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Cluster randomized controlled trial of group prenatal care: Perinatal outcomes among adolescents in New York city health centers

Author

Listed:
  • Ickovics, J.R.
  • Earnshaw, V.
  • Lewis, J.B.
  • Kershaw, T.S.
  • Magriples, U.
  • Stasko, E.
  • Rising, S.S.
  • Cassells, A.
  • Cunningham, S.
  • Bernstein, P.
  • Tobin, J.N.

Abstract

Objectives. We compared an evidence-based model of group prenatal care to traditional individual prenatal care on birth, neonatal, and reproductive health outcomes. Methods. We performed a multisite cluster randomized controlled trial in 14 health centers in New York City (2008-2012).Weanalyzed 1148 pregnant women aged 14 to 21 years, at less than 24 weeks of gestation, and not at high obstetrical risk. We assessed outcomes via medical records and surveys. Results. In intention-to-treat analyses, women at intervention sites were significantly less likely to have infants small for gestational age (> 10th percentile; 11.0% vs 15.8%; odds ratio = 0.66; 95% confidence interval = 0.44, 0.99). In as-treated analyses, women with more group visits had better outcomes, including small for gestational age, gestational age, birth weight, days in neonatal intensive care unit, rapid repeat pregnancy, condom use, and unprotected sex (P = .030 to > .001). There were no associated risks. Conclusions. CenteringPregnancy Plus group prenatal care resulted in more favorable birth, neonatal, and reproductive outcomes. Successful translation of clinical innovations to enhance care, improve outcomes, and reduce cost requires strategies that facilitate patient adherence and support organizational change.

Suggested Citation

  • Ickovics, J.R. & Earnshaw, V. & Lewis, J.B. & Kershaw, T.S. & Magriples, U. & Stasko, E. & Rising, S.S. & Cassells, A. & Cunningham, S. & Bernstein, P. & Tobin, J.N., 2016. "Cluster randomized controlled trial of group prenatal care: Perinatal outcomes among adolescents in New York city health centers," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 359-365.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.302960_9
    DOI: 10.2105/AJPH.2015.302960
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    Citations

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    Cited by:

    1. Shayna D. Cunningham & Ryan A. Sutherland & Chloe W. Yee & Jordan L. Thomas & Joan K. Monin & Jeannette R. Ickovics & Jessica B. Lewis, 2021. "Group Medical Care: A Systematic Review of Health Service Performance," IJERPH, MDPI, vol. 18(23), pages 1-19, December.
    2. Jordan L. Thomas & Jessica B. Lewis & Jeannette R. Ickovics & Shayna D. Cunningham, 2021. "Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women," IJERPH, MDPI, vol. 18(7), pages 1-10, April.
    3. Van De Griend, Kristin M. & Billings, Deborah L. & Frongillo, Edward A. & Hilfinger Messias, DeAnne K. & Crockett, Amy H. & Covington-Kolb, Sarah, 2020. "Core strategies, social processes, and contextual influences of early phases of implementation and statewide scale-up of group prenatal care in South Carolina," Evaluation and Program Planning, Elsevier, vol. 79(C).
    4. Jessica Harding & Jean Knab & Susan Zief & Kevin Kelly & Diana McCallum, "undated". "A Systematic Review of Programs to Promote Aspects of Teen Parents’ Self-Sufficiency: Supporting Educational Outcomes and Healthy Birth Spacing," Mathematica Policy Research Reports 05e656f1b4a54dae83654795b, Mathematica Policy Research.

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