Effect of Partners in Health Program on health promotion in rural Midwest infants

The purpose of this unmatched case-control study was to examine the effects of a partnership program on the age-appropriate health promotion in rural Midwest infants and to test the researcher developed Age-Appropriate Health Promotion Model. The study sample included 35 children enrolled in the Partners in Health Program (Partners) and 105 children not enrolled in Partners (Controls). The Partners program uses a parent-held checklist of age-appropriate health promotion activities needed for children and a reminder system for parents and health care providers. The instrument used for data collection was the Denver Child Health Passport visit sheet. The study and control groups were compared on age-appropriate health care rates during the first twelve months of their life. Hypotheses regarding age-appropriate health promotion, immunizations, history taking, physical measurements, screening, education were tested with contingency tables and Chi-square. If Chi-square was significant the associated strength was computed. The relative risk was calculated using an odds ratio if appropriate.

The Age-Appropriate Health Promotion Model was supported by significantly higher rates for the history taking, physical measurements, and education at the six-month visit ($\chi \backslash sp2=4.98, p=.03, \varphi =.19, RR=1.2)$, and tuberculosis screening ($\chi \backslash sp2=4.23, p=.04, \varphi =.17, RR=1.3).$ Results at the four, nine, and twelve-month visits were also in the direction predicted by the hypotheses.

Partners accounted for significant differences between the study and control groups. The following variables were significant: moved since last visit ($\chi \backslash sp2=129.55, p=.000, \varphi =.96,RR=102),$ changed payment since last visit ($\chi \backslash sp2=129.55, p=.000, \varphi =.96, RR=102),$ documented parental worries and questions ($\chi \backslash sp2=21.65, p$ =.000, Cramer's V =.40), and written recommendations of the health care provider to parents ($\chi \backslash sp2$ = 37.51, p =.000, Cramer's V =.52).

Nurses, as health care providers, must partner with parents, other health care providers, and community groups in order to secure age-appropriate health promotion for infants. Research and study using the researcher developed Age-Appropriate Health Promotion Model could guide local, state, and national policy decisions regarding age-appropriate health promotion in infants.