Impact of Two Scheduling Systems on Early Enrollment in a Group Prenatal Care Program

Authors

  • Barbara Hackley CNM, MSN,

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    • Barbara Hackley, CNM, MSN, provides individual and group prenatal care at Montefiore Medical Center, South Bronx Health Center for Children and Families, Bronx, NY, and is an Associate Professor at Yale University School of Nursing, New Haven, CT. She has presented on implementation and adoption of the group prenatal care model in a community health center at national conferences.

  • Jo Applebaum MPH,

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    • Jo Applebaum, MPH, is a Research Analyst at Montefiore Medical Center, Community Pediatric Programs, Bronx, NY. She has been involved in the implementation and evaluation of the group prenatal care program at South Bronx Health Center for Children and Families.

  • Wendy C. Wilcox MD, MPH,

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    • Wendy C. Wilcox, MD, MPH, FACOG, is currently Vice Chairperson and Assistant Professor in the Department of Obstetrics and Gynecology, North Bronx Healthcare Network/Jacobi Medical Center and North Central Bronx Hospital, Bronx, NY. She was one of the founding providers of group prenatal care at the South Bronx Health Center for Children and Families and has presented at various conferences on the implementation of group care.

  • Sandra Arevalo RD, MPH

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    • Sandra Arevalo, RD, MPH, graduated from the nutrition and public health program at Hunter College in 2005 and currently is the Nutrition Coordinator at the South Bronx Health Center for Children and Families, Bronx, NY. She has been involved in the implementation and evaluation of the nutritional component of group prenatal care.


Women's Health Services, Montefiore South Bronx Health Center for Children and Families, Associate Professor, Yale University School of Nursing, 871 Prospect Ave., Bronx, NY 10459. E-mail: Barbara.hackley@yale.edu

Abstract

Group care is an effective approach to prenatal care. Yet difficulties in recruiting, enrolling, and scheduling women into group care present obstacles to optimal program delivery. The purpose of this study was to determine whether the use of a scheduling system based on women's estimated date of delivery (EDD) decreased gestational age at entry to group care, increased attendance, and improved continuity of care. A total of 13 groups were held; seven groups used a scheduling system based on appointment availability and six groups used a scheduling system based on women's EDD. Compared with the availability-based scheduling system, the EDD-based system decreased mean gestational age (23.2 vs. 21.8 weeks; P = .058) and significantly decreased mean maximum gestational age (31.0 vs. 26.3 weeks; P = .002) at entry to group care. The EDD-based system increased the mean number of sessions offered per group (6.7 vs. 8.2 sessions; P < .001); however, attendance rates were similar across systems. The EDD-based system also increased the percentage of women who had the same initial visit and group provider (78.0% vs. 85.5%; P = .303). The use of this system by other health care facilities could ease the task of enrolling a sufficient number of participants into group care, minimize the need for women to change care providers if they desire group care, and allow more time for educational activities and the development of social networks for women by offering more sessions per group.

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