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Ayers BL, Short E, Cline C, Ammerman AS, Council SK, Kabua PM. Assessing the acceptability of a culturally adapted group-based pediatric intervention, Kokajjiriri, for Marshallese mothers and infants to improve nutrition and prevent childhood obesity. Child Care Health Dev 2024; 50:e13311. [PMID: 39056267 DOI: 10.1111/cch.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/25/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Marshallese Pacific Islanders experience higher rates of obesity than other racial and/or ethnic communities. Despite the obesity rates experienced in this community, there are currently no childhood obesity prevention interventions designed for Marshallese Pacific Islanders in the United States. The purpose of this study is to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. METHODS A multi-methods design was used to culturally adapt the Kokajjiriri intervention for Marshallese mothers in Arkansas (n = 17). In phase one, we conducted 24-h dietary recalls with 20 Marshallese mothers to inform the cultural adaptation of the group-based pediatric intervention, and then in phase two, we culturally adapted and piloted three sessions of the intervention to determine the acceptability and feasibility of the intervention. RESULTS Participants found the adapted intervention to be acceptable and feasible, found the location to be convenient and found the facilitator to be knowledgeable. Four themes emerged from the qualitative data: (1) Lactation Support; (2) Introducing Healthy Solids; (3) Rice Portion Control; and (4) Finding Resources. CONCLUSIONS This is the first study to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. The results from this culturally adapted group-based pediatric intervention, Kokajjiriri, will be used to inform future adaptations and implementation of the full intervention for Marshallese women and children.
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Affiliation(s)
- Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Eliza Short
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
| | - Chloe Cline
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah K Council
- Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Philmar Mendoza Kabua
- Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
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Lin H, Guo S, Zheng Q, Liu X, Hu A, Zeng J, Liu G. Couples' perceptions and experience of smartphone-assisted CenteringPregnancy model in southeast of China: a dyadic analysis of qualitative study. BMJ Open 2024; 14:e079121. [PMID: 39107027 PMCID: PMC11308902 DOI: 10.1136/bmjopen-2023-079121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 07/16/2024] [Indexed: 08/09/2024] Open
Abstract
OBJECTIVES The objectives of this study are to describe couples' experiences and perceived barriers to participation in the CenteringPregnancy model in southeast of China and to understand whether smartphones could play a potential role in this model. DESIGN This study employed a descriptive phenomenological qualitative study using semistructured dyadic interviews with women and their partners. The interviews were audiotaped, transcribed verbatim and subjected to thematic analysis. SETTING This study was conducted in two pilot prenatal clinics in southern China. PARTICIPANTS A purposive sample of 13 couples who underwent smartphone-assisted CenteringPregnancy were recruited. Data were collected until saturation through semistructured dyadic interviews between December 2022 and March 2023. RESULTS The study yielded four primary themes: (1) motivation for participation, (2) acceptance of CenteringPregnancy, (3) barriers and suggestions and (4) support for smartphone use of CenteringPregnancy. CONCLUSIONS CenteringPregnancy was well received by couples. Couples can access additional medical care and engage in intensive social interactions assisted by smartphones. However, certain objective challenges need to be acknowledged, including inadequate activity space, high demand for knowledge by couples and inflexible time for employed partners. Moreover, the risk that smartphones can lead to false expectations among couples needs to be noted.
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Affiliation(s)
- Huimin Lin
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Shengbin Guo
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | | | - Xiuwu Liu
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Anfen Hu
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Jing Zeng
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Guihua Liu
- Fujian Maternity and Child Health Hospital, Fuzhou, China
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Holman-Allgood I, Cline C, Durand C, Purvis RS, Mendoza Kabua P, Ayers BL. Providers' Perspectives of a Culturally Adapted CenteringPregnancy Intervention for Marshallese Women in Arkansas. Nurs Womens Health 2024; 28:117-127. [PMID: 38460942 PMCID: PMC10999336 DOI: 10.1016/j.nwh.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 03/11/2024]
Abstract
OBJECTIVE To explore health care providers' perspectives on the successes, challenges, and suggestions for future directions regarding the implementation of CenteringPregnancy for Marshallese women in Arkansas. DESIGN A descriptive qualitative design was used as an exploratory method. SETTING/LOCAL PROBLEM This study took place in northwest Arkansas. Arkansas is home to the largest Marshallese Pacific Islander population in the United States. Marshallese Pacific Islanders residing in the United States have disproportionally high rates of poor maternal and infant health outcomes, even compared to other Pacific Islanders. PARTICIPANTS Seven CenteringPregnancy providers from the University of Arkansas for Medical Sciences Northwest. INTERVENTION/MEASUREMENTS Individual interviews were conducted from February to March of 2023. Data were managed using MAXQDA12 software. Content analysis was used to analyze the data. Initial coding was completed to identify each data segment with short summations of emergent themes. The focused thematic codes that emerged were used to identify and develop the most salient thematic categories of the data, which became the thematic codes. RESULTS Three overarching themes emerged: Implementation Successes, Challenges to Implementation, and Future Suggestions to Improve Implementation and Sustainability. Each theme had representative subthemes. CONCLUSION Findings provide insight for future implementation of CenteringPregnancy for Marshallese and other Pacific Islander individuals.
