Increasing Prenatal Care Compliance in At-Risk Black Women: Findings from a RCT of Patient Navigation and Behavioral Incentives.
Increasing Prenatal Care Compliance in At-Risk Black Women: Findings from a RCT of Patient Navigation and Behavioral Incentives.
复制标题
提高高危黑人女性产前护理的依从性：患者导航和行为激励随机对照试验的结果。
DOI：
10.1007/s40615-021-00995-9
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发表时间：
2022
影响因子：
3.9
通讯作者：
Masho,SabaW
中科院分区：
文献类型：
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作者：
Svikis,DaceS;Kelpin,SydneyS;Keyser-Marcus,Lori;Bishop,DianeL;Parlier-Ahmad,AnnaBeth;Jones,Heather;Villalobos,Gabriela;Varner,SaraB;Lanni,SusanM;Karjane,NicoleW;Cathers,LaurettaA;Langhorst,DianeM;Masho,SabaW
背景在美国，婴儿死亡率仍然是一个主要的公共卫生问题，特别是黑人妇女和她们的婴儿，他们继续经历不成比例的高死亡率。产前护理是婴儿健康的关键决定因素，产前护理不足会增加早产、死产、新生儿丢失和婴儿死亡的风险。本研究的目的是，以确定是否同时交付的患者导航和行为激励的风险黑人孕妇可以提高产前护理出勤率和相关的孕产妇和婴儿outcomes.MethodsParticipants的目的是150名黑人孕妇招募在第一次产前检查和筛查的风险，不利的孕产妇和婴儿的结果。女性被随机分配到患者导航+行为激励干预（PNBI）或评估+标准护理对照（ASC）组。所有人都在整个怀孕期间和产后12周进行了随访。组比较使用意向治疗和每协议的敏感性analysis.ResultsWhile没有组差异，发现在产前检查的访问，平均访问次数为两组（9.3 PNBI和8.9 ASC）接近美国妇产科医师学会（ACOG）推荐的指南。在母婴结局方面也没有组间差异。意向治疗和每协议的敏感性分析，但是，一致发现PNBI妇女参加更多的产后访视比ASC controls.ConclusionsGiven ACOG的重新定义的产后期为第四个三个月，研究结果表明PNBI可以促进预防和干预工作，更成功地减少健康差距的结果为母亲和婴儿。
BackgroundIn the USA, infant mortality remains a major public health concern, particularly for Black women and their infants who continue to experience disproportionately high mortality rates. Prenatal care is a key determinant of infant health, with inadequate prenatal care increasing risk for prematurity, stillbirth, neonatal loss, and infant death. The aim of the present study was to determine if concurrent delivery of patient navigation and behavioral incentives to at-risk Black pregnant women could improve prenatal care attendance and associated maternal and infant outcomes.MethodsParticipants were 150 Black pregnant women recruited at first prenatal visit and screening at risk for adverse maternal and infant outcomes. Women were randomized to either the patient navigation + behavioral incentives intervention (PNBI) or assessment + standard care control (ASC) group. All were followed throughout pregnancy and 12-week postpartum. Group comparisons were made using intention-to-treat and per-protocol sensitivity analyses.ResultsWhile no group differences were found in prenatal care visits, the average number of visits for both groups (9.3 for PNBI and 8.9 for ASC) approached the American College of Obstetricians and Gynecologists (ACOG) recommended guidelines. There were also no group differences in maternal and infant outcomes. Both intention-to-treat and per-protocol sensitivity analyses, however, consistently found PNBI women attended more postpartum visits than ASC controls (p= 0.002).ConclusionsGiven ACOG’s redefining of the postpartum period as the fourth trimester, study findings suggest PNBI may facilitate prevention and intervention efforts to more successfully reduce health disparities in outcomes for both mother and infant.