Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers
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- 作者：Maureen I Heaman (1) (2) (3)
Wendy Sword (4)
Lawrence Elliott (2) (5)
Michael Moffatt (2) (6)
Michael E Helewa (3)
Heather Morris (7)
Patricia Gregory (8)
Lynda Tjaden (9)
Catherine Cook (10)
1. College of Nursing Faculty of Health Sciences ; University of Manitoba ; 89 Curry Place ; Winnipeg ; MB ; R3T 2N2 ; Canada
2. Department of Community Health Sciences ; College of Medicine ; Faculty of Health Sciences ; University of Manitoba ; Winnipeg ; MB ; R3E 0W3 ; Canada
3. Department of Obstetrics ; Gynecology & Reproductive Sciences ; College of Medicine ; Faculty of Health Sciences ; University of Manitoba ; Winnipeg ; MB ; R3E 0L8 ; Canada
4. School of Nursing and Department of Clinical Epidemiology and Biostatistics ; Faculty of Health Sciences ; McMaster University ; Hamilton ; ON ; L8N 3Z5 ; Canada
5. Department of Medical Microbiology ; College of Medicine ; Faculty of Health Sciences ; University of Manitoba ; Winnipeg ; MB ; R3E 0J9 ; Canada
6. Department of Pediatrics and Child Health ; College of Medicine ; Faculty of Health Sciences ; University of Manitoba ; Winnipeg ; MB ; R3A 1S1 ; Canada
7. Faculty of Nursing ; University of Alberta ; Edmonton ; AB ; T5G 1C9 ; Canada
8. Department of Nursing ; Red River College ; Winnipeg ; MB ; R3H 0J9 ; Canada
9. Public Health ; Winnipeg Regional Health Authority ; Winnipeg ; MB ; R3A 0X7 ; Canada
10. Population and Aboriginal Health ; Winnipeg Regional Health Authority ; Winnipeg ; MB ; R3B 1E2 ; Canada - 关键词：Prenatal care ; Pregnancy ; Health care providers ; Provider perceptions ; Barriers ; Facilitators ; Qualitative study
- 刊名：BMC Pregnancy and Childbirth
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：15
- 期：1
- 全文大小：517 KB
- 参考文献：1. The Chief Public Health Officer of Canada: The Chief Public Health Officer鈥檚 Report on the State of Public Health in Canada 2009: Growing Up Well - Priorities for a Healthy Future [http://publichealth.gc.ca/CPHOreport ]
2. Society of Obstetricians and Gynaecologists of Canada (SOGC). SOGC Clinical Practice Guidelines: Healthy Beginnings: Guidelines for care during pregnancy and childbirth. Ottawa: SOGC; 1998.
3. Chalmers B, Mangiaterra V, Porter R. WHO principles of perinatal care: the essential antenatal, perinatal, and postpartum care course. Birth. 2001;28:202鈥?. nal" href="http://dx.doi.org/10.1046/j.1523-536x.2001.00202.x" target="_blank" title="It opens in new window">CrossRef
4. D鈥橝scoli PT, Alexander GR, Petersen DJ, Kogan MD. Parental factors influencing patterns of prenatal care utilization. J Perinatol. 1997;17:283鈥?.
5. Heaman MI, Green CG, Newburn-Cook CV, Elliott LJ, Helewa ME. Social inequalities in use of prenatal care in Manitoba. J Obstet Gynaecol Can. 2007;29(10):806鈥?6.
6. Heaman M, Kingston D, Helewa ME, Brownell M, Derksen S, Bogdanovic B, et al. Perinatal Services and Outcomes in Manitoba. Winnipeg, Manitoba: Manitoba Center for Health Policy; 2012.