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Short VL, Hand DJ, Mancuso F, Raju A, Sinnott J, Caldarone L, Rosenthall E, Liveright E, Abatemarco DJ. Group prenatal care for pregnant women with opioid use disorder: Preliminary evidence for acceptability and benefits compared with individual prenatal care. Birth 2024; 51:144-151. [PMID: 37800365 DOI: 10.1111/birt.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/23/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION The effectiveness of group prenatal care (G-PNC) compared with individual prenatal care (I-PNC) for women with opioid use disorder (OUD) is unknown. The objectives of this study were to (1) assess the acceptability of co-locating G-PNC at an opioid treatment program and (2) describe the maternal and infant characteristics and outcomes of pregnant women in treatment for OUD who participated in G-PNC and those who did not. METHODS This was a retrospective cohort study of 71 women (G-PNC n = 15; I-PNC n = 56) who were receiving treatment for OUD from one center and who delivered in 2019. Acceptability was determined by assessing the representativeness of the G-PNC cohorts, examining attendance at sessions, and using responses to a survey completed by G-PNC participants. The receipt of health services and healthcare use, behaviors, and infant health between those who participated in G-PNC and those who received I-PNC were described. RESULTS G-PNC was successfully implemented among women with varying backgrounds (e.g., racial, ethnic, marital status) who self-selected into the group. All G-PNC participants reported that they were satisfied to very satisfied with the program. Increased rates of breastfeeding initiation, breastfeeding at hospital discharge, receipt of the Tdap vaccine, and postpartum visit attendance at 1-2 weeks and 4-8 weeks were observed in the G-PNC group compared with the I-PNC group. Fewer G-PNC reported postpartum depression symptomatology. CONCLUSION Findings suggest that co-located G-PNC at an opioid treatment program is an acceptable model for pregnant women in treatment for OUD and may result in improved outcomes.
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Affiliation(s)
- Vanessa L Short
- College of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Dennis J Hand
- College of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Amulya Raju
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jacqueline Sinnott
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Elizabeth Liveright
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Diane J Abatemarco
- College of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Short E, Council SK, Bennett Milburn A, Ammerman A, Callaghan-Koru J, Mendoza Kabua P, Ayers BL. Assessing the acceptability and implementation feasibility of a culturally adapted parenting intervention for Marshallese mothers: A study protocol. Contemp Clin Trials Commun 2024; 37:101240. [PMID: 38261960 PMCID: PMC10796808 DOI: 10.1016/j.conctc.2023.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/25/2024] Open
Abstract
Background Pacific Islanders, including the Marshallese, face higher rates of obesity and obesity-related chronic conditions. Early-life interventions targeting eating patterns during the first 1000 days of life are essential to promote proper nutrition and growth. Marshallese mothers and caregivers are important decision-makers for feeding practices that could affect childhood obesity rates in Marshallese children. However, little is known about dietary patterns and practices of Marshallese families from birth to 12 months. Culturally-adapted approaches using community-based assets and Pacific Islander cultural values/practices have demonstrated effectiveness in reducing obesity but have not been developed for children. Methods This article describes the protocol for a study to culturally adapt the Centering Parenting intervention for Marshallese mothers in Arkansas. Conclusion This will be the first study to culturally adapt and implement Centering Parenting with Marshallese women in the United States. This study will be an important first step to assess the feasibility and acceptability of an abbreviated parenting intervention to reduce childhood obesity in Marshallese communities.
