Structural inequities and higher burden of social determinants of health are more than home-based care nurses can mitigate, researchers said.

Even with home-based care interventions, social determinants of health and structural barriers get in the way of good maternal health outcomes, a new Health Affairs study has found.  [Patient Engagement HIT]

The report, received under embargo, showed that a home-based nursing care program had a negligible impact on the health outcomes of pregnant, Medicaid-eligible people. That’s likely because structural barriers and other social determinants of health are likely more than nurses can mitigate.

These findings call into question the efficacy of home-based nursing care among pregnant populations and how such programs can be reshaped in the future.

The researchers zeroed in on the Nurse-Family Partnership (NFP) program, which offers home visits from a registered nurse to Medicaid-eligible pregnant people throughout their pregnancy and up to 24 months after delivery. NFP operates in 40 states and, as of 2020, has served more than 50,000 families. It also received additional funding as part of the American Rescue Plan Act of 2021.

As part of their home visits, NFP nurses use different patient-provider communication strategies to uncover targeted needs and to tailor healthcare and social services solutions. In addition, NFP nurses conduct mental health screenings, monitor pregnancy, and provide guidance on healthy behaviors related to exercise and nutrition.

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