Preterm Birth Prevention: Marrying Centering Pregnancy and Community Health Workers
Title: Preterm Birth Prevention: Marrying Centering Pregnancy and Community Health Workers
- To describe an innovative program on the development of a centering pregnancy program for low-income women at high risk for preterm birth.
- To describe the development and implementation of an innovative program using community health workers serving as pregnancy peer mentors for low-income pregnant women at high risk for preterm birth.
- To describe the implementation of moving a medically based outpatient clinic model to a centering pregnancy model of care.
The goal of this proposal is to test a new model of coordinated and enhanced services for pregnant women, over and above traditional prenatal services, to improve perinatal outcomes for high-risk low-income women on Medicaid or CHIP, and ultimately reduce the risk of preterm births and improve health outcomes for babies in the first year of life. The innovative collaborative interdisciplinary program is designed to improve patient care and coordination, improve maternal and perinatal health outcomes, and, ultimately, reduce healthcare costs utilizing a centering model of care. The proposed project has selected areas of high-risk and high need that are served by different healthcare delivery systems where preterm birth statistics are alarming.
Proposed change: The goal of the program is to transform existing models of prenatal care to centering models of health for improved materna, and perinatal health outcomes and reduction of healthcare costs.
Implementation, outcomes and evaluation: Low-income pregnancy women will be identified by their Medicaid provider and prenatal care provider. Utilizing the components of Rising’s Centering Pregnancy Model (1998), prenatal care participating Federally Qualified Health Centers (FQHCs), with advisory support an academic setting, will implement and support the Centering Pregnancy group education model of enhanced prenatal care. Four FQHCs will participate in the transformation of a traditional medical model of prenatal care to a centering model of care, women who are pregnant will be enrolled in the centering program. All pregnant clients will be partnered with a culturally and linguistically appropriate trained community health worker that will serve as the client's pregnancy peer mentor. Data will be extracted from the FQHCs and tracked for perinatal health outcomes, healthcare utilization and costs, care coordination, and birth outcomes.Implications for nursing practice: Preterm birth is a critical public health problem in the United States (U.S.). Preterm birth is a complex, multifactorial process that accounts for 12% of all live births, and over 500,000 premature births annually. One in eight infants are born premature in the U.S. Infant prematurity is the leading cause of neonatal death in the U.S., and is responsible for 27% of infant deaths, or 1 million infant deaths annually. Prematurity is the leading cause of death among African American newborns as compared to non-Hispanic White newborns. The centering pregnancy model of care, primarily used in midwifery care centers has demonstrated reductions in preterm birth. Implication for improved maternal-child outcomes are vast.
Implications for nursing practice: see above
Keywords: Preterm Birth, Centering Pregnancy, Community Health Workers