Barriers to women's participation in inter-conceptional care: a cross-sectional analysis

BMC Public Health

Research Article

Jennifer F Culhane¹  David Webb¹  Leny Mathews¹  Diane Rowley²  M Ahinee Amamoo²  Vijaya K Hogan³  Althea D Anderson⁴ 

[1] Children's Hospital of Philadelphia, Philadelphia, USA;Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB# 7445, Room 425 Rosenau, 421 Pittsboro Street, 27599, Chapel Hill, NC, USA;Mailman School of Public Health, Columbia University, New York, NY, USA;

关键词: Prematurity;    Preterm birth;    African American women;    Pregnancy;    Perinatal periods of risk;    Health care participation;    Infant mortality;    Preventive care;    Access to care;    Utilization of care;    Preconception care;   

DOI  :  10.1186/1471-2458-12-93

 received in 2011-07-11, accepted in 2012-02-01,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundWe describe participation rates in a special interconceptional care program that addressed all commonly known barriers to care, and identify predictors of the observed levels of participation in this preventive care service.MethodsA secondary analysis of data from women in the intervention arm of an interconceptional care clinical trial in Philadelphia (n = 442). Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services (herein called Andersen model) was used as a theoretical base. We used a multinomial logit model to analyze the factors influencing women's level of participation in this enhanced interconceptional care program.ResultsAlthough common barriers were addressed, there was variable participation in the interconceptional interventions. The Andersen model did not explain the variation in interconceptional care participation (Wald ch sq = 49, p = 0.45). Enabling factors (p = 0.058), older maternal age (p = 0.03) and smoking (p = < 0.0001) were independently associated with participation.ConclusionsActively removing common barriers to care does not guarantee the long-term and consistent participation of vulnerable women in preventive care. There are unknown factors beyond known barriers that affect participation in interconceptional care. New paradigms are needed to identify the additional factors that serve as barriers to participation in preventive care for vulnerable women.

【 授权许可】

CC BY   
© Hogan et al; licensee BioMed Central Ltd. 2011