RESUMO
BACKGROUND: Centering Pregnancy (CP) is an effective method of delivering prenatal care, yet providers have been slow to adopt the CP model. Our main hypothesis is that a site's adoption of CP is contingent upon knowledge of the CP, characteristics health care personnel, anticipated patient impact, and system readiness. METHODS: Using a matched, pretest-posttest, observational design, 223 people completed pretest and posttest surveys. Our analysis included the effect of the seminar on the groups' knowledge of CP essential elements, barriers to prenatal care, and perceived value of CP to the patients and to the system of care. RESULTS: Before the CP Seminar only 34% of respondents were aware of the model, while knowledge significantly after the Seminar. The three greatest improvements were in understanding that the group is conducted in a circle, the health assessment occurs in the group space, and a facilitative leadership style is used. Child care, transportation, and language issues were the top three barriers. The greatest improvements reported for patients included improvements in timeliness, patient-centeredness and efficiency, although readiness for adoption was influenced by costs, resources, and expertise. DISCUSSION: Readiness to adopt CP will require support for the start-up and sustainability of this model.
Assuntos
Avaliação Educacional/estatística & dados numéricos , Serviços de Planejamento Familiar/educação , Pessoal de Saúde/educação , Obstetrícia/educação , Educação de Pacientes como Assunto/métodos , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Serviços de Planejamento Familiar/métodos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Missouri , Adulto JovemRESUMO
Adolescent pregnancy remains a significant social, economic, and health issue in the United States. The unique developmental needs of the pregnant adolescent require attention when designing prenatal care services. The CenteringPregnancy model of group prenatal care provides education and support for young women in an active and developmentally appropriate environment. Thirteen groups of adolescents (N = 124) have completed the Centering program at the Teen Pregnancy Center at Barnes Jewish Hospital in St. Louis, Missouri. Evaluation data suggest that the model has encouraged excellent health care compliance, satisfaction with prenatal care, and low rates of preterm birth and low birth weight infants.
Assuntos
Educação em Saúde , Serviços de Saúde Materna/organização & administração , Mães , Assistência Centrada no Paciente , Resultado da Gravidez , Gravidez na Adolescência , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Feminino , Educação em Saúde/métodos , Promoção da Saúde/métodos , Humanos , Recém-Nascido , Comportamento Materno/psicologia , Tocologia/métodos , Tocologia/normas , Missouri , Modelos de Enfermagem , Mães/educação , Mães/psicologia , Papel do Profissional de Enfermagem , Pesquisa Metodológica em Enfermagem , Assistência Centrada no Paciente/métodos , Gravidez , Avaliação de Programas e Projetos de Saúde , Autocuidado/métodos , Inquéritos e Questionários , Estados UnidosRESUMO
Centering Pregnancy, an innovative group model of prenatal care, shows promise to reduce persistent adverse maternal-infant outcomes and contain costs. Because this innovation requires systemwide change, clinics reported needing support enrolling women into groups and obtaining organizational buy-in. This study used the 3-step social marketing communication strategy to help clinic staff identify key customers and customer-specific barriers to adopting or supporting Centering Pregnancy. They developed targeted information to reduce barriers and built skills in communicating with different customers through role-playing. Findings provide practical information for others to use this communication strategy to improve implementation of Centering Pregnancy.