Evidence Tools
MCHbest. Early Prenatal Care.

Overview. Black, Hispanic, American Indian/Alaska Native, low SES, persons who are under-or uninsured. (including Medicaid), and those living in rural, frontier, or geographically isolated areas face tremendous barriers in accessing early prenatal care and maintaining access throughout pregnancy, thus increasing their risk of poor maternal and infant outcomes.[1-4] Researchers found that the longer the travel time to prenatal care appointments the more likely birthing persons are to be late or miss their appointments.[4] Community Health Workers, drop-in care pregnancy support centers, staffed with OB care teams, same-day appointments, and improved continuity and visibility of care teams can improve the utilization of PNC throughout pregnancy.[2,3] The incorporation of community health centers and trained family physicians has been found to improve maternal and infant outcomes in rural and geographically isolated areas.[3]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

• Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
• Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.
• Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).