effect is favorable to the intervention. Group differences are very small. |
Poisoning | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.02 | Unadjusted proportion = 0.02 | MD = 0.00 | HomVEE calculated = -0.07 | Not statistically significant, p = 0.33 | Negative effect is favorableNegative effect is favorable to the intervention. Group differences are very small. |
Proportion of infants with at least one injury episode | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.12 | Unadjusted proportion = 0.10 | MD = 0.01 | HomVEE calculated = 0.08 | Statistically significant, p = 0.00 | Negative effect is favorableNegative effect is favorable to the intervention. |
Superficial injuries and contusion | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.05 | Unadjusted proportion = 0.04 | MD = 0.01 | HomVEE calculated = 0.14 | Statistically significant, p = 0.01 | Negative effect is favorableNegative effect is favorable to the intervention. |
Vascular injury | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Full sample; Michigan Medicaid 2011 birth cohort | 27320 infants | Unadjusted proportion = 0.00 | Unadjusted proportion = 0.00 | MD = 0.00 | HomVEE calculated = -0.42 | Not statistically significant, p = 0.48 | Negative effect is favorableNegative effect is favorable to the intervention. Program and comparison group proportions are less than 0.005. Group differences are very small. |
Title | General population | Tribal population | Domains with favorable effects |
---|---|---|---|
Maternal Infant Health Program (MIHP) | Meets HHS criteria | Does not meet HHS criteria for tribal population because the model has not been evaluated with a tribal population. |
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The Maternal Infant Health Program (MIHP) serves pregnant women and infants up to 18 months old who live in Michigan and receive Medicaid. The model aims to reduce rates of maternal and infant morbidity and mortality by promoting healthy pregnancies, positive birth outcomes, and healthy growth and development for infants. Home visiting is offered by a team composed of a licensed social worker, a registered nurse, an infant mental health specialist, a lactation consultant, and a registered dietitian. MIHP is designed to supplement regular prenatal and infant care by offering tailored education and counseling, care coordination, and referrals. The model serves mothers and infants separately based on their respective needs. MIHP maternal services include an assessment visit and up to nine additional monthly visits to implement the plan of care during pregnancy. Mothers are also eligible to receive care as needed up to 60 days postpartum. MIHP infant services also include an assessment and up to nine additional monthly visits in the first year of the child’s life. If needs persist, the infant may be eligible for an additional nine visits, but services must conclude before the infant reaches 18 months of age. Each home visit must last at least 30 minutes.
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