Person-Centered Maternity Care and Health Outcomes at 1 and 6 Months Postpartum

Attanasio, Laura B.; Ranchoff, Brittany L; Paterno, Mary T.; Kjerulff, Kristen H.

doi:10.1089/jwh.2021.0643

Cited by 11 publications

(8 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25,26 Recent research also shows PCMC domains are associated with improved maternal and neonatal outcomes such as shorter duration of labor, decreased caesarean and instrumental vaginal birth, higher ve-minute Apgar scores, early postnatal care, breastfeeding, and lower risk of screening positive for post-partum depression. [27][28][29][30][31][32] Poor PCMC therefore undermines health gains for mothers and babies. 33 Several studies have highlighted the multilevel drivers of poor PCMC, which include inadequate provider knowledge of PCMC, poor provider attitudes, provider stress, burnout, and bias, power asymmetry between patients and providers, lack of accountability mechanisms, institutional and health system factors, and broader social and gender norms that facilitate and normalize disrespect and abuse.…”

Section: Introductionmentioning

confidence: 99%

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol

Afulani,

Getahun,

Ongeri

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Poor person-centered maternal care (PCMC) contributes to high maternal mortality and morbidity, directly and indirectly, through lack of, delayed, inadequate, unnecessary, or harmful care. While evidence on poor PCMC prevalence, as well as inequities, expanded in the last decade, there is still a significant gap in evidence-based interventions to address PCMC. We describe the protocol for a trial to test the effectiveness of the “Caring for Providers to Improve Patient Experience” (CPIPE) intervention, which includes five strategies for provider behavior change, targeting provider stress and bias as intermediate factors to improve PCMC and to address inequities. Methods The trial will assess the effect of CPIPE on PCMC, as well as on intermediate and distal outcomes, using a two-arm cluster randomized controlled trial in 40 health facilities in Migori and Homa Bay Counties in Kenya and Upper East and Northeast Regions in Ghana. Twenty facilities in each country will be randomized to 10 intervention and 10 control sites. The primary intervention targets are all healthcare workers who provide maternal health services. The intervention impact will also be assessed first among providers, and then among women who give birth in health facilities. The primary outcome is PCMC measured with the PCMC scale, via multiple cross-sectional surveys of mothers who gave birth in the preceding 12 weeks in study facilities at baseline (prior to the intervention), midline (6 months after intervention start), and endline (12 months post-baseline) (N = 2000 across both countries at each time point). Additionally, 400 providers in the study facilities across both countries will be followed longitudinally at baseline, midline, and endline, to assess intermediate outcomes. The trial incorporates a mixed-methods design; survey data alongside in-depth interviews (IDIs) with healthcare facility leaders, providers, and mothers to qualitatively explore factors influencing the outcomes. Finally, we will collect process and cost data to assess intervention fidelity and cost-effectiveness. Discussion This trial will be the first to rigorously assess an intervention to improve PCMC that addresses both provider stress and bias and will advance the evidence base for interventions to improve PCMC and contribute to equity in maternal and neonatal health.

show abstract

Section: Introductionmentioning

confidence: 99%

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol

Afulani,

Getahun,

Ongeri

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Patient-centered care can improve health outcomes by addressing each patient's individual needs, increasing patients' ownership of their health decisions, and improving patient-physician relationships [1][2][3][4]. In obstetrics, patient-centered care is recognized as important, yet providing this care during pregnancy remains challenging [5][6][7][8] as providers need to gather information from patients about their health and well-being throughout their pregnancies. To facilitate the gathering of person-centered information, there is increasing interest in the role of patients in reporting health-related data to their providers to inform patient-centered care.…”

