Abstract
Objectives Group prenatal care results in improved birth outcomes in randomized controlled trials, and better attendance at group prenatal care visits is associated with stronger clinical effects. This paper’s objectives are to identify determinants of group prenatal care attendance, and to examine the association between proportion of prenatal care received in a group context and satisfaction with care. Methods We conducted a secondary data analysis of pregnant adolescents (n = 547) receiving group prenatal care in New York City (2008–2012). Multivariable linear regression models were used to test associations between patient characteristics and percent of group care sessions attended, and between the proportion of prenatal care visits that occurred in a group context and care satisfaction. Results Sixty-seven groups were established. Group sizes ranged from 3 to 15 women (mean = 8.16, SD = 3.08); 87 % of groups enrolled at least five women. Women enrolled in group prenatal care supplemented group sessions with individual care visits. However, the percent of women who attended each group session was relatively consistent, ranging from 56 to 63 %. Being born outside of the United States was significantly associated with higher group session attendance rates [B(SE) = 11.46 (3.46), p = 0.001], and women who received a higher proportion of care in groups reported higher levels of care satisfaction [B(SE) = 0.11 (0.02), p < 0.001]. Conclusions Future research should explore alternative implementation structures to improve pregnant women’s ability to receive as much prenatal care as possible in a group setting, as well as value-based reimbursement models and other incentives to encourage more widespread adoption of group prenatal care.
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Barakat, S., Martinez, D., Thomas, M., & Handley, M. (2014). What do we know about gestational diabetes mellitus and risk for postpartum depression among ethnically diverse low-income women in the USA? Archives of Women's Mental Health, 17(6), 587–592.
Catling, C. J., Medley, N., Foureur, M., Ryan, C., Leap, N., Teate, A., & Homer, C. S. (2015). Group versus conventional antenatal care for women. Cochrane Database of Systematic Reviews, 4(2), CD007622. doi:10.1002/14651858.CD007622.pub3.
Doyle, C., Lennox, L., & Bell, D. (2013). A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open, 3(1), e001570.
Earnshaw, V. A., Rosenthal, L., Cunningham, S., Kershaw, T., Lewis, J., Rising, S., et al. (2015). Exploring group composition among young, urban women of color in prenatal care: Implications for satisfaction, engagement, and group attendance. Women’s Health Issues, 26(1), 110–115.
Edmonds, B. T., Mogul, M., & Shea, J. A. (2015). Understanding low-income African American women’s expectations, preferences, and priorities in prenatal care. Family & Community Health, 38(2), 149–157.
Eldridge, S., & Kerry, S. (2012). A practical guide to cluster randomised trials in health services research. Hoboken: Wiley Press.
Healthy People 2020 [Internet]. Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health Promotion cited 12/2/15. Available from: http://www.healthypeople.gov/.
Ickovics, J. R., Earnshaw, V. A., Lewis, J. B., Kershaw, T., Magriples, U., Stasko, E., et al. (2016). Group prenatal care: Cluster RCT of perinatal outcomes among young women in urban health centers. American Journal of Public Health, 106(2), 359–365.
Ickovics, J. R., Kershaw, T. S., Westdahl, C., Magriples, U., Massey, Z., Reynolds, H., et al. (2007). Group prenatal care and perinatal outcomes: A randomized controlled trial. Obstetrics and Gynecology, 110(2 Pt 1), 330.
Kershaw, T. S., Magriples, U., Westdahl, C., Rising, S. S., & Ickovics, J. (2009). Pregnancy as a window of opportunity for HIV prevention: effects of an HIV intervention delivered within prenatal care. American Journal of Public Health, 99(11), 2079.
Littlefield, V. M., & Adams, B. N. (1987). Patient participation in alternative perinatal care: Impact on satisfaction and health locus of control. Research in Nursing & Health, 10(3), 139–148.
Littlefield, V. M., Change, A., & Adams, B. N. (1990). Participation in alternative care: Relationship to anxiety, depression, and hostility. Research in Nursing & Health, 13, 17–25.
Magriples, U., Boynton, M. H., Kershaw, T. S., Lewis, J., Rising, S. S., Tobin, J. N., et al. (2015). The impact of group prenatal care on pregnancy and postpartum weight trajectories. American Journal of Obstetrics and Gynecology, 213(5), 688-e1.
March of Dimes. Final Natality Data. National Center for Health Statistics. Accessed March 5, 2015.
McDonald, S. D., Sword, W., Eryuzlu, L. N., Neupane, B., Beyene, J., & Biringer, A. B. (2016). Why are half of women interested in participating in group prenatal care? Maternal and Child Health Journal, 20(1), 97–105. doi:10.1007/s10995-015-1807-x.
Novick, G. (2009). Women’s experience of prenatal care: an integrative review. Journal of Midwifery & Women’s Health, 54(3), 226–237.
Novick, G., Reid, A. E., Lewis, J., Kershaw, T. S., Rising, S. S., & Ickovics, J. R. (2013). Group prenatal care: Model fidelity and outcomes. American Journal of Obstetrics and Gynecology, 209(2), 112-e1.
Novick, G., Sadler, L. S., Kennedy, H. P., Cohen, S. S., Groce, N. E., & Knafl, K. A. (2011). Women’s experience of group prenatal care. Qualitative Health Research, 21(1), 97–116.
Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 (2010).
Paul, K. H., Graham, M. L., & Olson, C. M. (2013). The web of risk factors for excessive gestational weight gain in low income women. Maternal and Child Health Journal, 17(2), 344–351.
Picklesimer, A. H., Billings, D., Hale, N., Blackhurst, D., & Covington-Kolb, S. (2012). The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population. American Journal of Obstetrics and Gynecology, 206(5), 415-e1.
Rowley, R. A., Phillips, L. E., O’Dell, L., El Husseini, R., Carpino, S., & Hartman, S. (2016). Group prenatal care: A financial perspective. Maternal and Child Health Journal, 20(1), 1–10.
Society for Maternal-Fetal Medicine (SMFM), Sciscione, A., Berghella, V., Blackwell, S., Boggess, K., Helfgott, A., et al. (2014). Society for Maternal-Fetal Medicine (SMFM) special report: The maternal-fetal medicine subspecialists’ role within a health care system. American Journal of Obstetrics and Gynecology, 211, 607–616.
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Cunningham, S.D., Grilo, S., Lewis, J.B. et al. Group Prenatal Care Attendance: Determinants and Relationship with Care Satisfaction. Matern Child Health J 21, 770–776 (2017). https://doi.org/10.1007/s10995-016-2161-3
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DOI: https://doi.org/10.1007/s10995-016-2161-3