Äitien ja vauvojen sitouttaminen; Reimagining Antenatal Care for Every (EMBRACE) -tutkimus (EMBRACE)

Active Comparator: Hehku! Ryhmän synnytyshoito

Ryhmän synnytyshoito ja wrap around -palvelut.

Muut: Hehku! Ryhmän synnytyshoito

Hehku! on tehostettu ryhmäsikiöiden hoitomalli, joka tarjoaa yhteisiä sosiaalipalveluita vakiintuneiden yhteisön ohjelmien ja itsenäisten rahoitusvirtojen kautta pienituloisille perheille. Hohto! Ryhmän synnytyshoidon malli yhdistää koulutetun fasilitaattorin ja lisensoidun synnytyshoidon ammattilaisen vastaanottopaikalta laskutettavan synnytyshoidon tarjoamiseksi vastaanottoon omille potilaille. 8-10 istunnon aikana 10-12 naista (6 viikon raskausviikolla) saa synnytystä edeltävää lääketieteellistä hoitoa, riskinarviointia ja sosiaalista tukea sekä hankkii tietoa ja taitoja liittyen raskauteen, synnytykseen ja vanhemmuuteen.

Active Comparator: Yksilöllinen synnytystä edeltävä hoito – CPSP

Yksilöllinen synnytystä edeltävä hoito CPSP:n kattamilla lisäpalveluilla.

Muut: Yksilöllinen synnytyshoito CPSP:llä

Comprehensive Perinatal Services Program (CPSP) on valtion rahoittama ohjelma Medi-Cal-kelpoisille perheille, jotka saavat tehostettua hoitoa ja palveluiden koordinointia. CPSP:n yksilölliseen hoitoon määrätyt osallistujat voivat osallistua CPSP-arviointeihin kokonaisvaltaisen synnytysterveystyöntekijän kanssa synnytyshoitopaikallaan, jossa tarjotaan yksilöllistä synnytystä.

Potilaan terveyskyselyn (PHQ-9) pistemäärän muutokset

Muutokset masennusoireiden vaikeudessa lähtötilanteesta synnytyksen jälkeiseen aikaan. Arvioitu potilaan terveyskyselyllä (PHQ-9), joka annettiin henkilökohtaisesti lähtötilanteessa ja puhelinhaastattelun aikana kolmen kuukauden kuluttua synnytyksestä. Kokonaispistemäärä vaihtelee välillä 0–27, ja korkeammat pisteet viittaavat vakavampaan masennukseen.

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.