Section: Introductionmentioning

confidence: 99%

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study

MacEwan,

Olvera,

Jonnalagadda

et al. 2024

JMIR Form Res

View full text Add to dashboard Cite

Background There is increasing interest in using patient-generated health data (PGHD) to improve patient-centered care during pregnancy. However, little research has examined the perspectives of patients and providers as they report, collect, and use PGHD to inform obstetric care. Objective This study aims to explore the perspectives of patients and providers about the use of PGHD during pregnancy, including the benefits and challenges of reporting, collecting, and using these data, as well as considerations for expanding the use of PGHD to improve obstetric care. Methods We conducted one-on-one interviews with 30 pregnant or postpartum patients and 14 health care providers from 2 obstetrics clinics associated with an academic medical center. Semistructured interview guides included questions for patients about their experience and preferences for sharing PGHD and questions for providers about current processes for collecting PGHD, opportunities to improve or expand the collection of PGHD, and challenges faced when collecting and using this information. Interviews were conducted by phone or videoconference and were audio recorded, transcribed verbatim, and deidentified. Interview transcripts were analyzed deductively and inductively to characterize and explore themes in the data. Results Patients and providers described how PGHD, including physiologic measurements and experience of symptoms, were currently collected during and between in-person clinic visits for obstetric care. Both patients and providers reported positive perceptions about the collection and use of PGHD during pregnancy. Reported benefits of collecting PGHD included the potential to use data to directly inform patient care (eg, identify issues and adjust medication) and to encourage ongoing patient involvement in their care (eg, increase patient attention to their health). Patients and providers had suggestions for expanding the collection and use of PGHD during pregnancy, and providers also shared considerations about strategies that could be used to expand PGHD collection and use. These strategies included considering the roles of both patients and providers in reporting and interpreting PGHD. Providers also noted the need to consider the unintended consequences of using PGHD that should be anticipated and addressed. Conclusions Acknowledging the challenges, suggestions, and considerations voiced by patients and providers can inform the development and implementation of strategies to effectively collect and use PGHD to support patient-centered care during pregnancy.

show abstract

“…Substantial efforts on a global level have been targeted at augmenting the quality of services within facilities providing maternal and reproductive health care(6). Consequently, there have been appeals for an increased emphasis on person-centric reproductive health care (7). This type of care is considerate towards and adaptable to the preferences, requirements, and values upheld by women and their families(8); aspects which are underscored in The World Health Organization's recommendations aiming for favorable childbirth experiences (9).…”

Section: Introductionmentioning

confidence: 99%

Translation and adaptation of the person-centered maternity care scale to a Persian speaking population: A confirmatory factor analysis

Mohammadkhani

2024

Preprint

View full text Add to dashboard Cite

Background: Recognized as the most exhaustive multi-dimensional evaluation of women's person-centered experiences during childbirth, the Person-Centered Maternity Care (PCMC) Scale offers domain-specific insights into facets of care. This instrument has yet to be translated into Persian. Hence, this study purposed to translate and ascertain the reliability and validity of a Persian version of the PCMC scale for postpartum women in Iran. Methods: A cross-sectional study was facilitated at multiple comprehensive health centers within Tehran, Iran from February 2022 until July 2022. Postpartum women within 7 days after childbirth who were referred to selected comprehensive health centers for newborn thyroid screening were conveniently sampled. The validation process for the questionnaire utilized confirmatory factor analysis (CFA), while it gauged convergent validity via factor loads, average variance extracted (AVE), along with composite reliability (CR). Discriminant credibility was evaluated utilizing HTMT alongside Fornell-Larcker Criteria. Data analysis procedures were conducted through IBM SPSS Statistics for Windows Version 16 and SMART PLS Statistics for Windows Version 4.0.9.9. Results: All the items were within the acceptable range of factor loading, except for questions 3 of facility and 6 of dignity, which were removed from the model. The AVE values for all the variables were above 0.50 and the CR values were above 0.78, indicating convergent validity. On the horizontal loading table, all of the indicators met the conditions. Additionally, the findings validate that the HTMT indicator associated with all constructs remained below 0.9 which confirms divergent relevance pertaining to the survey tool under consideration. The composite reliability values also indicated good overall reliability for all the constructs, ranging from 0.78 to 0.91. Conclusions: The results of the present study indicate that the Persian version of the PCMC is a reliable and valid tool for measuring person-centered maternity care in Persian-speaking populations.

show abstract

Person-Centered Maternity Care and Health Outcomes at 1 and 6 Months Postpartum

Cited by 11 publications

References 77 publications

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study

Translation and adaptation of the person-centered maternity care scale to a Persian speaking population: A confirmatory factor analysis

Contact Info

Product

Resources

About