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Affiliation(s)
- Eliza Short
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Sarah K. Council
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | | | - Alice Ammerman
- University of North Carolina at Chapel Hill, 1700 MLK, Chapel Hill, NC, 27599, USA
| | - Jennifer Callaghan-Koru
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Philmar Mendoza Kabua
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Britni L. Ayers
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
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Smith JC, Heberlein EC, Domingue A, LaBoy A, Britt J, Crockett AH. Randomized Controlled Trial on the Effect of Group Versus Individual Prenatal Care on Psychosocial Outcomes. J Obstet Gynecol Neonatal Nurs 2023; 52:467-480. [PMID: 37604352 PMCID: PMC10840617 DOI: 10.1016/j.jogn.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE To assess the effect of group prenatal care (GPNC) compared with individual prenatal care (IPNC) on psychosocial outcomes in late pregnancy, including potential differences in outcomes by subgroups. DESIGN Randomized controlled trial. SETTING An academic medical center in the southeastern United States. PARTICIPANTS A total of 2,348 women with low-risk pregnancies who entered prenatal care before 20 6/7 weeks gestation were randomized to GPNC (n = 1,175) or IPNC (n = 1,173) and stratified by self-reported race and ethnicity. METHODS We surveyed participants during enrollment (M = 12.21 weeks gestation) and in late pregnancy (M = 32.51 weeks gestation). We used standard measures related to stress, anxiety, coping strategies, empowerment, depression symptoms, and stress management practices in an intent-to-treat regression analysis. To account for nonadherence to GPNC treatment, we used an instrumental variable approach. RESULTS The response rates were high, with 78.69% of participants in the GPNC group and 83.89% of participants in the IPNC group completing the surveys. We found similar patterns for both groups, including decrease in distress and increase in anxiety between surveys and comparable levels of pregnancy empowerment and stress management at the second survey. We identified greater use of coping strategies for participants in the GPNC group, particularly those who identified as Black or had low levels of partner support. CONCLUSION Group prenatal care did not affect stress and anxiety in late pregnancy; however, the increased use of coping strategies may suggest a benefit of GPNC for some participants.
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Mikolajczak-Degrauwe K, Slimmen SR, Gillissen D, de Bil P, Bosmans V, Keemink C, Meyvis I, Kuipers YJ. Strengths, weaknesses, opportunities and threats of peer support among disadvantaged groups: A rapid scoping review. Int J Nurs Sci 2023; 10:587-601. [PMID: 38020843 PMCID: PMC10667317 DOI: 10.1016/j.ijnss.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To explore the current state of knowledge and evidence about peer support for various disadvantaged groups; to identify the strengths, weaknesses, opportunities, and threats of peer support to critically reflect on peer support within health and social services. Methods A rapid scoping review was conducted according to Arksey and O'Malley's framework, aiming to identify eligible studies in PubMed, APA PsychInfo, Education Resources Information Center, Cochrane Library, Academic Search Premier, ScienceDirect, Directory of Open Access Journals, ResearchGate, WorldCat, and Google Scholar. According to Rodgers' concept analysis steps and the SWOT model, data was reported using thematic synthesis. Results Forty-five studies were included, describing a variety of peer support initiatives among groups of young migrants and unsupervised minors, young adults with autism, people with (mental) health problems, foster/shelter families, vulnerable pregnant women, people outside the labour force, older adults, and homeless people. The strength of peer support is its positive effect on the quality of life among vulnerable people. The weakness is represented by peers both being too involved and focused on personal interest or by peers lacking expertise and knowledge. Opportunities for peer support are mutual learning, the anticipated long-term effects, and the potential to facilitate social inclusion. Culture, language barriers, drop-out rates, securing sustainability, and peers' lack of time and commitment are regarded as threats to peer support. Conclusion Although peer support offers good outcomes for various groups of vulnerable people, the weaknesses and threats need to be considered to provide and proliferate peer support.
