Engagerende mødre og babyer; Genopfattende fødselspleje for alle (EMBRACE) undersøgelse (EMBRACE)

Aktiv komparator: Glød! Gruppe prænatal pleje

Gruppe prænatal pleje med wrap around-tjenester.

Andet: Glød! Gruppe prænatal pleje

Glød! er en forbedret gruppe prænatal plejemodel, der tilbyder samlokaliserede sociale tjenester leveret af etablerede samfundsprogrammer med uafhængige finansieringsstrømme rettet mod lavindkomstfamilier. Gløden! gruppe prænatal pleje model parrer en uddannet facilitator med en autoriseret prænatal pleje praktiserende læge fra et praksissted for at yde fakturerbar prænatal pleje til praksisens egne patienter. I løbet af 8-10 sessioner modtager 10-12 kvinder (inden for en 6-ugers svangerskabsalder) prænatal lægehjælp, risikovurderinger og social støtte og får viden og færdigheder relateret til graviditet, fødsel og forældreskab.

Aktiv komparator: Individuel prænatal pleje- CPSP

Individuel prænatal pleje med supplerende ydelser omfattet af CPSP.

Andet: Individuel prænatal pleje med CPSP

Comprehensive Perinatal Services Program (CPSP) er et statsfinansieret program for Medi-Cal-berettigede familier til at modtage forbedret pleje og servicekoordinering. Deltagere, der er tildelt individuel CPSP-pleje, kan deltage i CPSP-vurderingerne med en Comprehensive Perinatal Health Worker på deres prænatalplejested, hvor individuel prænatal pleje vil blive ydet

Ændringer i Patient Health Questionnaire (PHQ-9) Score

Ændringer i sværhedsgraden af ​​depressive symptomer fra baseline til postpartum. Vurderet ved hjælp af Patient Health Questionnaire (PHQ-9), administreret personligt ved baseline og under telefoninterview tre måneder efter fødslen. Samlet score spænder fra 0-27 med højere score, der indikerer mere alvorlig depression.

Person-centered Prenatal Care

This outcome focuses on the extent to which the participants feels their prenatal care was person centered.

The title of the measure is Person Centered Prenatal Care (primary). This measurement tool is a questionnaire that includes series of items that were developed in collaboration with community members to measure their experience of care. In addition to the overall score, the scale includes three subscales identified as important by community members: dignity and respect, communication and autonomy, and responsive and supportive care. The measures have been validated in several languages.

The total scores range from 0-100 with higher scores indicating the receipt of more person centered care.

Preterm Birth

Whether the participant had a baby born less than 37 weeks gestation, as noted in the participant's medical record.

Changes in Anxiety Symptom Severity

Changes in anxiety symptom severity from baseline to postpartum. Assessed using the 7-item Generalized Anxiety Disorder (GAD-7) scale, administered in-person at baseline and during telephone interview at three months postpartum.

The total scores range from 0-21 with higher scores indicating more severe anxiety.

Perceptions of Respectful/Disrespectful Maternity Care

Extent to which the participant feels that the maternity care they received was respectful. Assessed using the Mothers on Respect Index (MORi), administered during telephone interview or in-person at three months postpartum.

The total scores range from 14-100 with higher scores indicating a higher level of respect.

Satisfaction With Prenatal Care

Extent to which the participant feels satisfied with the prenatal care they received. Assessed using the Prenatal Care Satisfaction Scale, administered during telephone interview or in-person interview at third trimester.

The total scores range from 0-100 with higher scores indicating higher levels of satisfaction.

Gestational Age at Delivery

The gestation age at which the baby was born (number of weeks), as noted in the participant's medical record.

Person Centered Maternity Care

Extent to which birthing person feels their prenatal and birthing experience was person centered, as measured by the Person-Centered Maternity Care scale.

This measure focuses on the extent to which the participants feels their prenatal and maternity/birthing care was person centered.

The title of the measure is Person Centered Maternity Care. This measurement tool is a questionnaire that includes series of items that were developed in collaboration with community members to measure their experience of care. In addition to the overall score, the scale includes three subscales identified as important by community members: dignity and respect, communication and autonomy, and responsive and supportive care. The measures have been validated in several languages.

The total scores range from 0-100 with higher scores indicating the receipt of more person centered care.