Table 1 Definition of Risk factor identification, interventions, and participation

Infection

Identification: Positive, based on standard medical diagnostics for STD’s and urogenital tract infections, including Bacterial Vaginosis (BV), Chlamydia, Trichomoniasis, Gonorrhea, yeast infection, excessive bacteruria, and Syphilis. Tests were conducted at the centralized clinical setting; all lab results were reviewed by the study-trained laboratory coordinator.

Participation: Prescribed and provided (on site) standard medical treatment for all infections. with confirmation by direct observation that medication was taken

Treatment: Follow-up and standard medical treatment for all conditions identified; supervised by the study medical team and free of charge.

Strategies. No cost treatment, flexible clinical hours, transportation to and from appointments, free childcare, follow up by social workers

Periodontal disease

Identification. Screened positive for clinical periodontal disease. Assessment, including soft tissue exam for oral cancer, Plaque Scores, Gingivitis Index Scores, Probing Pocket Depth, Bleeding Upon Probing, Clinical Attachment Level, and cementoenamel junction. Initial screening, was completed by the study registered dental hygienist and the presence of periodontal diseases was confirmed by a licensed periodontist.

Participation Attended at least one dental clinic appointment for scaling, root planning or surgery

Treatment: Individually-tailored intervention including oral hygiene education and comprehensive clinical treatment for all conditions identified. Presence of periodontal disease was confirmed through x-ray and clinical exam by a DDM. Treatment for periodontal disease was provided by or under direct supervision of a periodontist/DDM, free of charge

Strategies: No cost treatment, flexible clinical hours, transportation to and from appointments, free childcare. appointment reminders. PCPPP staff was also available to accompany women to dental visits when requested.

Smoking

Identification. Reported smoking during pregnancy or postpartum period based on standardized questionnaire administered by study staff.

Participation: Attended at least one individualized or group counseling session, and/or received nicotine replacement therapy

Treatment: Referral and follow-up for smokers, who were offered individually-tailored one-on-one cessation counseling and pharmacotherapy, including standard nicotine replacement therapy, and bupropion. One-on-one counseling was provided by certified smoking cessation counselor; pharmacotherapy was provided and prescribed by physician

Strategies: Free treatment, flexible hours, in home visits, free transportation to and from any scheduled appointment, free childcare., appointment reminders

Major depressive disorder

Identification. Screening with Center for Epidemiological Studies of Depression Scale (CES-D ≥16) followed by a diagnostic interview with the Structured Clinical Interview for DSM Disorders (SCID) for those with a positive screen. The SCID was administered by appropriately trained study physician or social worker.

Participation: Attended at least one therapy session and/or received medication for depression

Treatment: Participants who were diagnosed with current major depressive disorder were offered medical treatments comprised of cognitive behavioral therapy, antidepressant psychopharmacology, following standardized protocols, or the combination of the two treatments. Women who declined these therapies were offered supportive counseling and problem solving training delivered by clinical social workers in home visits.

Strategies: Free treatment, flexible hours, free transportation to and from any scheduled appointment, free childcare, appointment reminders, in home visits.

Low literacy

Identification. Based on Short Test of Functional Health Literacy in Adults (inadequate and marginal: English and Spanish), Test of Adult Basic Education - Reading Locator (levels E&M; TABE) administered by study staff.

Participation: Attended at least one, one-on-one or classroom session to improve literacy

Treatment: An individually tailored learner-driven intervention model was utilized using a contextual adult educational curriculum focused on building skills for navigating hurdles to maternal-infant care and family management/economics. Adult literacy skills were developed through working individually with professional adult educators on specific challenges faced by the participants and selected by them.

Strategies Free treatment, flexible hours, free transportation to and from any scheduled appointment, free childcare, appointment reminders

Housing

Identification. Based on comprehensive assessment of housing status and stability conducted by study staff. Those with problems indicating imminent eviction, in unsafe or unhealthy living environments were considered as

Participation: Received any form of financial, or relocation assistance in order to improve/stabilize housing situation, or mediation services to resolve landlord/tenant dispute

Instability

Treatment: Housing assistance, when appropriate, was provided in the form of cash grants for down payments or back rent, relocation services, or resolution of landlord/renter disputes, provided under the direction of a MSW, with experience in resolving housing-related issues

Strategies. Flexible hours, free transportation to and from any scheduled appointment, free childcare, appointment reminders