Engasjerende mødre og babyer; Reimagining svangerskapsomsorg for alle (EMBRACE) Studie (EMBRACE)

Aktiv komparator: Gløde! Gruppe svangerskapsomsorg

Gruppeprenatal omsorg med omsluttende tjenester.

Annen: Gløde! Gruppe svangerskapsomsorg

Gløde! er en forbedret gruppe svangerskapsomsorgsmodell som tilbyr samlokaliserte sosiale tjenester levert av etablerte samfunnsprogrammer med uavhengige finansieringsstrømmer rettet mot lavinntektsfamilier. Gløden! gruppe svangerskapsomsorgsmodellen kobler en utdannet tilrettelegger med en lisensiert svangerskapspleier fra et praksissted for å gi fakturerbar svangerskapsomsorg til praksisens egne pasienter. I løpet av 8-10 økter får 10-12 kvinner (innenfor en 6-ukers svangerskapsalder) prenatal medisinsk behandling, risikovurderinger og sosial støtte, og får kunnskap og ferdigheter knyttet til graviditet, fødsel og foreldreskap.

Aktiv komparator: Individuell svangerskapsomsorg - CPSP

Individuell svangerskapsomsorg med tilleggstjenester dekket av CPSP.

Annen: Individuell svangerskapsomsorg med CPSP

Comprehensive Perinatal Services Program (CPSP) er et statlig finansiert program for Medi-Cal-kvalifiserte familier for å motta forbedret omsorg og servicekoordinering. Deltakere som er tildelt individuell CPSP-omsorg, kan delta i CPSP-vurderingene med en omfattende perinatal helsearbeider på deres prenatal omsorgssted, hvor individuell svangerskapsomsorg vil bli gitt

Endringer i pasienthelsespørreskjema (PHQ-9) Score

Endringer i alvorlighetsgraden av depressive symptomer fra baseline til postpartum. Vurdert ved hjelp av pasienthelsespørreskjemaet (PHQ-9), administrert personlig ved baseline og under telefonintervju tre måneder etter fødselen. Total poengsum varierer fra 0-27 med høyere poengsum som indikerer mer alvorlig depresjon.

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.