Somerville Caitlin, Shireman Hannah, Geppert Amanda, McHugh Ashley, White VanGompel Emily, Holl Jane L, Stulberg Debra B
Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
Department of Family Medicine, University of Chicago, Chicago, Illinois, USA.
Womens Health Rep (New Rochelle). 2024 Dec 13;5(1):1032-1039. doi: 10.1089/whr.2024.0110. eCollection 2024.
Many reproductive age women, cared for routinely by primary care providers (PCPs), would benefit from interconception care, yet a minority of primary care visits include interconception care. This study assessed barriers to providing interconception care from the perspective of primary care clinicians, staff, and patients.
Clinicians ( = 11), staff ( = 14), and patients eligible for interconception care ( = 6) from three primary care clinics in Chicago, Illinois participated in focus groups or interviews. Sessions with clinicians and staff elicited descriptions of their clinic's current care delivery processes; sessions with patients focused on their experiences accessing care following pregnancy. Data were used to produce a process map and to identify barriers and facilitators to providing interconception care. Sessions were audio-recorded, transcribed, and thematically analyzed using Dedoose. Findings on barriers are presented here.
Processes for clinics to identify patients eligible for interconception care are lacking. PCPs do not routinely receive information about their patients' prior pregnancies, and relevant information can be hard to access. While patients describe many care needs between pregnancies, they are unsure of where to turn for help: their PCP, obstetrical clinician, or other sources. Contributing organizational limitations involve clinic structure, appointment availability, resources, and insurance coverage.
Multiple barriers in current primary care systems and processes contribute to poor interconception care delivery. These findings, given the known benefits of interconception care, can inform human-centered design to overcome barriers.
许多由初级保健提供者（PCP）常规护理的育龄妇女将从孕后护理中受益，但只有少数初级保健就诊包含孕后护理。本研究从初级保健临床医生、工作人员和患者的角度评估了提供孕后护理的障碍。
来自伊利诺伊州芝加哥市三家初级保健诊所的临床医生（n = 11）、工作人员（n = 14）以及符合孕后护理条件的患者（n = 6）参加了焦点小组或访谈。与临床医生和工作人员的会议引出了他们诊所当前护理提供流程的描述；与患者的会议则聚焦于他们怀孕后获得护理的经历。数据用于生成流程图，并识别提供孕后护理的障碍和促进因素。会议进行了录音、转录，并使用Dedoose进行主题分析。此处呈现关于障碍的研究结果。
诊所缺乏识别符合孕后护理条件患者的流程。初级保健提供者通常不会收到关于其患者既往妊娠的信息，且相关信息可能难以获取。虽然患者描述了孕期之间的许多护理需求，但他们不确定向何处寻求帮助：他们的初级保健提供者、产科临床医生或其他来源。相关的组织限制包括诊所结构、预约可用性、资源和保险覆盖范围。
当前初级保健系统和流程中的多重障碍导致孕后护理提供不佳。鉴于孕后护理的已知益处，这些发现可为以人为主的设计提供参考，以克服障碍。