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Affiliation(s)
| | - Sybren R. Slimmen
- Research Group Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Dylan Gillissen
- Research Group Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Petra de Bil
- Research Group Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Valerie Bosmans
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
| | - Corrine Keemink
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
| | - Inge Meyvis
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
| | - Yvonne J. Kuipers
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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Moyett JM, Ramey-Collier K, Zambrano Guevara LM, MacDonald A, Kuller JA, Wheeler SM, Dotters-Katz SK. CenteringPregnancy: A Review of Implementation and Outcomes. Obstet Gynecol Surv 2023; 78:490-499. [PMID: 37594439 DOI: 10.1097/ogx.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Importance CenteringPregnancy (CP) is a model for group prenatal care associated with improved perinatal outcomes for preterm birth and low birthweight, increased rates of breastfeeding, and higher rates of patient and clinician satisfaction. Objective The study aims to review the literature related to perinatal outcomes associated with CP, benefits and barriers to implementation, and utility of the model. Evidence An electronic-based search was performed in PubMed using the search terms "CenteringPregnancy" OR "Centering Pregnancy," revealing 221 articles. Results The CP model improves patient centeredness, efficiency, and equality in prenatal care. Challenges include administrative buy-in, limited resources, and financial support. Multisite retrospective studies of CP demonstrate improved maternal, neonatal, postpartum, and well-being outcomes, especially for participants from minority backgrounds; however, prospective studies had mixed results. CenteringPregnancy is feasibly implemented with high tenet fidelity in several low- and middle-income settings with improved perinatal outcomes compared with traditional care. Conclusions CenteringPregnancy is feasible to implement, largely accepted by communities, and shows positive qualitative and quantitative health outcomes. This body of literature supports CP as a potential tool for decreasing racial inequalities in prenatal access, quality of care, and maternal mortality. Further investigation is necessary to inform obstetric clinicians about the potential outcome differences that exist between group and traditional prenatal care.
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Affiliation(s)
- Julia M Moyett
- Medical Student, Duke University School of Medicine, Durham, NC
| | | | | | - Amy MacDonald
- Director, Group Care, Pomelo Care Affiliation, Bethesda, MD
| | | | | | - Sarah K Dotters-Katz
- Associate Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University, Durham, NC
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Ayers BL, Eswaran H, CarlLee S, Reece S, Manning N, McElfish PA. Exploring the feasibility, acceptability, and preliminary effectiveness of a culturally adapted group prenatal program, CenteringPregnancy, to reduce maternal and infant health disparities among Marshallese Pacific Islanders: A study protocol. Contemp Clin Trials Commun 2023; 33:101127. [PMID: 37091509 PMCID: PMC10120290 DOI: 10.1016/j.conctc.2023.101127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Background Marshallese Pacific Islanders residing in the United States have higher rates of adverse perinatal outcomes than the general population and experience numerous barriers to prenatal care. CenteringPregnancy is a group prenatal care model which occurs in the patient's community. CenteringPregnancy, when applied to the Marshallese population, presents a potentially highly successful group-based intervention that can mitigate adverse perinatal outcomes among Marshallese Pacific Islanders. Methods This article describes the protocol of a mixed-methods study designed to examine the feasibility, acceptability, and preliminary effectiveness of the implementation of CenteringPregnancy for Marshallese Pacific Islander women. The mixed-methods design collects qualitative and quantitative data at the onset of CenteringPregnancy and during their last session and then augments the data with post-partum data abstraction. Conclusion This will be the first study to culturally adapt and implement CenteringPregnancy with Marshallese pregnant women in the United States. This study will be an important first step to exploring the feasibility, acceptability, and preliminary effectiveness of CenteringPregnancy and will better prepare the research team to assess and refine the intervention moving forward. Trial registration This study was registered at ClinicalTrials.gov on September 22, 2020 under identifier NCT04558619 and can be accessed at https://clinicaltrials.gov/ct2/show/NCT04558619?term=K%C5%8Dmmour+Prenatal&draw=2&rank=1.
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Affiliation(s)
- Britni L. Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
- Corresponding author.
| | - Hari Eswaran
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
| | - Nirvana Manning
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
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Heberlein EC, Smith JC, Marton J, Otekunrin A, LaBoy A, Britt JL, Crockett AH. Well Child Visit Attendance for Group Prenatal Care Participants. Acad Pediatr 2023; 23:296-303. [PMID: 36220619 DOI: 10.1016/j.acap.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Participation in group prenatal care (GPNC) has been associated with increased attendance at prenatal, family planning and postpartum visits. We explored whether GPNC participation is associated with pediatric care engagement by measuring well-child visit (WCV) attendance among infants whose births were covered by Medicaid. METHODS We used Medicaid claims and vital statistics from the South Carolina Department of Health and Human Services and GPNC site participation records (2013-2018). We compared WCV attendance of CenteringPregnancy GPNC patients to a propensity-score matched cohort of individual prenatal care patients (IPNC) across 21 prenatal care practices using linear probability models. The primary outcome measure was attending 6 or more WCVs in the first 15 months, a Healthcare Effectiveness Data and Information Set (HEDIS) performance measure. RESULTS No differences in WCV were observed when comparing any exposure to GPNC (one or more sessions) to IPNC. We identified 3191 patients who participated in GPNC and matched these with 5184 in IPNC. Participation in 5 or more GPNC sessions compared to 5 or more prenatal visits was associated with higher rates of WCV compliance over the first 15 months (4.7 percentage point difference [95% CI 3.1-6.3%, P < .001]), with stronger associations between GPNC and WCV attendance for low birthweight infants, for Black infants, and for infants of mothers with no previous live births. CONCLUSIONS This study suggests GPNC may modestly influence WCV attendance. The potential mechanisms and dose response require further investigation. Gaps in WCV attendance compared to benchmarks persist regardless of PNC model.
