Statement of Problem. Program evaluation is vital to examining the effectiveness of existing public health programs in the area of infant mortality. Despite considerable progress in reducing infant mortality in the United States, African Americans experience nearly twice the rate of infant mortality than their Caucasian counterparts for the past decade. Low birth weight (LBW) and preterm delivery are the two leading causes of infant mortality and this disparity. Methods. Participants were 384

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... rican American/Black women with singleton pregnancies enrolled in the Start More Infants Living Equally Healthy (SMILE) program, a program targeting high-risk African American/Black women in Montgomery County, MD. Health outcomes at birth (i.e., LBW, prematurity, and birth anomalies) were examined in relation to the week of entry, trimester of enrollment, and frequency of nurse home visits. Results. Infants within the program experienced few adverse birth outcomes: 76% had no birth anomaly, while only 3.4% were born at a LBW and 8.3% were born prematurely. Women received an average of 2.08 (SD=1.66) home visits. No statistically significant association between the enrollment trimester or in the frequency of their home visits and the outcome variables were observed. However, analyses by week of program entry found earlier enrollment, up to 21 gestational weeks, offered a protective influence against preterm delivery (p=.006). Conclusions. Women enrolled in this NHV program were at-risk for adverse birth outcomes and yet experienced fewer adverse outcomes than would be anticipated despite receiving fewer than expected visits. Earlier enrollment increased the protective influence of NHV against premature birth. Results of this program evaluation suggest antepartum NHV program may be protective against infant mortality in this population.