Daily Catherine, Gresh Ashley, Hamilton Elizabeth R, Marea Christina X
Georgetown University School of Nursing, Washington, District of Columbia.
Mary's Center, Washington, District of Columbia.
J Midwifery Womens Health. 2024 Nov-Dec;69(6):945-951. doi: 10.1111/jmwh.13701. Epub 2024 Oct 28.
The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care. Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling. The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.
在2019年冠状病毒病(COVID-19)大流行期间,远程医疗产前护理的使用呈指数级增长,但目前尚无文献描述在此期间其用于团体产前护理的情况。COVID-19大流行还加剧了护理方面的结构性障碍,这些障碍对黑人和拉丁裔人群的影响尤为严重。远程医疗使孕妇能够获得医疗保健并将感染风险降至最低。远程医疗团体产前护理(T-GPNC)将“集中孕期护理”的基本要素与远程医疗相结合,是COVID-19大流行期间因需要而产生的一种创新护理提供方式,有潜力减轻护理方面的结构性障碍。玛丽中心是华盛顿特区和马里兰州的一家联邦合格健康中心(FQHC),在大流行初期迅速转向了个体远程医疗产前护理。玛丽中心利用我们在团体护理方面的经验以及来自集中医疗保健研究所关于虚拟集中护理的指导,推出了T-GPNC。这种新模式包括家庭自我监测设备和视频教室,并与面对面的个体护理就诊相结合。我们采用了由护士、助产士和社区卫生工作者组成的团队协作方法,为孕妇提供全面护理。我们强大的护理协调团队还将她们与家庭访视、心理健康服务和营养咨询联系起来。本文的目的是描述玛丽中心如何遵循“集中孕期护理”的特点,为远程医疗修改团体产前护理的“集中孕期护理”模式,并满足说西班牙语的客户(即拉丁裔客户)的需求。第二个目的是展示远程医疗如何扩大医疗保健的可及性,并消除可能阻止孕妇参加面对面预约的结构性障碍。我们还在项目实施的背景下讨论了数字接入和数字素养方面的结构性不平等问题。