Telehealth to Improve Perinatal Care Access

Stanley, Angela Y; Wallace, Jerrol B

doi:10.1097/nmc.0000000000000841

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Implementing programs such as NFP or integrating interventions based off NFP principles within rural public health nursing may offer valuable resources and support to this underserved population. Integration of telehealth services for the maternity population may also improve access to perinatal care for women in rural areas, thus addressing the theme of geographical isolation as described by our participants ( Latendresse et al, 2023;Stanley & Wallace, 2022).…”

Section: Discussionmentioning

confidence: 97%

Challenges in Accessing Mental Health Care during Pregnancy and Postpartum in Rural Montana

Hanson

Reese

Newcomer

2023

McN: The American Journal of Maternal/Child Nursing

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Purpose: Postpartum depression is a well-known maternal health care concern. For women using substances or experiencing underlying mental health conditions, incidence of postpartum depression is higher than that of the general population. The purpose of this study was to identify barriers and facilitators associated with seeking mental health care among women with substance use disorder or mental health concerns. Study Design and Methods: Qualitative methods using interviews were conducted via the narrative inquiry approach. Women receiving care at a clinic in rural Montana and reporting substance use or mental health concerns were referred to the research team by the care manager. Participants were at least 18 years of age, English speaking, and pregnant or within 12 months postpartum at time of referral. Results: Twenty-five women met inclusion criteria and were referred for potential study participation. Seven women were interviewed. Four themes on family history, stigmatization, lack of postpartum depression awareness, and isolation were identified. Clinical Implications: Our findings provide a better understanding of barriers and facilitators to seeking mental health care during pregnancy and postpartum among women living in rural areas with mental health concerns or perinatal substance use. An environment where opportunities for women to receive mental health care in a location that is free of stigma and judgment, while understanding the effects of familial trauma and limited or inconsistent social support, is essential to promote optimal outcomes.

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Section: Discussionmentioning

confidence: 97%

Challenges in Accessing Mental Health Care during Pregnancy and Postpartum in Rural Montana

Hanson

Reese

Newcomer

2023

McN: The American Journal of Maternal/Child Nursing

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Racial and Ethnic and Rural Variations in the Use of Hybrid Prenatal Care in the US

Hung,

Yu,

Harrison

et al. 2024

JAMA Netw Open

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ImportanceUnderstanding whether there are racial and ethnic and residential disparities in prenatal telehealth uptake is necessary for ensuring equitable access and guiding implementation of future hybrid (ie, both telehealth and in-person) prenatal care.ObjectiveTo assess temporal changes in individuals using hybrid prenatal care before and during the COVID-19 public health emergency (PHE) by race and ethnicity and residence location in the US.Design, Setting, and ParticipantsThis retrospective cohort study analyzed electronic health record data of prenatal care visits from the National COVID Cohort Collaborative Data Enclave, comprising data from 75 health systems and freestanding institutes in all 50 US states. Data were analyzed on 349 682 nationwide pregnancies among 349 524 people who gave birth from June 1, 2018, through May 31, 2022. Multivariable generalized estimating equations were used to examine variations in receiving hybrid vs only in-person prenatal care. Data phenotyping and analysis occurred from June 13, 2023, to September 27, 2024.ExposuresPrenatal period overlap (never, partially, or fully overlapping) with the COVID-19 PHE, maternal race and ethnicity, and urban or rural residence.Main Outcomes and MeasuresHybrid vs in-person–only prenatal care.ResultsOf 349 682 pregnancies (mean [SD] age, 29.4 [5.9] years), 59 837 (17.1%) were in Hispanic or Latino individuals, 14 803 (4.2%) in non-Hispanic Asian individuals, 65 571 (18.8%) in non-Hispanic Black individuals, 162 677 (46.5%) in non-Hispanic White individuals, and 46 794 (13.4%) in non-Hispanic individuals from other racial and ethnic groups. A total of 31 011 participants (8.9%) resided in rural communities. Hybrid prenatal care increased from nearly none before March 2020 to a peak of 8.1% telehealth visits in November 2020, decreasing slightly to 6.2% by March 2022. Among the fully overlapping group, urban residents had nearly 2-fold odds of hybrid prenatal care compared with rural people (adjusted odds ratio [AOR], 1.98; 95% CI, 1.84-2.12). Hispanic or Latino people (AOR, 1.48; 95% CI, 1.41-1.56), non-Hispanic Asian people (AOR, 1.47; 95% CI, 1.35-1.59), and non-Hispanic Black people (AOR, 1.18; 95% CI, 1.12-1.24) were more likely to receive hybrid prenatal care than non-Hispanic White people.Conclusions and RelevanceIn this cohort study, hybrid prenatal care increased substantially during the COVID-19 PHE, but pregnant people living in rural areas had lower levels of hybrid care than urban people, and individuals who belonged to racial and ethnic minority groups were more likely to have hybrid care than White individuals. These findings suggest that strategies that improve equitable access to telehealth for people who live in rural areas and people in some minority racial and ethnic groups may be useful.

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