Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
BMC Public Health. 2012 Feb 1;12:93. doi: 10.1186/1471-2458-12-93.
We describe participation rates in a special interconceptional care program that addressed all commonly known barriers to care, and identify predictors of the observed levels of participation in this preventive care service.
A secondary analysis of data from women in the intervention arm of an interconceptional care clinical trial in Philadelphia (n = 442). Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services (herein called Andersen model) was used as a theoretical base. We used a multinomial logit model to analyze the factors influencing women's level of participation in this enhanced interconceptional care program.
Although common barriers were addressed, there was variable participation in the interconceptional interventions. The Andersen model did not explain the variation in interconceptional care participation (Wald ch sq = 49, p = 0.45). Enabling factors (p = 0.058), older maternal age (p = 0.03) and smoking (p = < 0.0001) were independently associated with participation.
Actively removing common barriers to care does not guarantee the long-term and consistent participation of vulnerable women in preventive care. There are unknown factors beyond known barriers that affect participation in interconceptional care. New paradigms are needed to identify the additional factors that serve as barriers to participation in preventive care for vulnerable women.
我们描述了参与一个特殊的围孕期保健计划的情况，该计划解决了所有已知的保健障碍，并确定了观察到的这种预防保健服务参与水平的预测因素。
对费城围孕期保健临床试验干预组的女性（n=442）的数据进行二次分析。盖尔伯格-安德森弱势群体健康服务行为模型（以下简称安德森模型）被用作理论基础。我们使用多项逻辑回归模型来分析影响妇女参与这种强化围孕期保健计划的因素。
尽管解决了常见的障碍，但围孕期干预的参与程度存在差异。安德森模型不能解释围孕期保健参与的变化（Wald ch sq = 49，p = 0.45）。有利因素（p = 0.058）、产妇年龄较大（p = 0.03）和吸烟（p < 0.0001）与参与独立相关。
积极消除保健障碍并不能保证弱势妇女长期和持续地参与预防保健。除了已知的障碍之外，还有未知的因素影响着围孕期保健的参与。需要新的模式来确定影响弱势妇女参与预防保健的其他因素。
