Telephone interviews are largely neglected in the qualitative research literature and, when discussed, they are often depicted as a less attractive alternative to face-to-face interviewing. The absence of visual cues via telephone is thought to result in loss of contextual and nonverbal data and to compromise rapport, probing, and interpretation of responses. Yet, telephones may allow respondents to feel relaxed and able to disclose sensitive information, and evidence is lacking that they produce lower quality data. This apparent bias against telephone interviews contrasts with a growing interest in electronic qualitative interviews. Research is needed comparing these modalities, and examining their impact on data quality and their use for studying varying topics and populations. Such studies could contribute evidence-based guidelines for optimizing interview data.

Objectives-To identify, synthesize and critically analyze published research on women's experiences of prenatal care.Methods-A search of online databases and relevant citations for research published from 1996 −2007 was conducted. Thirty-six articles were reviewed. Qualitative analysis methods were used, assisted by research software.Results-Some women were treated respectfully and reported comprehensive, individualized care. However, some women experienced long waits and rushed visits, and perceived prenatal care as mechanistic or harsh. Women's preferences included reasonable waits, unhurried visits, continuity, flexibility, comprehensive care, meeting with other pregnant women in groups, developing meaningful relationships with professionals, and becoming more active participants in care. Some low income and minority women experienced discrimination or stereotyping as well as external barriers to care.Conclusions-Further research is recommended to understand women's experiences and to develop and implement evidence-based, women-centered approaches. Clinicians should inquire regarding women's needs and modify care accordingly and also advocate for institutional changes that reduce barriers to care. Implementing comprehensive, redesigned models of care may be one effective way to simultaneously address a variety of women's needs and preferences. If prenatal care becomes more attractive as well as more accessible, women's experience and pregnancy outcomes may both improve.Prenatal care is one of the most common health interventions in the United States. 1, 2 With approximately 50 million prenatal visits annually, 2 it is often viewed as indispensable for assuring healthy pregnancy outcomes. 3-5 Nonetheless, prenatal care (PNC) has produced disappointing results for the U.S., 1,6 including an international ranking of 29 th among industrialized nations in infant mortality, 7 and rising rates of low birth weight and preterm birth. 8 These critical health indicators are especially poor among certain minority and low income groups. 8,9 As researchers seek for etiologies and interventions to improve these distressing outcomes, recognition is growing that they may result from a cluster of interwoven problems. These include psychosocial and behavioral factors, environmental exposures, pre-pregnancy medical conditions, stress, racism and poverty. This awareness has led to recommendations for Contact information: Address: 65 Wright Lane, Hamden, CT 06517 gina.novick@yale.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Précis: Women reported varied experiences of, and mi...

Group prenatal care (GPNC) is an innovative alternative to individual prenatal care. In this longitudinal study we used ethnographic methods to explore African American and Hispanic women’s experiences of receiving GPNC in two urban clinics. Methods included individual, in-depth, semistructured interviews of women and group leaders in GPNC, participant observation of GPNC sessions, and medical record review. GPNC offered positive experiences and met many of the women’s expressed preferences regarding prenatal care. Six themes were identified, which represented separate aspects of women’s experiences: investment, collaborative venture, a social gathering, relationships with boundaries, learning in the group, and changing self. Taken together, the themes conveyed the overall experience of GPNC. Women were especially enthusiastic about learning in groups, about their relationships with group leaders, and about having their pregnancy-related changes and fears normalized. There were also important boundaries on relationships between participants, and some women wished for greater privacy during physical examinations.

Objective CenteringPregnancy group prenatal care has been demonstrated to improve pregnancy outcomes. However, there is likely variation in how the model is implemented in clinical practice, which may be associated with efficacy, and therefore variation, in outcomes. We examined the association of fidelity to process and content of the CenteringPregnancy group prenatal care model with outcomes previously shown to be affected in a clinical trial: preterm birth, adequacy of prenatal care and breastfeeding initiation. Study Design Participants were 519 women who received CenteringPregnancy group prenatal care. Process fidelity reflected how facilitative leaders were and how involved participants were in each session. Content fidelity reflected whether recommended content was discussed in each session. Fidelity was rated at each session by a trained researcher. Preterm birth and adequacy of care were abstracted from medical records. Participants self-reported breastfeeding initiation at 6-months postpartum. Results Controlling for important clinical predictors, greater process fidelity was associated with significantly lower odds of both preterm birth (B=−0.43, Wald χ2=8.65, P=.001) and intensive utilization of care (B=−0.29, Wald χ2=3.91, P=.05). Greater content fidelity was associated with lower odds of intensive utilization of care (B=−0.03, Wald χ2=9.31, P=.001). Conclusion Maintaining fidelity to facilitative group processes in CenteringPregnancy was associated with significant reductions in preterm birth and intensive care utilization of care. Content fidelity also was associated with reductions in intensive utilization of care. Clinicians learning to facilitate group care should receive training in facilitative leadership, emphasizing the critical role that creating a participatory atmosphere can play in improving outcomes.