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4. Group Prenatal Care Attendance: Determinants and Relationship with Care Satisfaction

Author

Cunningham, Shayna D., Grilo, Stephanie, Lewis, Jessica B., Novick, Gina, Rising, Sharon Schindler, Tobin, Jonathan N., and Ickovics, Jeannette R.

Subjects
Delivery (Childbirth) -- Health aspects, Women's health -- Analysis, Linear models (Statistics) -- Usage, Prenatal care -- Analysis, Health care industry
Abstract

Objectives Group prenatal care results in improved birth outcomes in randomized controlled trials, and better attendance at group prenatal care visits is associated with stronger clinical effects. This paper's objectives are to identify determinants of group prenatal care attendance, and to examine the association between proportion of prenatal care received in a group context and satisfaction with care. Methods We conducted a secondary data analysis of pregnant adolescents (n = 547) receiving group prenatal care in New York City (2008-2012). Multivariable linear regression models were used to test associations between patient characteristics and percent of group care sessions attended, and between the proportion of prenatal care visits that occurred in a group context and care satisfaction. Results Sixty-seven groups were established. Group sizes ranged from 3 to 15 women (mean = 8.16, SD = 3.08); 87 % of groups enrolled at least five women. Women enrolled in group prenatal care supplemented group sessions with individual care visits. However, the percent of women who attended each group session was relatively consistent, ranging from 56 to 63 %. Being born outside of the United States was significantly associated with higher group session attendance rates [B(SE) = 11.46 (3.46), p = 0.001], and women who received a higher proportion of care in groups reported higher levels of care satisfaction [B(SE) = 0.11 (0.02), p < 0.001]. Conclusions Future research should explore alternative implementation structures to improve pregnant women's ability to receive as much prenatal care as possible in a group setting, as well as value-based reimbursement models and other incentives to encourage more widespread adoption of group prenatal care., Author(s): Shayna D. Cunningham [sup.1] , Stephanie Grilo [sup.1] , Jessica B. Lewis [sup.1] , Gina Novick [sup.2] , Sharon Schindler Rising [sup.3] , Jonathan N. Tobin [sup.4] [sup.5] [sup.6] [...]

Published
2017
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15. Hormonal contraceptive use in HIV-infected women using antiretroviral therapy: a systematic review

Author

Womack, Julie A., Novick,Gina, and Goulet,Joseph L.

Subjects
Open Access Journal of Contraception
Abstract

Julie A Womack,1,2 Gina Novick,1 Joseph L Goulet2 1Yale School of Nursing, 2Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT, USA Background: While extensive research has explored pharmacokinetic interactions between antiretroviral therapy (ART) and hormonal contraception, few studies have examined whether these interactions affect clinical outcomes. To address this gap, we conducted a systematic review of the literature that describes hormonal contraceptive use among HIV-infected women who also use ART, focusing on papers that address clinically important outcomes such as pregnancy or ovulation. Methods/design: An electronic literature search was conducted of PubMed and Ovid to identify all articles that addressed hormonal contraception co-administered with ART published in English between January 1, 1990 and October 30, 2014. In addition, manual reference checks of all articles of interest were conducted to identify articles not captured in the electronic search. Our search criteria identified 405 records. The title and abstract of data reports retrieved via the search were reviewed to identify potential articles of interest. Those with any indication of the main outcomes of interest were considered for inclusion (N=162). Abstracts were then reviewed to identify those manuscripts that would merit a review of the full-text version (N=64). Eight articles that addressed the outcomes of interest were identified. The Newcastle-Ottawa Scale was used to assess the quality of these articles. Results: The studies reviewed were limited in a number of ways that precluded their providing a rigorous assessment of the efficacy of contraception when co-administered with ART. Discussion: None of the studies were of adequate quality to provide the guidance that providers and HIV-infected women need when considering contraceptive options. High-quality, well-powered studies are required to address the efficacy of hormonal contraception when co-administered with ART. Keywords: hormonal contraception, HIV, antiretroviral therapy, systematic review

Published
2015

17. Hormonal contraceptive use in HIV-infected women using antiretroviral therapy: a systematic review

Author

Womack,Julie A, Novick,Gina, Goulet,Joseph L, Womack,Julie A, Novick,Gina, and Goulet,Joseph L

Abstract

Julie A Womack,1,2 Gina Novick,1 Joseph L Goulet2 1Yale School of Nursing, 2Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT, USA Background: While extensive research has explored pharmacokinetic interactions between antiretroviral therapy (ART) and hormonal contraception, few studies have examined whether these interactions affect clinical outcomes. To address this gap, we conducted a systematic review of the literature that describes hormonal contraceptive use among HIV-infected women who also use ART, focusing on papers that address clinically important outcomes such as pregnancy or ovulation. Methods/design: An electronic literature search was conducted of PubMed and Ovid to identify all articles that addressed hormonal contraception co-administered with ART published in English between January 1, 1990 and October 30, 2014. In addition, manual reference checks of all articles of interest were conducted to identify articles not captured in the electronic search. Our search criteria identified 405 records. The title and abstract of data reports retrieved via the search were reviewed to identify potential articles of interest. Those with any indication of the main outcomes of interest were considered for inclusion (N=162). Abstracts were then reviewed to identify those manuscripts that would merit a review of the full-text version (N=64). Eight articles that addressed the outcomes of interest were identified. The Newcastle-Ottawa Scale was used to assess the quality of these articles. Results: The studies reviewed were limited in a number of ways that precluded their providing a rigorous assessment of the efficacy of contraception when co-administered with ART. Discussion: None of the studies were of adequate quality to provide the guidance that providers and HIV-infected women need when considering contraceptive options. High-quality, well-powered studies are required to address the efficacy of horm

Published
2015

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