Implementing Maternal Infant Health Program (MIHP) Meets HHS Criteria

Last updated: June 2019

This report summarizes information on how a given model was implemented in the studies reviewed. The report includes only information provided in (1) implementation studies and (2) effectiveness studies that rate moderate or high. These studies vary in the level of detail they provide about implementation features. Thus, the report does not provide an exhaustive picture of how the model was implemented across the programs studied. HomVEE notes, in the text or in parentheses, the number of studies that reported information on a given implementation feature.

Implementation experiences

Summary of sources

Information in this section is based on studies included in the HomVEE review. For the Maternal Infant Health Program, we reviewed four publications about three quasi-experimental studies. (Please see Studies for Implementation Experiences for a list of the studies and to link to the characteristics of the samples examined in the effectiveness studies.)

In the following sections, we consider all pieces of research about a particular sample to be a single study. For example, two publications were based on the same group of participants and are cited as one study. There are three distinct samples across the four publications. One of the publications reported the effects of MIHP across a range of years, while the other three each reported the effect of MIHP in specific years within that range.

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Characteristics of model participants

Caregivers participating in the program were mothers (three studies). The studies reviewed did not include information on child gender. The average age of mothers was 24 to 25 (three studies). One study reported that 63 percent of mothers were ages 20 to 29; 20 percent were younger than 20; 16 percent were ages 30 to 39; and 1 percent were 40 or older. In all three studies, infants participated in MIHP during their first year of life.

The percentage of mothers who identified as white ranged from 51 to 57 (three studies); 36 to 38 percent identified as African American (three studies); 8 percent identified as Hispanic (one study); 1 percent identified as American Indian (two studies); and 3 to 6 percent identified as another race (three studies).

Eighteen to 30 percent of mothers had incomes at or below 33 percent of the federal poverty level (three studies). The percentage of mothers who received Medicaid before becoming pregnant ranged from 57 to 68 (three studies). Thirty-one to 33 percent of mothers reported smoking during pregnancy (three studies).

Twenty-five to 33 percent of mothers were married (three studies). One study reported that 43 percent of mothers were not married, but paternity was acknowledged, and 24 percent of mothers were the only parent listed on the birth certificate.

Twenty-four to 25 percent of mothers had been pregnant less than 18 months earlier with a child other than the one participating in the program; for 32 to 35 percent of mothers, the time since their last pregnancy with a child other than the one participating in the program was 18 months or more; and 37 to 39 percent of mothers were pregnant for the first time (three studies).
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Location and setting

MIHP was implemented in both rural and large metropolitan areas of Michigan. Implementing agencies were not reported in the studies reviewed.
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Staffing and supervision

The home visitors were described as MIHP case managers (one study) and registered nurses and licensed social workers (two studies). The studies reviewed did not include information about staff education, supervision, training, or caseloads.
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Model services

Home visiting was the main service provided to participants (three studies). According to the author of one study, 89 percent of MIHP visits occurred in the home, 4 percent were office visits, and 7 percent took place in other settings, including federally qualified health centers and public health clinics. MIHP programs supplemented medical prenatal and infant care by providing home-based care coordination (three studies), services based on individual care plans (three studies), risk screening (two studies), and referrals (two studies). One study reported that infant safety education was provided and covered topics such as safe sleep, not shaking the baby, and childproofing the home.

The model allows eligible women to enroll at any time during pregnancy and supports families through the infant’s first birthday (three studies). The studies reviewed did not include information about the intended number or length of visits.

Home visitors followed standardized program protocols (two studies).

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Model adaptations or enhancements

The studies reviewed did not adapt or enhance the MIHP model.
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Lessons learned

One study suggested that the home visitors’ efforts to coordinate care with medical providers and the participants’ Medicaid health plan helped participants access medical care.
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