Involucrando a Madres y Bebés; Estudio Reimaginando la atención prenatal para todos (EMBRACE) (EMBRACE)

Comparador activo: ¡Brillo! Atención prenatal grupal

Atención prenatal grupal con servicios integrales.

Otro: ¡Brillo! Atención prenatal grupal

¡Brillo! es un modelo mejorado de atención prenatal grupal que ofrece servicios sociales compartidos proporcionados por programas comunitarios establecidos con flujos de financiamiento independientes dirigidos a familias de bajos ingresos. ¡El brillo! El modelo de atención prenatal grupal empareja a un facilitador capacitado con un profesional de atención prenatal con licencia de un sitio de práctica para brindar atención prenatal facturable a los propios pacientes de la práctica. En el transcurso de 8 a 10 sesiones, 10 a 12 mujeres (dentro de un rango de edad gestacional de 6 semanas) reciben atención médica prenatal, evaluaciones de riesgo y apoyo social, y adquieren conocimientos y habilidades relacionados con el embarazo, el parto y la crianza de los hijos.

Comparador activo: Atención Prenatal Individual - CPSP

Atención prenatal individual con servicios complementarios cubiertos por CPSP.

Otro: Atención prenatal individual con CPSP

El Programa Integral de Servicios Perinatales (CPSP, por sus siglas en inglés) es un programa financiado por el estado para que las familias elegibles para Medi-Cal reciban atención mejorada y coordinación de servicios. Los participantes asignados a la atención individual del CPSP pueden participar en las evaluaciones del CPSP con un trabajador de salud perinatal integral en su sitio de atención prenatal, donde se brindará la atención prenatal individual.

Cambios en la puntuación del Cuestionario de salud del paciente (PHQ-9)

Cambios en la gravedad de los síntomas depresivos desde el inicio hasta el posparto. Evaluado mediante el Cuestionario de salud del paciente (PHQ-9), administrado en persona al inicio del estudio y durante una entrevista telefónica a los tres meses del posparto. La puntuación total oscila entre 0 y 27 y las puntuaciones más altas indican una depresión más grave.

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.