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Marie C. McCormick, MD, ScD, Lisa W. Deal, ScD, MS, MN, MPH, Barbara L. Devaney, PhD, Dexter Chu, MS, Lorenzo Moreno, PhD and Karen T. Raykovich, PhD

Marie C. McCormick and Lisa W. Deal are with the Department of Maternal and Child Health, Harvard School of Public Health, Boston, Mass. Lisa W. Deal is also with the David and Lucile Packard Foundation, Los Altos, Calif. Barbara L. Devaney, Dexter Chu, and Lorenzo Moreno are with Mathematica Policy Research Inc, Princeton, NJ, and Washington, DC. Karen T. Raykovich is with the Office of Program Evaluation and Legislation, Health Resources and Services Administration, Rockville, Md.

Correspondence: Requests for reprints should be sent to Marie C. McCormick, MD, ScD, Department of Maternal and Child Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115-6096 (e-mail: mmccormi{at}hsph.harvard.edu).

Objectives. This study assessed the effect of the national Healthy Start Program on its clients.

Methods. We used a cross-sectional survey of a sample from Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) rosters of women less than 6 months postpartum who were residents of Healthy Start Program areas.

Results. Healthy Start clients revealed higher sociodemographic risk, but not behavioral risk, for adverse pregnancy outcome than other area residents. They did not differ from other residents in receipt of services except for a greater likelihood of receiving case management, using birth control at the time of the interview, and rating their prenatal care more highly.

Conclusions. The Healthy Start Program succeeded in enrolling women at high risk. It had little effect on the immediately concluded pregnancy, but it might influence future outcomes.

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