Institution: | 1. Uniformed Services University of the Health Sciences, Bethesda, MD, USA;2. Jacksonville Naval Hospital, Jacksonville, FL, USA;3. Military Primary Care Research Network, 4301 Jones Bridge Road, Bethesda, MD, USA |
Abstract: | ObjectiveTo demonstrate how the chronic care model can be applied in prenatal care.MethodsThis study was conducted through analysis of data generated in the women’s health and family medicine departments of one community hospital and two medical centers across three states (Georgia, Nevada, and Virginia). 159 low-risk obstetric patients were monitored throughout their pregnancy for patient activation and biometric measures including: blood pressure at each appointment, baby’s gestational age at birth, and mode of delivery. Patient activation was assessed with the validated, licensed patient activation measure.ResultsPatient activation was strongly associated with the Prenatal Interpersonal Processes of Care metric (F (2, 155)?=?3.41, p?<?.05). Also, increased age, decreased Prenatal Interpersonal Processes of Care, fewer pregnancies, and increased diastolic blood pressure were associated with an increased likelihood of cesarean delivery and the model correctly predicted 81% of cases.ConclusionWomen who identified as feeling more activated reported more positive pregnancy experiences, and women who reported more positive pregnancy experiences were more likely to experience a vaginal delivery.Practice implicationsActivated patients, more positive prenatal experience, and improved delivery outcomes can be achieved through applying the chronic care model. |