Alleviating perinatal depressive symptoms and stress: a nurse-community health worker randomized trial.

To determine whether a Nurse-Community Health Worker (CHW) home visiting team, in the context of a Medicaid enhanced prenatal/postnatal services (EPS), would demonstrate greater reduction of depressive symptoms and stress and improvement of psychosocial resources (mastery, self-esteem, social support) when compared with usual Community Care (CC) that includes Medicaid EPS delivered by professionals. Greatest program benefits were expected for women who reported low psychosocial resources, high stress, or both at the time of enrollment. Medicaid eligible pregnant women (N = 613) were randomly assigned to either usual CC or the Nurse-CHW team.

Addressing mental health and stress in Medicaid-insured pregnant women using a nurse-community health worker home visiting team.

Objective: To describe the conceptual framework and program features of a nurse-community health worker (CHW) team home visiting intervention, the trial design to test the program, and the results of a comparative evaluation of prenatal program participation.

Design: In the context of a community-based, randomized trial, we compared participation in a nurse-CHW team intervention with the standard community care that included a state Medicaid program (enhanced prenatal services) with nurse home visiting.

Sample: Medicaid-eligible pregnant women (n=530), who maintained their pregnancies, had a live birth, retained custody of the child, completed more than an enrollment assessment, did not move out of the county, and were not lost to follow-up.