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Anumba D, Soma-Pillay P, Bianchi A, Valencia González CM, Jacobbson B. FIGO good practice recommendations on optimizing models of care for the prevention and mitigation of preterm birth. Int J Gynaecol Obstet 2024. [PMID: 39045669 DOI: 10.1002/ijgo.15833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 07/25/2024]
Abstract
The global challenge of preterm birth persists with little or no progress being made to reduce its prevalence or mitigate its consequences, especially in low-resource settings where health systems are less well developed. Improved delivery of respectful person-centered care employing effective care models delivered by skilled healthcare professionals is essential for addressing these needs. These FIGO good practice recommendations provide an overview of the evidence regarding the effectiveness of the various care models for preventing and managing preterm birth across global contexts. We also highlight that continuity of care within existing, context-appropriate care models (such as midwifery-led care and group care), in primary as well as secondary care, is pivotal to delivering high quality care across the pregnancy continuum-prior to conception, through pregnancy and birth, and preparation for a subsequent pregnancy-to improve care to prevent and manage preterm birth.
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Affiliation(s)
- Dilly Anumba
- Division of Clinical Medicine, School of Medicine and Population Health, Faculty of Health, University of Sheffield, Sheffield, UK
| | - Priya Soma-Pillay
- Department of Obstetrics and Gynecology, University of Pretoria, Pretoria, South Africa
- Steve Biko Academic Hospital, Pretoria, South Africa
| | - Ana Bianchi
- Perinatal Department, Pereira Rossell Hospital Public Health, Montevideo, Uruguay
| | | | - Bo Jacobbson
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
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Riggs E, Yelland J, Mensah FK, Gold L, Szwarc J, Kaplan I, Small R, Middleton P, Krastev A, McDonald E, East C, Homer C, Nesvadba N, Biggs L, Braithwaite J, Brown SJ. Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design. BMJ Open 2021; 11:e048271. [PMID: 34281928 PMCID: PMC8291298 DOI: 10.1136/bmjopen-2020-048271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Pregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework. METHODS AND ANALYSIS The evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation. ETHICS AND DISSEMINATION Ethics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.
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Affiliation(s)
- Elisha Riggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Yelland
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Josef Szwarc
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Ida Kaplan
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Rhonda Small
- Judith Lumely Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Philippa Middleton
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ann Krastev
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ellie McDonald
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Christine East
- School of Nursing and Midwifery/Mercy Hospital for Women, La Trobe University, Melbourne, Victoria, Australia
| | - Caroline Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Natalija Nesvadba
- Multicultural Services, Mercy Hospitals Victoria Ltd, Melbourne, Victoria, Australia
| | - Laura Biggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Abstract
The millennial pregnant patient expects an innovative approach to prenatal care. Patients are reaching to peer support online communities or engaging in direct-to-consumer mobile applications during their pregnancy. Currently developed solutions show promise, however, the clinical impact and generalizability of these solutions remains unclear. Technology has the potential to decrease health care disparities, improve patient and provider satisfaction as well as clinical outcomes. In this article we discuss traditional models of prenatal education as well and suggest how obstetricians should consider utilizing technology as an approach to provide prenatal education to their patients.
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Affiliation(s)
- Anna Graseck
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Van De Griend KM, Billings DL, Frongillo EA, Hilfinger Messias DK, Crockett AH, Covington-Kolb S. Core strategies, social processes, and contextual influences of early phases of implementation and statewide scale-up of group prenatal care in South Carolina. EVALUATION AND PROGRAM PLANNING 2020; 79:101760. [PMID: 31835150 DOI: 10.1016/j.evalprogplan.2019.101760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/23/2019] [Accepted: 11/20/2019] [Indexed: 06/10/2023]
Abstract
This mixed-methods process evaluation examined a state-wide, interagency collaborative in South Carolina that expanded CenteringPregnancy group prenatal care from two to five additional healthcare practices from 2012 to 2015. The evaluation focused on delineating core processes, strategies, and external contextual elements of group prenatal care implementation and scale-up. Success of this scale-up was enhanced by the effective use and creation of windows of opportunity, which allowed stakeholders to pursue actions consistent with their own values, at both state and organizational levels. Most importantly, strong political advocacy and state-level financial commitment for group prenatal care made it possible for clinics throughout South Carolina to begin providing CenteringPregnancy to their patients. Improved understanding of the processes involved in scaling-up pilot interventions may enhance the effectiveness and efficiency of future expansion efforts.
