Zaangażowanie matek i dzieci; Nowe wyobrażenie opieki przedporodowej dla każdego (EMBRACE). (EMBRACE)

Aktywny komparator: Blask! Grupowa Opieka Prenatalna

Grupowa opieka prenatalna z usługami towarzyszącymi.

Inny: Blask! Grupowa Opieka Prenatalna

Blask! to udoskonalony grupowy model opieki prenatalnej, który oferuje kolokowane usługi socjalne świadczone przez ustanowione programy społeczne z niezależnymi strumieniami finansowania skierowanymi do rodzin o niskich dochodach. Blask! grupowy model opieki prenatalnej łączy wyszkolonego facylitatora z licencjonowanym lekarzem prenatalnym z miejsca praktyki, aby zapewnić płatną opiekę prenatalną swoim pacjentkom. W ciągu 8-10 sesji 10-12 kobiet (w przedziale wieku ciążowego 6 tygodni) otrzymuje prenatalną opiekę medyczną, ocenę ryzyka i wsparcie społeczne oraz zdobywa wiedzę i umiejętności związane z ciążą, porodem i rodzicielstwem.

Aktywny komparator: Indywidualna Opieka Prenatalna- CPSP

Indywidualna opieka prenatalna wraz z usługami dodatkowymi objętymi CPSP.

Inny: Indywidualna Opieka Prenatalna z CPSP

Comprehensive Perinatal Services Program (CPSP) to finansowany przez państwo program dla rodzin kwalifikujących się do programu Medi-Cal w celu uzyskania udoskonalonej opieki i koordynacji usług. Uczestnicy przydzieleni do indywidualnej opieki CPSP mogą uczestniczyć w ocenach CPSP z pracownikiem kompleksowej opieki okołoporodowej w ich miejscu opieki prenatalnej, gdzie zapewniona zostanie indywidualna opieka prenatalna

Zmiany w punktacji w Kwestionariuszu Zdrowia Pacjenta (PHQ-9).

Zmiany w nasileniu objawów depresji od stanu wyjściowego do okresu poporodowego. Oceniano za pomocą Kwestionariusza Zdrowia Pacjentki (PHQ-9), podawanego osobiście na początku badania i podczas wywiadu telefonicznego trzy miesiące po porodzie. Całkowity wynik waha się od 0 do 27, przy czym wyższe wyniki wskazują na cięższą depresję.

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.