Evidence Tools
MCHbest. Early Prenatal Care.

Overview. Novel models of care can increase early access to prenatal care. Examples include the Early Care Model [1], a Telephonic Case Management System [2], and PodCare [3] have promising results.[1, 2, 3] The Early Care Model for initiation of perinatal care aims to increase access to early prenatal care by providing access as soon as the pregnancy is confirmed, offering relevant services, including virtual and in-person prenatal care, and addressing the social needs of patients. Using a collaborative care model that incorporates licensed midwives and certified nurse midwives, a referral and education system can address the comprehensive needs of birthing persons using virtual care. The Telephonic Case Management System for perinatal care coordination enrolls patients as soon as pregnancy is confirmed and supports them with a risk assessment, patient education, coordination of care for home services and clinic appointments, coordination of interventions requested by care providers, and patient support. Based on best practices and methods of patient care delivery developed by the Case Management Society of America. (CMSA), the program was designed to improve both clinical and financial outcomes for low-income, high-risk pregnant women.[2] PodCare is an interdisciplinary model of care that seeks to reduce the number of prenatal care visits by increasing care coordination and streamlining care.[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):

• 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.
• Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
• 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. Case Management (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).