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Affiliation(s)
- Kristin M Van De Griend
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States.
| | - Deborah L Billings
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States
| | | | - Amy H Crockett
- University of South Carolina School of Medicine Greenville, Prisma Health-Upstate, United States
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Effects of customer self-audit on the quality of maternity care in Tabriz: A cluster-randomized controlled trial. PLoS One 2018; 13:e0203255. [PMID: 30307957 PMCID: PMC6181295 DOI: 10.1371/journal.pone.0203255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 08/16/2018] [Indexed: 11/19/2022] Open
Abstract
Objective To study the effects of customer self-audit on the service quality (SQ) and customer quality (CQ) of maternity care. Design A community-based cluster-randomized controlled trial. Setting Twenty-one health centres and health posts in Tabriz, Iran. Participants Of 21 health centres/health posts, 10 were randomly assigned to the intervention group and 11 randomly assigned to the control group. Participants were 185 pregnant women selected from health centre/post registration lists (intervention group: n = 92; control group: n = 93). Interventions The intervention was a customer self-audit based on the CenteringPregnancy® model of prenatal group care. The intervention group attended group support sessions focused on participants’ opinions, questions, and self-management concerns. They also received sessions on experiential learning, coping, problem-solving, and goal-setting by a family health expert, a midwife, and a doctor. Control group participants continued to receive individual care. Primary outcome measures SQ and CQ were assessed using questionnaires. Patients rated the importance and performance of non-health quality dimensions. SQ was calculated as: SQ = 10 − (Importance × Performance). Results Total mean SQ scores were 7.63 (0.91) and 8.91 (0.76) for the control and intervention groups, respectively, a statistically significant difference (p<0.001). Compared with the control group, the intervention group scored higher on the SQ aspects confidentiality, communication, autonomy, availability of support group, dignity, safety, prevention, and accessibility. Total mean CQ scores for the control and intervention groups were 82.63(7.21) and 87.47 (6.75), respectively, a statistically significant difference (p<0.001). After intervention, 82.6% of intervention group participants and 50.5% of control group participants reached the highest stage of self-management, showing an ability to take care of themselves under stress and financial constraints. Conclusions The group prenatal care customer self-audit improved the SQ and CQ of maternity care by increased involvement of participants and giving them active roles in the care process.
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Riggs E, Muyeen S, Brown S, Dawson W, Petschel P, Tardiff W, Norman F, Vanpraag D, Szwarc J, Yelland J. Cultural safety and belonging for refugee background women attending group pregnancy care: An Australian qualitative study. Birth 2017; 44:145-152. [PMID: 28110517 DOI: 10.1111/birt.12272] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Refugee women experience higher incidence of childbirth complications and poor pregnancy outcomes. Resettled refugee women often face multiple barriers accessing pregnancy care and navigating health systems in high income countries. METHODS A community-based model of group pregnancy care for Karen women from Burma was co-designed by health services in consultation with Karen families in Melbourne, Australia. Focus groups were conducted with women who had participated to explore their experiences of using the program, and whether it had helped them feel prepared for childbirth and going home with a new baby. RESULTS Nineteen women (average time in Australia 4.3 years) participated in two focus groups. Women reported feeling empowered and confident through learning about pregnancy and childbirth in the group setting. The collective sharing of stories in the facilitated environment allowed women to feel prepared, confident and reassured, with the greatest benefits coming from storytelling with peers, and developing trusting relationships with a team of professionals, with whom women were able to communicate in their own language. Women also discussed the pivotal role of the bicultural worker in the multidisciplinary care team. Challenges in the hospital during labor and birth were reported and included lack of professional interpreters and a lack of privacy. CONCLUSION Group pregnancy care has the potential to increase refugee background women's access to pregnancy care and information, sense of belonging, cultural safety using services, preparation for labor and birth, and care of a newborn.
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Affiliation(s)
- Elisha Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Vic., Australia
| | - Sumaiya Muyeen
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - Stephanie Brown
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Vic., Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
| | - Wendy Dawson
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - Pauline Petschel
- Maternal and Child Health, Wyndham City Council, Werribee, Vic., Australia
| | - Waan Tardiff
- Maternal and Child Health, Wyndham City Council, Werribee, Vic., Australia.,VICSEG New Futures, Coburg, Vic., Australia
| | - Fiona Norman
- Department of Education and Training, State Government of Victoria, East Melbourne, Vic., Australia
| | - Dannielle Vanpraag
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - Jo Szwarc
- Victorian Foundation for Survivors of Torture, Brunswick, Vic., Australia
| | - Jane Yelland
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Vic., Australia
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Investing in CenteringPregnancy™ Group Prenatal Care Reduces Newborn Hospitalization Costs. Womens Health Issues 2017; 27:60-66. [DOI: 10.1016/j.whi.2016.09.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 07/19/2016] [Accepted: 09/19/2016] [Indexed: 11/19/2022]
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Heberlein EC, Picklesimer AH, Billings DL, Covington-Kolb S, Farber N, Frongillo EA. Qualitative Comparison of Women's Perspectives on the Functions and Benefits of Group and Individual Prenatal Care. J Midwifery Womens Health 2016; 61:224-34. [DOI: 10.1111/jmwh.12379] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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