Lessard Lauren, Oberholtzer Christy, Shaver Amber, Newel Gail, Middleton Ellen, Kuppermann Miriam, Fuchs Jonathan, Garza Mary A, Rand Larry, Capitman John
California State University Fresno, Fresno, CA, USA.
University of California San Francisco, Fresno, CA, USA.
Health Promot Pract. 2023 Sep;24(5):895-902. doi: 10.1177/15248399221098015. Epub 2022 Jun 4.
In response to disproportionately high rates of infant mortality and preterm birth among women of color and women in poverty in Fresno County, California, community and academic partners coordinated a community-based participatory research (CBPR) project with local residents. Social isolation and stress, inaccessible prenatal care, and dissatisfaction with care experiences were identified as leading predictors of poor birth outcomes. The PRECEDE-PROCEED framework was used to lead the CBPR effort that resulted in the development of a model of group prenatal care, named Glow! Group Prenatal Care Program (Glow! Program). Group prenatal care (GPNC), which focuses on pregnancy health assessments, education, and peer support, has the potential to address the health and social priorities of women during pregnancy. As a result of the employed CBPR process and the extensive participation from stakeholders, this modified GPNC model responds to the unique needs of the at-risk community members, the agencies aiming to improve maternal-child health experiences and outcomes, and the prenatal care providers offering it to their patients. The methods from this study can be applied in the design and implementation of community-based health care interventions. Returning to community partners throughout the design, implementation, and evaluation phases underscored that health care interventions cannot be designed in silos, and require flexibility to respond to factors that promote improved maternal and infant outcomes, which affect the end goal for the intervention.
针对加利福尼亚州弗雷斯诺县有色人种女性和贫困女性中婴儿死亡率和早产率过高的问题，社区和学术伙伴与当地居民协调开展了一项基于社区的参与性研究（CBPR）项目。社会隔离和压力、难以获得产前护理以及对护理体验的不满被确定为不良分娩结局的主要预测因素。采用PRECEDE-PROCEED框架引领CBPR工作，最终开发出了一种团体产前护理模式，名为“焕发光彩！团体产前护理项目”（“焕发光彩！项目”）。团体产前护理（GPNC）专注于孕期健康评估、教育和同伴支持，有潜力解决女性孕期的健康和社会优先事项。由于采用了CBPR流程以及利益相关者的广泛参与，这种经过改进的GPNC模式回应了高危社区成员、旨在改善母婴健康体验和结局的机构以及为患者提供产前护理的提供者的独特需求。本研究的方法可应用于基于社区的医疗保健干预措施的设计和实施。在设计、实施和评估阶段回归社区伙伴强调，医疗保健干预措施不能孤立设计，需要具备灵活性以应对促进改善母婴结局的因素，这些因素会影响干预的最终目标。
