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Florence Talrich,1,2 Astrid Van Damme,1,2 Hilde LA Bastiaens,3 Jochen Bergs,4 Marlies EB Rijnders,5 Katrien Beeckman1,2,6 1Department of Public Health, Vrije Universiteit Brussel (VUB), Jette, Belgium; 2Departement of Nursing and Midwifery Research Group (NUMID), Universitair Ziekenhuis Brussel (UZ Brussel), Jette, Belgium; 3Department Family Medicine and Population Health, Universiteit Antwerpen, Antwerp, Belgium; 4Department of Healthcare, Universiteit Hasselt, Hasselt, Belgium; 5Department of Child Health, TNO, Leiden, the Netherlands; 6Department Nursing and Midwifery, Universiteit Antwerpen, Antwerp, BelgiumCorrespondence: Florence Talrich, Laarbeeklaan 103, Brussel, Jette, 1090, Belgium, Tel +324749853, Email florence.talrich@vub.beIntroduction: Group Antenatal Care (GANC) is an alternative for traditional antenatal care. Despite the model is well accepted among participants and is associated with positive effects on pregnancy outcomes, recruitment of participants can be an ongoing challenge, depending on the structure and financing of the wider health system. This is especially the case for primary care organizations offering GANC, which depend on other health care providers to refer potential participants. The main objective of this study is to understand what determinants are at play for health care providers to refer to GANC facilitators in primary care organizations. Accordingly, we make recommendations for strategies in order to increase the influx of women in GANC.Methods: Qualitative findings were obtained from 31 interviews with healthcare providers responsible for the referral of women to the GANC facilitators working in primary care organizations, GANC facilitators and stakeholders indirectly involved in the referral. The domains of the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF) helped to develop interview questions and raise awareness of important elements during interviews and thematic analyses.Results: The findings show that before health care providers decide to refer women, they undergo a complex process that is influenced by characteristics of the potential referrer, GANC facilitator, woman, professional relationship between the potential referrer and the GANC facilitator, organization and broader context.Discussion: Based on these findings and current literature, we recommend that the GANC team implements strategies that anticipate relevant determinants: identify and select potential referrers based on their likelihood to refer, select champions, invest in communication, concretise the collaboration, provide practical tools, involve in policymaking.Keywords: antenatal care, CenteringPregnancy, group-based care, recruitment, primary healthcare

Jiamiao Dai,1,* Yun Yu,2,* Yuchen Wang,3 Yinying Huang,4 Juan Liu,5 Yumin Lin,4 Xiaoxiao Fan,1 Mingjing Zhang,4 Xiaofang Xu,4 Jinbing Bai,6 Hong Chen,2,* Yanqun Liu1,* 1School of Nursing, Wuhan University, Wuhan, People’s Republic of China; 2Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 3Department of Nursing, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 4Department of Nursing, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 5Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 6Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA*These authors contributed equally to this workCorrespondence: Yanqun Liu, School of Nursing, Wuhan University, Wuhan, People’s Republic of China, Tel +86 27-68758591, Email liuyanqun1984@163.com Hong Chen, Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China, Tel +86 27-68758591, Email 2077374407@qq.comBackground: CenteringPregnancy Care is a promising group prenatal care innovation that combines assessment, education, and peer support. In China, it is not clear how best to integrate the CenteringPregnancy Care into existing maternal health care models. This qualitative study aimed to explore Chinese pregnant women’s experience in the Internet-based CenteringPregnancy management model.Methods: The Internet-based CenteringPregnancy was applied in a tertiary hospital between 2018 and 2019 in Wuhan, Hubei Province. Through purposive sampling, a total of 9 pregnant women who had experienced Internet-based CenteringPregnancy were recruited. A semi-structured interview was used to collect qualitative data, and Colaizzi’s 7-step method of phenomenological data analysis was used to analyze the collected data.Results: Three themes were extracted from the participants’ interviews, including: 1) empowerment; 2) psychological and social support; 3) challenges of the Internet-based CenteringPregnancy. The Internet-based CenteringPregnancy management model retained advantages of CenteringPregnancy, emphasizing the pregnant woman as the subject of health care and promoting them to participate in health care. Participants believed that they could exchange pregnancy knowledge, help each other, and improve mood both timely and efficiently from the new model. However, it was found that there were challenges in seminar time arrangement, topic selection, and discussion management.Conclusion: The Internet-based CenteringPregnancy management model positively affected pregnant women’s empowerment, psychological, and social support. It is recommended to improve the seminar’s design in future studies.Keywords: CenteringPregnancy, mobile health, health management, prenatal care

Andi M Multazam Department of Public Health, Faculty of Public Health, Universitas Muslim Indonesia, Makassar, IndonesiaCorrespondence: Andi M Multazam, Faculty of Public Health, Universitas Muslim Indonesia, Urip Sumoharjo Street KM 05, Makassar, South Sulawesi, Indonesia, Email andimuhammad.multazam@umi.ac.id