Envolvendo Mães e Bebês; Estudo Reimagining Prenatal Care for Everyone (EMBRACE) (EMBRACE)

Comparador Ativo: Brilho! Pré-Natal em Grupo

Pré-natal em grupo com serviços envolventes.

Outro: Brilho! Pré-Natal em Grupo

Brilho! é um modelo aprimorado de atendimento pré-natal em grupo que oferece serviços sociais co-localizados fornecidos por programas comunitários estabelecidos com fluxos de financiamento independentes voltados para famílias de baixa renda. O brilho! o modelo de atendimento pré-natal em grupo combina um facilitador treinado com um profissional de atendimento pré-natal licenciado de um local de prática para fornecer atendimento pré-natal pago aos próprios pacientes do consultório. Ao longo de 8 a 10 sessões, 10 a 12 mulheres (dentro de uma faixa de idade gestacional de 6 semanas) recebem cuidados médicos pré-natais, avaliações de risco e apoio social, e adquirem conhecimento e habilidades relacionadas à gravidez, parto e paternidade.

Comparador Ativo: Pré-Natal Individual - CPSP

Pré-natal individual com serviços complementares cobertos pelo CPSP.

Outro: Pré-Natal Individual com CPSP

Programa de serviços perinatais abrangentes (CPSP) é um programa financiado pelo estado para famílias qualificadas do Medi-Cal receberem cuidados aprimorados e coordenação de serviços. Os participantes designados para atendimento individual do CPSP podem participar das avaliações do CPSP com um profissional de saúde perinatal abrangente em seu local de atendimento pré-natal, onde o atendimento pré-natal individual será fornecido

Mudanças na pontuação do questionário de saúde do paciente (PHQ-9)

Mudanças na gravidade dos sintomas depressivos desde o início até o pós-parto. Avaliado por meio do Questionário de Saúde do Paciente (PHQ-9), administrado pessoalmente no início do estudo e durante entrevista por telefone três meses após o parto. A pontuação total varia de 0 a 27, com pontuações mais altas indicando depressão mais 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.