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Aligning Health and Social Systems to Improve Maternal Behaviors and Birth Outcomes Among Clients Engaged in Evidence-Based Home Visiting.

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Title: Aligning Health and Social Systems to Improve Maternal Behaviors and Birth Outcomes Among Clients Engaged in Evidence-Based Home Visiting.
Authors: Williams, Venice Ng, Knudtson, Michael D., Allison, Mandy A., Tung, Gregory J.
Source: American Journal of Public Health. 2026 Suppl 3, Vol. 116, pS181-S191. 11p.
Subjects: Home care services, Community health services, Patients' families, Poisson distribution, Professional practice, Maternal health services, Medical personnel, Mental health, Mental health services, Scientific observation, Parenting, Pregnancy outcomes, Descriptive statistics, Continuum of care, Pediatrics, Motherhood, Evidence-based medicine, Data analysis software, Integrated health care delivery, Nutrition, Sensitivity & specificity (Statistics)
Abstract: Objectives. To examine the association between system alignment among Nurse–Family Partnership (NFP) home visitors and other community service providers and maternal behaviors and birth outcomes among NFP clients. Methods. NFP implementation data from 2015 to 2021 were matched to the 2018 to 2021 NFP Collaboration Panel Survey (n = 102 690). We used Poisson-based general estimating equations to examine a measure of cross-sector collaboration (based on relational coordination and structural integration) and the relationship with prenatal smoking cessation, breastfeeding, low birth weight, and preterm birth after adjustment for client-, nurse-, and agency-level covariates. Results. Stronger coordination with women's care providers (relative risk [RR] = 1.010; 95% confidence interval [CI] = 1.00, 1.02) and greater integration with mental health providers (RR = 1.002; 95% CI = 1.00, 1.00) were slightly positively associated with initiation of breastfeeding. The slight positive association with greater integration with mental health providers was sustained for continued breastfeeding at 6 months postpartum (RR = 1.004; 95% CI = 1.00, 1.01). System alignment was not related to prenatal smoking cessation, low birth weight, or preterm birth. Conclusions. Future implementation studies should explore whether strategies to increase system alignment result in changes in quantitative measures of cross-sector collaboration and meaningful improvement in maternal and child outcomes at a population level. (Am J Public Health. 2026;116(S3): S181–S191. https://doi.org/10.2105/AJPH.2026.308457) [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Aligning Health and Social Systems to Improve Maternal Behaviors and Birth Outcomes Among Clients Engaged in Evidence-Based Home Visiting.
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  Data: <searchLink fieldCode="AR" term="%22Williams%2C+Venice+Ng%22">Williams, Venice Ng</searchLink><br /><searchLink fieldCode="AR" term="%22Knudtson%2C+Michael+D%2E%22">Knudtson, Michael D.</searchLink><br /><searchLink fieldCode="AR" term="%22Allison%2C+Mandy+A%2E%22">Allison, Mandy A.</searchLink><br /><searchLink fieldCode="AR" term="%22Tung%2C+Gregory+J%2E%22">Tung, Gregory J.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Public+Health%22">American Journal of Public Health</searchLink>. 2026 Suppl 3, Vol. 116, pS181-S191. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Home+care+services%22">Home care services</searchLink><br /><searchLink fieldCode="DE" term="%22Community+health+services%22">Community health services</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+families%22">Patients' families</searchLink><br /><searchLink fieldCode="DE" term="%22Poisson+distribution%22">Poisson distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+practice%22">Professional practice</searchLink><br /><searchLink fieldCode="DE" term="%22Maternal+health+services%22">Maternal health services</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+personnel%22">Medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health+services%22">Mental health services</searchLink><br /><searchLink fieldCode="DE" term="%22Scientific+observation%22">Scientific observation</searchLink><br /><searchLink fieldCode="DE" term="%22Parenting%22">Parenting</searchLink><br /><searchLink fieldCode="DE" term="%22Pregnancy+outcomes%22">Pregnancy outcomes</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Continuum+of+care%22">Continuum of care</searchLink><br /><searchLink fieldCode="DE" term="%22Pediatrics%22">Pediatrics</searchLink><br /><searchLink fieldCode="DE" term="%22Motherhood%22">Motherhood</searchLink><br /><searchLink fieldCode="DE" term="%22Evidence-based+medicine%22">Evidence-based medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Integrated+health+care+delivery%22">Integrated health care delivery</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink><br /><searchLink fieldCode="DE" term="%22Sensitivity+%26+specificity+%28Statistics%29%22">Sensitivity & specificity (Statistics)</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Objectives. To examine the association between system alignment among Nurse–Family Partnership (NFP) home visitors and other community service providers and maternal behaviors and birth outcomes among NFP clients. Methods. NFP implementation data from 2015 to 2021 were matched to the 2018 to 2021 NFP Collaboration Panel Survey (n = 102 690). We used Poisson-based general estimating equations to examine a measure of cross-sector collaboration (based on relational coordination and structural integration) and the relationship with prenatal smoking cessation, breastfeeding, low birth weight, and preterm birth after adjustment for client-, nurse-, and agency-level covariates. Results. Stronger coordination with women's care providers (relative risk [RR] = 1.010; 95% confidence interval [CI] = 1.00, 1.02) and greater integration with mental health providers (RR = 1.002; 95% CI = 1.00, 1.00) were slightly positively associated with initiation of breastfeeding. The slight positive association with greater integration with mental health providers was sustained for continued breastfeeding at 6 months postpartum (RR = 1.004; 95% CI = 1.00, 1.01). System alignment was not related to prenatal smoking cessation, low birth weight, or preterm birth. Conclusions. Future implementation studies should explore whether strategies to increase system alignment result in changes in quantitative measures of cross-sector collaboration and meaningful improvement in maternal and child outcomes at a population level. (Am J Public Health. 2026;116(S3): S181–S191. https://doi.org/10.2105/AJPH.2026.308457) [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.2105/AJPH.2026.308457
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 11
        StartPage: S181
    Subjects:
      – SubjectFull: Home care services
        Type: general
      – SubjectFull: Community health services
        Type: general
      – SubjectFull: Patients' families
        Type: general
      – SubjectFull: Poisson distribution
        Type: general
      – SubjectFull: Professional practice
        Type: general
      – SubjectFull: Maternal health services
        Type: general
      – SubjectFull: Medical personnel
        Type: general
      – SubjectFull: Mental health
        Type: general
      – SubjectFull: Mental health services
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      – SubjectFull: Scientific observation
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      – SubjectFull: Parenting
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      – SubjectFull: Pregnancy outcomes
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Continuum of care
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      – SubjectFull: Pediatrics
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      – SubjectFull: Motherhood
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      – SubjectFull: Evidence-based medicine
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      – SubjectFull: Data analysis software
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      – SubjectFull: Integrated health care delivery
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      – SubjectFull: Nutrition
        Type: general
      – SubjectFull: Sensitivity & specificity (Statistics)
        Type: general
    Titles:
      – TitleFull: Aligning Health and Social Systems to Improve Maternal Behaviors and Birth Outcomes Among Clients Engaged in Evidence-Based Home Visiting.
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            NameFull: Williams, Venice Ng
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              Text: 2026 Suppl 3
              Type: published
              Y: 2026
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