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Malchi F, Abedi P, Iravani M, Maraghi E, Mohammadi E, Saadati N. The Effect of Group Prenatal Care on the Empowerment of Pregnant Adolescents: Randomised controlled trial. Sultan Qaboos Univ Med J 2023; 23:502-509. [PMID: 38090240 PMCID: PMC10712397 DOI: 10.18295/squmj.6.2023.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/19/2023] [Accepted: 04/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to evaluate the effect of group prenatal care (GPNC) on the empowerment of pregnant adolescents. Methods In this trial, 294 pregnant adolescents (aged 15-19 years) were randomly assigned into the GPNC (n = 147) and individual prenatal care (IPNC; n = 147) groups, where they received 5 sessions of GPNC (90-120 min) and IPNC, respectively, between the 16th and 40th weeks of pregnancy. The empowerment of participants in the two groups was measured using the Empowerment Scale for Pregnant Women. Data were analysed using various tests. Results The mean total score of pregnant women's empowerment in both groups after the intervention was 86.46 ± 4.95 and 81.89 ± 4.75, respectively (β = 6.11, 95% confidence interval: 4.89, 7.33; P <0.0001). Conclusion GPNC can improve pregnant adolescent empowerment. The current study's results can provide a foundation for implementing the GPNC model in Iran.
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Affiliation(s)
- Fatemeh Malchi
- Midwifery Department, Nursing and Midwifery School, Reproductive Health Promotion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Parvin Abedi
- Midwifery Department, Nursing and Midwifery School, Reproductive Health Promotion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Mina Iravani
- Midwifery Department, Nursing and Midwifery School, Reproductive Health Promotion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Elham Maraghi
- Department of Biostatics and Epidemiology, Faculty of Public Health, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Najmieh Saadati
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Gerontakos S, Leach M, Steel A, Wardle J. Feasibility and efficacy of implementing group visits for women's health conditions: a systematic review. BMC Health Serv Res 2023; 23:549. [PMID: 37237255 DOI: 10.1186/s12913-023-09582-6] [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: 11/09/2022] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Shared medical appointments, also known as group visits, are a feasible and well-accepted approach for women receiving antenatal care, yet the feasibility and efficacy of this approach for female-specific reproductive conditions is uncertain. OBJECTIVE The aim of this systematic review was to (a) determine the feasibility of group visits in adults with any female-specific reproductive condition, and (b) identify whether delivering group care for these conditions impacts clinical outcomes. METHOD Six databases and two clinical trials registries were searched from inception through to 26 January 2022 for original research examining group medical visits or group consultation interventions for adults with female reproductive conditions or pathologic conditions specific to the female reproductive system. RESULTS The search yielded 2584 studies, of which four met the inclusion criteria. Included studies sampled women with breast cancer, chronic pelvic pain, polycystic ovary syndrome and gynaecological cancers. Studies reported high levels of patient satisfaction, with participants indicating their expectations had been met or exceeded. The impact of group visits on clinical outcomes was inconclusive however. DISCUSSION/CONCLUSIONS The studies in this review indicate delivery of female-specific healthcare via a group model maybe feasible and well-accepted. The review provides a solid basis for proposing larger and longer studies on group visits for female reproductive conditions. TRIAL REGISTRATION The review protocol was registered with PROSPERO (CRD42020196995).
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Affiliation(s)
- Sophia Gerontakos
- National Centre for Naturopathic Medicine, Southern Cross University, A Block, Military Road, Lismore, NSW, 2480, Australia.
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, A Block, Military Road, Lismore, NSW, 2480, Australia
| | - Amie Steel
- Faculty of Health, University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine, Broadway, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, A Block, Military Road, Lismore, NSW, 2480, Australia
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Malchi F, Abedi P, Iravani M, Mohammadi E, Saadati N, Maraghi E. Perception of group prenatal care among pregnant adolescents: A qualitative study in Iran. J Pediatr Adolesc Gynecol 2023:S1083-3188(23)00276-0. [PMID: 36889456 DOI: 10.1016/j.jpag.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 02/10/2023] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Understanding the pregnant adolescent's perception of group prenatal care is necessary for introducing and implementing this model of care. This qualitative study aims to explore adolescent pregnant women's perception of group prenatal care in Iran. METHODS This qualitative study was conducted in Iran to explore adolescents' perception of group prenatal care during pregnancy, from November 2021 to May 2022. Fifteen adolescent pregnant women (from low-income population) who received group prenatal care were recruited and interviewed individually in public health care center through an intentional sampling method. Interviews were digitally recorded and transcribed verbatim in Persian and analyzed using conventional content analysis. RESULTS From the data analysis, two themes, six main categories, and 21 subcategories emerged. The themes were "Maternal empowerment" and "Pleasant prenatal care". The first theme included four categories of knowledge enhancement, improving self-efficacy, perceived support, and feeling of security. The second theme is composed of two categories of motivation and effective interaction with peers. CONCLUSION The findings of this study showed the effectiveness of group prenatal care in promoting feelings of empowerment and satisfaction of adolescent pregnant women. Further research is needed to assess the benefits of group prenatal care for adolescents in Iran and other populations.
