Women's Perceptions of CenteringPregnancy

Herrman, Judith W.; Rogers, Stephanie; Ehrenthal, Deborah B.

doi:10.1097/nmc.0b013e3182385204

Cited by 29 publications

(37 citation statements)

References 14 publications

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“…20,22–24 Women receiving CenteringPregnancy have previously reported developing meaningful relationships with women and group leaders. 2,25 Highly facilitative groups can help women feel comfortable, relieve fears, 2,24–26 and enable behavior change. 2,26 These effects may be especially important for women from vulnerable populations who are at risk of adverse pregnancy outcomes, 27 and who may experience chronic challenges such as poverty, neighborhood stressors, and homelessness.…”

Section: Commentmentioning

confidence: 99%

Group prenatal care: model fidelity and outcomes

Novick

Reid

Lewis

et al. 2013

American Journal of Obstetrics and Gynecology

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Objective CenteringPregnancy group prenatal care has been demonstrated to improve pregnancy outcomes. However, there is likely variation in how the model is implemented in clinical practice, which may be associated with efficacy, and therefore variation, in outcomes. We examined the association of fidelity to process and content of the CenteringPregnancy group prenatal care model with outcomes previously shown to be affected in a clinical trial: preterm birth, adequacy of prenatal care and breastfeeding initiation. Study Design Participants were 519 women who received CenteringPregnancy group prenatal care. Process fidelity reflected how facilitative leaders were and how involved participants were in each session. Content fidelity reflected whether recommended content was discussed in each session. Fidelity was rated at each session by a trained researcher. Preterm birth and adequacy of care were abstracted from medical records. Participants self-reported breastfeeding initiation at 6-months postpartum. Results Controlling for important clinical predictors, greater process fidelity was associated with significantly lower odds of both preterm birth (B=−0.43, Wald χ2=8.65, P=.001) and intensive utilization of care (B=−0.29, Wald χ2=3.91, P=.05). Greater content fidelity was associated with lower odds of intensive utilization of care (B=−0.03, Wald χ2=9.31, P=.001). Conclusion Maintaining fidelity to facilitative group processes in CenteringPregnancy was associated with significant reductions in preterm birth and intensive care utilization of care. Content fidelity also was associated with reductions in intensive utilization of care. Clinicians learning to facilitate group care should receive training in facilitative leadership, emphasizing the critical role that creating a participatory atmosphere can play in improving outcomes.

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Section: Commentmentioning

confidence: 99%

Group prenatal care: model fidelity and outcomes

Novick

Reid

Lewis

et al. 2013

American Journal of Obstetrics and Gynecology

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“…Furthermore, future studies of group care should also evaluate processes used to carry out group care. Women in this study, as well as in others, emphasized the need for group to be a respectful safe space where they can learn and share with others . Indeed, how group is conducted appears to be significantly related to its outcomes .…”

Section: Discussionmentioning

confidence: 65%

A Qualitative Study of Women's Recall of Content and Skills Developed in Group Prenatal and Well‐Baby Care 2 Years Later

Hackley¹,

Elyachar‐Stahl²,

Savage³

et al. 2018

J Midwife Womens Health

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Introduction Group prenatal and well‐baby care is a system of health care visits that occur in a group setting. Each individual session lasts approximately 2 hours, allowing more time for education and support than can occur in an individual visit. Compared with individual care, research suggests that group care is associated with similar or better short‐term outcomes, but no studies have yet examined potential long‐term benefits beyond one year postpartum. The purpose of this qualitative descriptive study was to elicit women's recall about content covered in group prenatal and well‐baby care and whether they were or were not continuing to use skills discussed during group prenatal and well‐baby care 2 or more years after their group ended. Methods Eligible women participated in group prenatal and/or well‐baby care between 2008 and 2012, were aged at least 18 years, and were English‐speaking. Of the 127 eligible women, 32 were reached and 17 agreed to participate. Women were interviewed on average 3 years after group prenatal or well‐baby care ended using a semistructured interview guide. Transcripts were reviewed and coded by each team member. Final codes and themes were identified using an iterative review process among the research team. Results Three themes were identified: sustained change, transferable skills, and group as a safe haven. All women were still using strategies discussed during group and had made sustained improvements in nutrition, stress management, and/or in the quality of their interactions with their children, partner, or families. The group environment was described as a safe haven: a respectful, nonjudgmental space that allowed women to share and support each other while learning new skills. Discussion This is the first study to document that group prenatal and well‐baby care is associated with long‐term benefits in areas not yet reported in the literature: nutrition, family communication, and parenting.

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“…Centering provides substantially greater contact time with pregnant women than individual prenatal care, yet requires a minimal increase in provider time (Tanner-Smith et al, 2012). This multifaceted program is attractive to clinicians seeking to provide prenatal care that addresses pregnant women’s emotional, social, and behavioral concerns (Rising et al, 2004, Klima, 2009, Tanner-Smith et al, 2012) and may be particularly beneficial for women from low income and minority populations (Ickovics et al, 2007, Herrman et al, 2012, Novick et al, 2012, Picklesimer et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

“…In a program evaluation of five sites, four sites reported “implementation difficulties,” including inadequate administrative buy-in and allocation of administrative time for managing Centering. Furthermore, this paradigm shift may be unsettling for clinicians and staff who view traditional, individual prenatal care as indispensible, or who are unfamiliar with the advantages of group health care (Strong, 2000, Novick, 2004, Yalom and Leszcz, 2005, Herrman et al, 2012, Tanner-Smith et al, 2012). Consequently, clinicians providing GPNC may confront resistance from colleagues, or encounter logistical challenges in implementing the Centering model as designed because of institutional limitations.…”

Section: Introductionmentioning

confidence: 99%

“…Women who scored in the third tertile of stress on the Perceived Stress Scale who were randomized to Centering reported increased self-esteem, and decreased stress and social conflict (Ickovics et al, 2011). Qualitative studies report that women were enthusiastic about learning in groups, felt supported by other women and clinicians (Kennedy et al, 2009, Novick et al, 2011, Herrman et al, 2012, Novick et al, 2012), and found that talking with others normalized fears (Novick et al, 2011, Herrman et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

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