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Affiliation(s)
- Emily C Heberlein
- Georgia Health Policy Center, Andrew Young School of Policy Studies (EC Heberlein, JC Smith, A Otekunrin, and A LaBoy), Georgia State University, Atlanta.
| | - Jessica C Smith
- Georgia Health Policy Center, Andrew Young School of Policy Studies (EC Heberlein, JC Smith, A Otekunrin, and A LaBoy), Georgia State University, Atlanta
| | - James Marton
- Department of Economics, Andrew Young School of Policy Studies (J Marton), Georgia State University, Atlanta
| | - Adejumobi Otekunrin
- Georgia Health Policy Center, Andrew Young School of Policy Studies (EC Heberlein, JC Smith, A Otekunrin, and A LaBoy), Georgia State University, Atlanta
| | - Ana LaBoy
- Georgia Health Policy Center, Andrew Young School of Policy Studies (EC Heberlein, JC Smith, A Otekunrin, and A LaBoy), Georgia State University, Atlanta
| | - Jessica L Britt
- Department of Obstetrics and Gynecology, Prisma Health (JL Britt), Greenville, SC
| | - Amy H Crockett
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Prisma Health (AH Crockett), University of South Carolina School of Medicine Greenville, Greenville, SC
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Bruxvoort C. Emotional and Birth Outcomes Associated With Different Types of Prenatal Care for Women With Low Income. Nurs Womens Health 2021; 25:450-460. [PMID: 34756838 DOI: 10.1016/j.nwh.2021.10.001] [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: 12/22/2020] [Revised: 08/10/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
This article summarizes findings from the literature on the emotional and birth outcomes of women with low income receiving different types of prenatal care. This literature review included studies published between 2015 and 2020. The results indicated that women with low income have challenging experiences in traditional models of prenatal care. Evidence of improved birth outcomes with nontraditional prenatal care is mixed, but qualitative findings indicate that it is associated with better emotional outcomes for women with low income when compared to traditional prenatal care. Future research should investigate ways to improve the negative interpersonal and structural dimensions that can characterize prenatal care for women with low income.
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Garcia T, Duncanson K, Shrewsbury VA, Wolfson JA. A Qualitative Study of Motivators, Strategies, Barriers, and Learning Needs Related to Healthy Cooking during Pregnancy. Nutrients 2021; 13:nu13072395. [PMID: 34371903 PMCID: PMC8308614 DOI: 10.3390/nu13072395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/01/2021] [Accepted: 07/07/2021] [Indexed: 02/04/2023] Open
Abstract
Nutrition during pregnancy has lifelong impacts on the health of mother and child. However, this life stage presents unique challenges to healthy cooking and eating. Cooking interventions show promising results, but often lack theoretical basis and rigorous evaluation. The objective of this formative, qualitative study was to explore motivators, strategies, and barriers related to healthy cooking during pregnancy. Pregnant individuals’ preferences for a cooking education program were also explored. We conducted five focus groups with pregnant individuals (n = 20) in Southeast Michigan in 2019. Focus groups were audio-recorded and transcribed verbatim, then double coded by two members of the research team. Mean gestational age was 18.3 ± 9.6 weeks. Common motivators included feeding other children, avoiding pregnancy complications, promoting fetal growth, and avoiding foodborne illness. Challenges included pregnancy symptoms, navigating nutrition recommendations, mental energy of meal planning, family preferences, and time constraints. Strategies employed were meal planning and including a variety of foods. Participants identified organizational strategies, recipes, nutrition information, and peer support as important components of a cooking intervention during pregnancy. This study characterized multiple challenges to healthy home cooking during pregnancy, providing novel insight to inform the development of cooking skills education programs during this important life stage.
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Affiliation(s)
- Travertine Garcia
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
- Department of Human Nutrition, Foods & Exercise, Virginia Tech, Blacksburg, VA 24061, USA
| | - Kerith Duncanson
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, Australia; (K.D.); (V.A.S.)
| | - Vanessa A. Shrewsbury
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, Australia; (K.D.); (V.A.S.)
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan 2308, Australia
| | - Julia A. Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +410-955-3781
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