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Affiliation(s)
- Fatemeh Malchi
- Ph.D Student of midwifery, Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Parvin Abedi
- Professor in Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mina Iravani
- Assistance Professor in midwifery Department, Reproductive Health Promotion Research Center, Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Eesa Mohammadi
- BScN., MScN., Ph.D., Professor, Nursing Department, Faculty of Medical Sciences Tarbiat Modares University, Tehran, Iran.
| | - Najmieh Saadati
- Associate Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Elham Maraghi
- PhD of Biostatistics, Assistant Professor, Department of biostatics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Dai J, Yu Y, Wang Y, Huang Y, Liu J, Lin Y, Fan X, Zhang M, Xu X, Bai J, Chen H, Liu Y. The Experience of Pregnant Women in the Health Management Model of Internet-Based Centering Pregnancy: A Qualitative Study. Int J Womens Health 2022; 14:1281-1289. [PMID: 36105790 PMCID: PMC9464633 DOI: 10.2147/ijwh.s375675] [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: 05/21/2022] [Accepted: 08/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background CenteringPregnancy Care is a promising group prenatal care innovation that combines assessment, education, and peer support. In China, it is not clear how best to integrate the CenteringPregnancy Care into existing maternal health care models. This qualitative study aimed to explore Chinese pregnant women’s experience in the Internet-based CenteringPregnancy management model. Methods The Internet-based CenteringPregnancy was applied in a tertiary hospital between 2018 and 2019 in Wuhan, Hubei Province. Through purposive sampling, a total of 9 pregnant women who had experienced Internet-based CenteringPregnancy were recruited. A semi-structured interview was used to collect qualitative data, and Colaizzi’s 7-step method of phenomenological data analysis was used to analyze the collected data. Results Three themes were extracted from the participants’ interviews, including: 1) empowerment; 2) psychological and social support; 3) challenges of the Internet-based CenteringPregnancy. The Internet-based CenteringPregnancy management model retained advantages of CenteringPregnancy, emphasizing the pregnant woman as the subject of health care and promoting them to participate in health care. Participants believed that they could exchange pregnancy knowledge, help each other, and improve mood both timely and efficiently from the new model. However, it was found that there were challenges in seminar time arrangement, topic selection, and discussion management. Conclusion The Internet-based CenteringPregnancy management model positively affected pregnant women’s empowerment, psychological, and social support. It is recommended to improve the seminar’s design in future studies.
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Affiliation(s)
- Jiamiao Dai
- School of Nursing, Wuhan University, Wuhan, People's Republic of China
| | - Yun Yu
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yuchen Wang
- Department of Nursing, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Yinying Huang
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Juan Liu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yumin Lin
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Xiaoxiao Fan
- School of Nursing, Wuhan University, Wuhan, People's Republic of China
| | - Mingjing Zhang
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Xiaofang Xu
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Hong Chen
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yanqun Liu
- School of Nursing, Wuhan University, Wuhan, People's Republic of China
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Somji A, Ramsey K, Dryer S, Makokha F, Ambasa C, Aryeh B, Booth K, Xueref S, Moore S, Mwenesi R, Rashid S. "Taking care of your pregnancy": a mixed-methods study of group antenatal care in Kakamega County, Kenya. BMC Health Serv Res 2022; 22:969. [PMID: 35906642 PMCID: PMC9336107 DOI: 10.1186/s12913-022-08200-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/15/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Traditional antenatal care (ANC) models often do not meet women's needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. F studies show associations between GANC and various outcomes. METHODS We employed a pre-post quasi-experimental design using mixed methods to assess a GANC model (Lea Mimba Pregnancy Clubs) at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1652 women assigned to 162 GANC cohorts. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes including experience of care, empowerment and self-efficacy, knowledge of healthy practices and danger signs, and practice of healthy behaviors, including ANC retention. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders. RESULTS The proportion of survey respondents with knowledge of three or more danger signs during pregnancy more than tripled, from 7.1% at baseline to 26.4% at endline (OR: 4.58; 95% CI: 2.26-10.61). We also found improvements in women's reports about their experience of care between baseline and endline, particularly in their assessment of knowledge and competence of health workers (OR: 2.52 95% CI: 1.57-4.02), respect shown by ANC providers (OR: 1.82, 95% CI: 1.16-2.85), and women's satisfaction with overall quality of care (OR: 1.62, 95% CI: 1.03-2.53). We saw an increase from 58.9% at baseline to 71.7% at endline of women who strongly agreed that they shared their feelings and experiences with other women (OR: 1.73, 95% CI: 1.1-2.7). The mean number of ANC visits increased by 0.89 visits (95% CI: 0.47-1.42) between baseline (4.21) and endline (5.08). No changes were seen in knowledge of positive behaviors, empowerment, self-efficacy, and several aspects related to women's experience of care and adoption of healthy behavior constructs. Qualitatively, women and stakeholders noted improved interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely and strengthened social networks and enhanced social cohesion among women. CONCLUSIONS GANC offers promise for enhancing women's experience of care by providing improved counseling and social support. Additional research is needed to develop and test measures for empowerment, self-efficacy, and experience of care, and to understand the pathways whereby GANC effects changes in specific outcomes.
