Introduction <p>: Low birth weight (LBW) is one of the most important factors affecting neonatal mortality and is a determinant of post-neonatal mortality. This study aimed to assess the effectiveness of the Pathways Community HUB Institute^® Model (PCHI^® Model) in improving birth outcomes among high-risk pregnant women.</p> Methods <p>In this retrospective study, data were drawn from the Pathways Community HUB Program (Community Health Access Project – CHAP) in Richland, Ohio, and the Ohio Department of Health from 2014 to 2017. We employed a 1:1 nearest neighbor propensity score matching for 315 participating and 315 non-participating women and used conditional logistic regression to analyze our data. The pregnancy outcomes we assessed included preterm birth and birth weight.</p> Results <p>The incidence of LBW in the Community Health Access Program (CHAP) group was 8.6% compared to 12.4% in the non-CHAP group. CHAP participants had a 43% lower chance of low birth weight births (OR = 0.572, 95% CI = 0.335–0.979), while the program’s effect on preterm delivery approached but did not achieve statistical significance (OR = 0.640, 95% CI = 0.407–1.007). We also found that those who entered the CHAP program and those who had their first prenatal care appointment in the first trimester of their pregnancies were less likely to deliver a LBW infant than those who entered the program and had their first prenatal care appointment later in their pregnancies.</p> Conclusions <p>Among high-risk pregnant women, the PCHI^® Model can significantly improve prenatal care utilization and reduce the incidence of LBW infants. In addition, pregnant women participating in the Pathways Community HUB program appeared to benefit more if they entered the program in their first trimester rather than later in their pregnancy, suggesting that longer durations of program participation are associated with better birth outcomes.</p>