1Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, OH.
2Esperanza Health Center, Philadelphia, PA.
J Altern Complement Med. 2019 Jul;25(7):727-732. doi: 10.1089/acm.2019.0090.
For CenteringParenting-an integrated, group participatory approach to maternal and child health-this study aimed to explore maternal participants' experiences and children's clinical metrics compared with those receiving traditional well-care visits in the same community health center. A mixed-methods approach evaluated the impact of the CenteringParenting program on infant outcomes and maternal and staff experiences. This study was conducted at Neighborhood Family Practice (NFP), an urban federally qualified community health center on the west side of Cleveland, Ohio. NFP is an accredited Centering Health care Institute site for both CenteringPregnancy and CenteringParenting. Consecutive participants from the CenteringParenting program at NFP were included with age-matched controls. Quantitative outcome measures included the number of well-child visits attended, immunization and lead screening rates, as well as breastfeeding initiation and duration. Semistructured interviews assessed maternal, provider, and program staff satisfaction with the program. Children participating in CenteringParenting as compared with traditional individual care were demographically similar. Well-child care visits in the first 15 months of life were higher in the CenteringParenting Group (9.19 vs. 5.28, < 0.001), which also exhibited a trend toward higher rates of completing noninfluenza immunizations. There was no difference in lead screening, with high percentages of completion in both groups. Interviews discovered strong maternal, clinician, and staff satisfaction with the program. Mothers noted the unique benefits of learning from and building relationships with each other. This study in a community health center indicates that innovative group care models, such as CenteringParenting, hold promise for delivering value-added elements of social interaction between parents and health care staff, in addition to increasing the number of visits attended by parents and children in the first 15 months of life. Future study is needed to further elucidate maternal, population health, and cost benefits.
对于以综合、小组参与为特色的母婴健康方法——“核心父母”（CenteringParenting），本研究旨在探索参与该方法的产妇的体验以及与同一社区健康中心中接受传统常规保健就诊的儿童的临床指标。本研究采用混合方法评估“核心父母”项目对婴儿结局以及产妇和工作人员体验的影响。该研究在位于俄亥俄州克利夫兰市西侧的城市联邦合格社区健康中心——邻里家庭实践（Neighborhood Family Practice，NFP）开展。NFP 既是“核心妊娠”（CenteringPregnancy）也是“核心父母”（CenteringParenting）的认证“核心健康关怀”（Centering Health care Institute）机构。NFP 的“核心父母”项目中连续的参与者与年龄匹配的对照组一起纳入研究。定量结果包括接受的常规儿童保健就诊次数、免疫和铅筛查率，以及母乳喂养开始和持续时间。半结构化访谈评估了产妇、提供者和项目工作人员对项目的满意度。与接受传统个体保健的儿童相比，参与“核心父母”项目的儿童在人口统计学方面相似。在生命的头 15 个月中，“核心父母”组的常规儿童保健就诊次数更多（9.19 次 vs. 5.28 次， < 0.001），且非流感疫苗接种完成率也呈上升趋势。两组的铅筛查率没有差异，均完成度较高。访谈发现了产妇、临床医生和工作人员对项目的强烈满意度。母亲们注意到了从彼此身上学习和建立关系的独特好处。这项在社区健康中心开展的研究表明，创新性的小组护理模式（如“核心父母”）有望在增加父母和儿童在前 15 个月的就诊次数之外，为父母和医疗保健人员之间的社交互动提供附加值。还需要进一步研究以阐明产妇、人群健康和成本效益。