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Affiliation(s)
- Aleefia Somji
- Management Sciences for Health (MSH), Alexandria, USA
| | | | - Sean Dryer
- Globally Minded Foundation, Burgas, Bulgaria
| | | | | | | | - Kathleen Booth
- Columbia University Mailman School of Public Health, New York, USA
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Grenier L, Onguti B, Whiting-Collins LJ, Omanga E, Suhowatsky S, Winch PJ. Transforming women’s and providers’ experience of care for improved outcomes: A theory of change for group antenatal care in Kenya and Nigeria. PLoS One 2022; 17:e0265174. [PMID: 35503773 PMCID: PMC9064109 DOI: 10.1371/journal.pone.0265174] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 02/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Group antenatal care (G-ANC) is a promising model for improving quality of maternal care and outcomes in low- and middle-income countries (LMICs) but little has been published examining the mechanisms by which it may contribute to those improvements. Substantial interplay can be expected between pregnant women and providers’ respective experiences of care, but most studies report findings separately. This study explores the experience and effects of G-ANC on both women and providers to inform an integrated theory of change for G-ANC in LMICs. Methods This paper reports on multiple secondary outcomes from a pragmatic cluster randomized controlled trial of group antenatal care in Kenya and Nigeria conducted from October 2016—November 2018 including 20 clusters per country. We collected qualitative data from providers and women providing or receiving group antenatal care via focus group discussions (19 with women; 4 with providers) and semi-structured interviews (42 with women; 4 with providers). Quantitative data were collected via surveys administered to 1) providers in the intervention arm at enrollment and after facilitating 4 cohorts and 2) women in both study arms at enrollment; 3–6 weeks postpartum; and 1 year postpartum. Through an iterative approach with framework analysis, we explored the interactions of voiced experience and perceived effects of care and placed them relationally within a theory of change. Selected variables from baseline and final surveys were analyzed to examine applicability of the theory to all study participants. Results Findings support seven inter-related themes. Three themes relate to the shared experience of care of women and providers: forming supportive relationships and open communication; becoming empowered partners in learning and care; and providing and receiving meaningful clinical services and information. Four themes relate to effects of that experience, which are not universally shared: self-reinforcing cycles of more and better care; linked improvements in health knowledge, confidence, and healthy behaviors; improved communication, support, and care beyond G-ANC meetings; and motivation to continue providing G-ANC. Together these themes map to a theory of change which centers the shared experience of care for women and providers among multiple pathways to improved outcomes. Discussion The reported experience and effects of G-ANC on women and providers are consistent with other studies in LMICs. This study is novel because it uses the themes to present a theory of change for G-ANC in low-resource settings. It is useful for G-ANC implementation to inform model development, test adaptations, and continue exploring mechanisms of action in future research.
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Affiliation(s)
- Lindsay Grenier
- Maternal and Newborn Health Unit, Jhpiego, Baltimore, Maryland, United States of America
- * E-mail:
| | | | - Lillian J. Whiting-Collins
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Eunice Omanga
- Department of Monitoring, Evaluation, and Research, Jhpiego, Nairobi, Kenya
| | - Stephanie Suhowatsky
- Maternal and Newborn Health Unit, Jhpiego, Baltimore, Maryland, United States of America
| | - Peter J. Winch
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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D’Avila CG, Oliveira KLBDS, Castro RM, Pina-Oliveira AA, Freitas NDO, Fernandes RAQ. Efetividade de jogo educativo para gestantes: conhecimento agregado e vivência das mulheres. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos verificar a efetividade do jogo educativo para gestantes sobre seus direitos durante o trabalho de parto e parto; comparar o conhecimento das gestantes sobre seus direitos antes e após a aplicação do jogo e conhecer como foi para elas essa experiência. Método estudo quantitativo com análise qualitativa secundária. A coleta de dados ocorreu entre julho e setembro de 2019. Participaram 51 gestantes atendidas em duas Unidades Básicas de Saúde do município de Guarulhos. Utilizaram-se os testes Kolmogorov-Smirnov e o não-paramétrico Wilcoxon e nível de significância de 0,05. Adotou-se a análise lexical de conteúdo com apoio do software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados a efetividade do jogo foi comprovada pela comparação da média do conhecimento das gestantes antes e após a atividade educativa (Z = -5,924; p = 0,000). Houve diferença significativa na comparação da avaliação do conhecimento das gestantes antes e após o jogo (p=0,000). As respostas das gestantes enfatizaram a positividade da ação educativa e valorizaram as imagens do jogo como recurso educacional inovador. Conclusão e Implicações para a prática O jogo mostrou-se efetivo para ser utilizado na orientação de gestantes de forma lúdica e demonstrou agregar conhecimento de modo imagético e participativo.
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Sultana M, Ali N, Akram R, Jahir T, Mahumud RA, Sarker AR, Islam Z. Correction: Group prenatal care experiences among pregnant women in a Bangladeshi community. PLoS One 2019; 14:e0220816. [PMID: 31365596 PMCID: PMC6668819 DOI: 10.1371/journal.pone.0220816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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