Using Community-Based Participatory Research to Design a Patient and Practitioner-Centered Group Prenatal Care Model

Abstract

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.

A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic

“…The original group prenatal care model had been developed through several community engagement activities; the adaptation process expanded on these activities by soliciting community feedback from additional stakeholders, including people with low income who had been pregnant during the pandemic. 23 We recruited from the Black Infant Health Program to increase the representation of Black/African American participants in the qualitative study. Participants in this qualitative study consisted of Medicaid-eligible individuals, who self-identified as Black, Latinx, or multi-racial, and were either pregnant or gave birth in Fresno, California, during the COVID-19 pandemic.…”