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Liaisons Perform at Acceptable Levels

• Liaisons provide similar risk scores to one another (interrater reliability) and that their assessments were similar over time (test–retest reliability). Liaison interrater reliabilities are highest for the Demographics/Basic Needs subscale and somewhat lower for the Medical subscale.
• Experience as a liaison and use of liaison training materials improved performance.

The Modified Bridges Might Overidentify Mothers as Being High Risk

• The Modified Bridges' ability to distinguish similar levels of risk compared with that ability in other widely used tools would improve if a higher risk threshold were implemented.

The Current Risk Threshold of 50 May Not Be Able to Distinguish Between the Highest Levels of Risk

• The current reliability of the Modified Bridges indicates, in practical terms, that First 5 LA can have only limited confidence that the given risk score for a mother reflects that mother's true level of risk. The current scoring protocol and item weights used for the Modified Bridges have a moderate level of reliability (0.65), below the widely used reliability threshold of 0.70, while scoring the tool without the current item weights would improve its reliability to a more acceptable level (0.74).

Welcome Baby, a program that First 5 Los Angeles (First 5 LA) sponsors, provides new mothers with supportive services intended to create enriching environments for their children. To identify mothers in need of these services, First 5 LA employs hospital liaisons who administer a maternal risk assessment tool, the Modified Bridges for Newborns screening tool, during postpartum interviews of mothers. First 5 LA uses risk assessment scores from the Modified Bridges to classify mothers as low, moderate, or high risk; high-risk mothers are eligible for additional supportive services that are not available to low- and moderate-risk mothers. This report describes RAND Corporation work evaluating the psychometric characteristics of the Modified Bridges.

• Chapter One

  Introduction

• Chapter Two

  Do Hospital Liaisons Assign Similar Scores When Using the Modified Bridges for Newborns Screening Tool?

• Chapter Three

  Does the Modified Bridges for Newborns Screening Tool Identify a Similar Level of Risk Among the Same Women as Other Measures of Psychosocial and/or Medical Risk?

• Chapter Four

  Does the Modified Bridges for Newborns Screening Tool Accurately Distinguish Between Low-/Moderate-Risk Mothers and High-Risk Mothers?

• Chapter Five

  Conclusion

• Appendix A

  Legacy Instrument Protocol

• Appendix B

  Modified Bridges Frequencies and Descriptive Statistics from the Validity Study