Engagera mödrar och bebisar; En ny undersökning om mödravård för alla (EMBRACE). (EMBRACE)

Aktiv komparator: Glöd! Förlossningsvård i grupp

Mödravård i grupp med omslutande tjänster.

Övrig: Glöd! Förlossningsvård i grupp

Glöd! är en förbättrad grupp mödravårdsmodell som erbjuder samlokaliserade sociala tjänster som tillhandahålls av etablerade samhällsprogram med oberoende finansieringsströmmar inriktade på låginkomstfamiljer. Glöden! grupp mödravårdsmodellen kopplar ihop en utbildad handledare med en legitimerad mödravårdsläkare från en praktikplats för att tillhandahålla fakturerbar mödravård till mottagningens egna patienter. Under loppet av 8-10 sessioner får 10-12 kvinnor (inom en 6-veckors graviditetsålder) prenatal medicinsk vård, riskbedömningar och socialt stöd, och får kunskap och färdigheter relaterade till graviditet, födelse och föräldraskap.

Aktiv komparator: Individuell mödravård- CPSP

Individuell mödravård med tilläggstjänster som omfattas av CPSP.

Övrig: Individuell mödravård med CPSP

Comprehensive Perinatal Services Program (CPSP) är ett statligt finansierat program för Medi-Cal-berättigade familjer att få förbättrad vård och servicesamordning. Deltagare som tilldelats individuell CPSP-vård kan delta i CPSP-bedömningarna med en omfattande perinatal hälsoarbetare på deras mödravårdsplats, där individuell mödravård kommer att tillhandahållas

Förändringar i Patient Health Questionnaire (PHQ-9) Poäng

Förändringar i svårighetsgraden av depressiva symtom från baslinje till postpartum. Bedöms med hjälp av Patient Health Questionnaire (PHQ-9), administrerat personligen vid baslinjen och under telefonintervju tre månader efter förlossningen. Totalpoäng varierar från 0-27 med högre poäng som indikerar svårare depression.

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.