Poster Session 2
Category: Obstetric Quality and Safety
Poster Session 2
Patience A. Afulani, MBCHB, MPH, PhD (she/her/hers)
Associate Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
Universiy of California San Francisco, California, United States
Daisy León-Martínez, MD (she/her/hers)
Assistant Professor
Division of Maternal-Fetal Medicine at the University of California San Francisco
University of California San Francisco, California, United States
Bethany Simard, MPH
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
UCSF, California, United States
Cinthia Blat, MPH
Data Systems Supervisor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
San Francisco, California, United States
Venise Curry, MD
Central Valley Health Policy Institute at California State University, Fresno
Fresno, California, United States
Kristin Carraway, MPH
Project Manager
Central Valley Health Policy Institute at California State University, Fresno
Fresno, California, United States
Kimberly Coleman-Phox, MPH
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
San Francisco, California, United States
Brittany D. Chambers Butcher, MPH, PhD (she/her/hers)
Associate Professor
Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
Davis, California, United States
Bridgette Blebu, PhD, MPH (she/her/hers)
Assistant Professor
Lundquist Institute for Biomedical Innovation - Harbor-UCLA
Los Angeles, California, United States
Jennifer N. Felder, PhD
Associate Professor
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
San Francisco, California, United States
Deborah Karasek, MPH, PhD
Assistant Professor
Oregon Health & Science University-Portland State University School of Public Health
Portland, Oregon, United States
Mary A. Garza, MPH, PhD
Central Valley Health Policy Institute at California State University, Fresno
Fresno, California, United States
Martha A. Tesfalul, MD
Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
San Francisco, California, United States
Christopher Downer, MD
Associate Professor
Medical Education Program, University of California, San Francisco, Fresno
Fresno, California, United States
Charles E. McCulloch, BA, MA, MS, PhD
Professor
University of California, San Francisco
University of California San Francisco, California, United States
Miriam Kuppermann, MPH, PhD (she/her/hers)
Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
University of California San Francisco, California, United States
To compare the effect of enhanced group (eGPC) and enhanced individual prenatal care (eIPC) models on prenatal care experience.
Study Design:
Engaging Mothers and Babies; Reimagining Antenatal Care for Everyone (EMBRACE) was a pragmatic, two-arm, randomized trial comparing the effect of eGPC vs eIPC on depression (primary), experience of care (secondary), and preterm birth (exploratory) among Medicaid-eligible pregnant people in California’s San Joaquin Valley. The primary outcome of this analysis was Person-Centered Prenatal Care (PCPC), measured with the PCPC-US scale. Secondary outcomes of care experience were measured with the Mothers on Respect index (MORi) and the Prenatal Care Satisfaction (PCS) scale, all completed at 30–34 weeks gestation. Summative scores were generated for all scales and standardized to range from 0 to 100, with higher scores indicating better care experience. We used an intention-to-treat approach in the primary analysis; subgroup analyses were conducted by prenatal care attendance (≥1 visit, ≥4 visits) and self-reported race and ethnicity (Black, Latine). Analyses included mean differences in scores and restricted maximum likelihood mixed linear regression models adjusted for language of interview with random intercepts for provider. The analytic sample includes 526 participants (n=223 eGPC, n=303 eIPC).
Results:
Most participants identified as Latine (72.2%). Prenatal care experience scores were generally high for both groups, with PCPC scores of 92.8±0.91 for eGPC participants and 90.9±0.81 for eIPC participants. Although eGPC participants had a slightly better experience than eIPC participants, differences did not reach statistical significance, with adjusted mean differences in scores for participants randomized to eGPC versus eIPC at 1.96 (CI:-0.16,4.08), 0.39 (CI:-1.63,2.41), 2.68 (CI:-0.72,6.09) for PCPC, MORi, and PCS, respectively. The subgroup analysis yielded similar findings.
Conclusion:
The findings suggest that both enhanced prenatal models may result in favorable care experiences for low-income populations.