Abstract
Introduction
Rural pregnant women experience challenges in accessing quality prenatal care (PNC), leaving them vulnerable to disparate health outcomes for their infants. Few studies have compared the effectiveness of Centering group prenatal care (GPC) to traditional prenatal care (TPC) among pregnant women of low socioeconomic status in a rural area. This project evaluates perceived barriers to care and GPC outcomes to address gaps specific to this population.
Methods
A prospective cohort comparison based on convenience sampling of 32 women used the Barriers Scale survey and satisfaction questionnaire to assess perceived barriers to PNC. In addition, a retrospective chart review used purposeful sampling of 106 charts to evaluate low birth weight, preterm birth, PNC use, and breastfeeding outcomes.
Results
Although GPC participants were high users of PNC (χ2 = 28.62, p = 0.0001), they had higher rates of low-birth-weight infants (11.3%, n = 6) and preterm births (13.2%, n = 7) than TPC participants (9.4%, n = 5 and 9.4%, n = 5, respectively). Breastfeeding outcomes were comparable. TPC participants reported provider relationship as a slight barrier, but both groups were satisfied with their care overall.
Conclusion
Despite relative progress in promoting evidence-based PNC, maternal and neonatal disparities persist in rural communities. These findings indicate further need to explore social determinants of PNC use and outcomes.
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The authors would like to thank the advanced care practitioners, clinical support staff, administration, and patients at the project site.
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Statement of Human Rights: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent
Informed consent was not required for this quality improvement project as traditional and group visit models were the standard of care at this FQHC. Involvement in either program option was based on self-selection at the time of entry. Survey completion was voluntary and anonymous, and abstracted chart review data included no identifiable information, required no interaction, and was anonymous and aggregated. Project approval was received from the site’s director and Winston-Salem State University’s Institutional Review Board in accordance with ethical principles.
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The Winston-Salem State University’s Institutional Review Board approved the study protocol.
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Walton, S., Roberson, K., Onsomu, E.O. et al. Evaluating Centering group prenatal care in rural women with low socioeconomic status to promote access to care and improve pregnancy outcomes. J Public Health (Berl.) 29, 285–291 (2021). https://doi.org/10.1007/s10389-019-01121-0
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DOI: https://doi.org/10.1007/s10389-019-01121-0