October 3, 2019

Findings of Applied Research Fellows to help inform King County program changes

The Population Health Initiative’s 2019 Applied Research Fellows spent 10 weeks this summer analyzing the impact of a program called First Steps, which provides wraparound maternity and infant services for low-income pregnant women in King County. Their findings, which were presented to staff and leadership of the Community Health Services Division (CHSD) of Public Health – Seattle & King County, will help inform CHSD’s plans for redesigning and refining its delivery of prevention-based services.

CHSD is the largest provider of these services for low-income pregnant women in King County. Despite successes in improving care for this population, the County has not been able to comprehensively achieve race equitable birth outcomes. The team assessed the impact of CHSD’s current services on important birth outcomes, including low gestational age, low birthweight, gestational hypertension and infant mortality. The fellows also parsed the impact of CHSD services by race and ethnicity, and compared the demographic characteristics of women enrolled in CHSD programs with those who were eligible to enroll but did not do so.

The research shows that women who did enroll in maternity service programs during pregnancy have a different demographic profile to women who have never enrolled in these programs. Differences were identified in race, education, marital status and country of birth. This finding could help CHSD to refine their outreach approach to underrepresented women.

Analysis of birth outcomes shows that CHSD services are particularly impactful in reducing the risk of low gestational age and gestational hypertension for all clients. The benefits are found for all races/ethnicities, with some variation in the magnitude of impact across groups. The analysis also implies that the biggest benefits arise when women are provided with services early in their pregnancy.

“As the Community Health Services division embarks on a redesign of how we provide First Steps services to best meet client need, evaluation is key,” shared Sheryl Davis, Parent Child Health Programs manager at CHSD. “Our partnership with UW’s Applied Research Fellows this summer laid the groundwork for understanding current client outcomes, which will be an important component of our ongoing evaluation.”

The Applied Research Fellowship program was launched this year to equip students with data analysis, critical thinking and team science skills to enable them to effectively tackle complex population health challenges and become future leaders in the field. The inaugural program, which was run in partnership with the University of Washington’s Center for Studies in Demography & Ecology, as well as faculty from the Departments of Epidemiology and Global Health, consisted of the following students:

Name	Degree Program	School
Matt Driver	Master of Public Health	School of Public Health
Jane Kim	Doctorate of Nursing Practice	School of Nursing
Michelle Shin	PhD	School of Nursing
Hilary Wething	PhD in Public Policy and Management	Evans School of Public Policy & Governance
Claire Branley	Undergraduate Public Health Major	School of Public Health
Kiana Rahni	Undergraduate Economics and Political Science Major	College of Arts & Sciences

By working on a real-world, client-driven project as part of a multidisciplinary team, the fellows learned how to integrate their disciplinary expertise into a team-oriented, problem-solving approach that developed multi-pronged solutions to a pressing population health challenge.

The application period for the summer 2020 Applied Research Fellowship program will open in winter 2020.