7. Bloom KC, Bednarzyk MS, Devitt DL, Renault RA, Teaman V, Van Loock DM. Barriers to prenatal care for homeless pregnant women. J Obstet Gynecol Neonatal Nurs. 2004;33:428鈥?5. nal" href="http://dx.doi.org/10.1177/0884217504266775" target="_blank" title="It opens in new window">CrossRef
8. Braveman P, Marchi K, Egerter S, Pearl M, Neuhaus J. Barriers to timely prenatal care among women with insurance: the importance of prepregnancy factors. Obstet Gynecol. 2000;95:874鈥?0. nal" href="http://dx.doi.org/10.1016/S0029-7844(00)00780-8" target="_blank" title="It opens in new window">CrossRef
9. Cook CA, Selig KL, Wedge BJ, Gohn-Baube EA. Access barriers and the use of prenatal care by low-income, inner-city women. Soc Work. 1999;44:129鈥?9. nal" href="http://dx.doi.org/10.1093/sw/44.2.129" target="_blank" title="It opens in new window">CrossRef
10. Fuller CA, Gallagher R. What鈥檚 happening: perceived benefits and barriers of prenatal care in low income women. J Am Acad Nurse Pract. 1999;11:527鈥?2. nal" href="http://dx.doi.org/10.1111/j.1745-7599.1999.tb01222.x" target="_blank" title="It opens in new window">CrossRef
11. Hulsey TM, Laken M, Miller V, Ager J. The influence of attitudes about unintended pregnancy on use of prenatal and postpartum care. J Perinatol. 2000;20:513鈥?. nal" href="http://dx.doi.org/10.1038/sj.jp.7200455" target="_blank" title="It opens in new window">CrossRef
12. Johnson AA, El Khorazaty MN, Hatcher BJ, Wingrove BK, Milligan R, Harris C, et al. Determinants of late prenatal care initiation by African American women in Washington. DC Matern Child Health J. 2003;7(3):103鈥?4. nal" href="http://dx.doi.org/10.1023/A:1023816927045" target="_blank" title="It opens in new window">CrossRef
13. Mayer JP. Unintended childbearing, maternal beliefs, and delay of prenatal care. Birth. 1997;24:247鈥?2. nal" href="http://dx.doi.org/10.1111/j.1523-536X.1997.tb00598.x" target="_blank" title="It opens in new window">CrossRef
14. Meikle SF, Orleans M, Leff M, Shain R, Gibbs RS. Women鈥檚 reasons for not seeking prenatal care: racial and ethnic factors. Birth. 1995;22:81鈥?. nal" href="http://dx.doi.org/10.1111/j.1523-536X.1995.tb00564.x" target="_blank" title="It opens in new window">CrossRef
15. Mikhail B. Prenatal care utilization among low-income African American women. J Community Health Nurs. 2000;17:235鈥?6. nal" href="http://dx.doi.org/10.1207/S15327655JCHN1704_5" target="_blank" title="It opens in new window">CrossRef
16. Mikhail BI. Perceived impediments to prenatal care among low-income women. West J Nurs Res. 1999;21:335鈥?0. nal" href="http://dx.doi.org/10.1177/019394599902100305" target="_blank" title="It opens in new window">CrossRef
17. Nothnagle M, Marchi K, Egerter S, Braveman P. Risk factors for late or no prenatal care following Medicaid expansions in California. Matern Child Health J. 2000;4:251鈥?. nal" href="http://dx.doi.org/10.1023/A:1026647722295" target="_blank" title="It opens in new window">CrossRef
18. Perloff JD, Jaffee KD. Late entry into prenatal care: the neighborhood context. Soc Work. 1999;44:116鈥?8. nal" href="http://dx.doi.org/10.1093/sw/44.2.116" target="_blank" title="It opens in new window">CrossRef
19. Rogers C, Schiff M. Early versus late prenatal care in New Mexico: barriers and motivators. Birth. 1996;23:26鈥?0. nal" href="http://dx.doi.org/10.1111/j.1523-536X.1996.tb00457.x" target="_blank" title="It opens in new window">CrossRef
20. Teagle SE, Brindis CD. Perceptions of motivators and barriers to public prenatal care among first-time and follow-up adolescent patients and their providers. Matern Child Health J. 1998;2:15鈥?4. nal" href="http://dx.doi.org/10.1023/A:1021889424627" target="_blank" title="It opens in new window">CrossRef
21. York R, Grant C, Tulman L, Rothman RH, Chalk L, Perlman D. The impact of personal problems on accessing prenatal care in low-income urban African American women. J Perinatol. 1999;19:53鈥?0. nal" href="http://dx.doi.org/10.1038/sj.jp.7200052" target="_blank" title="It opens in new window">CrossRef
22. Johnson AA, Hatcher BJ, El-Khorazaty MN, Milligan RA, Bhaskar B, Rodan MF, et al. Determinants of inadequate prenatal care utilization by African American women. J Health Care Poor Underserved. 2007;18:620鈥?6. nal" href="http://dx.doi.org/10.1353/hpu.2007.0059" target="_blank" title="It opens in new window">CrossRef
23. Feijen-de Jong EI, Jansen DE, Baarveld F, van der Schans CP, Schellevis FG, Reijneveld SA. Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review. Eur J Public Health. 2011;22(6):904鈥?3. nal" href="http://dx.doi.org/10.1093/eurpub/ckr164" target="_blank" title="It opens in new window">CrossRef
24. Heaman MI, Gupton AL, Moffatt ME. Prevalence and predictors of inadequate prenatal care: a comparison of Aboriginal and non-Aboriginal women in Manitoba. J Obstet Gynaecol Can. 2005;27:237鈥?6.
25. Heaman M. Prenatal Care. In: What Mothers Say: The Canadian Maternity Experiences Survey. Ottawa: Public Health Agency of Canada; 2009. p. 42鈥?.
26. Blackwell DA. Prenatal care services in the public and private arena. J Am Acad Nurse Pract. 2002;14:562鈥?. nal" href="http://dx.doi.org/10.1111/j.1745-7599.2002.tb00090.x" target="_blank" title="It opens in new window">CrossRef
27. Daniels P, Noe GF, Mayberry R. Barriers to prenatal care among Black women of low socioeconomic status. Am J Health Behav. 2006;30:188鈥?8. nal" href="http://dx.doi.org/10.5993/AJHB.30.2.8" target="_blank" title="It opens in new window">CrossRef
28. Milligan R, Wingrove BK, Richards L, Rodan M, Monroe-Lord L, Jackson V, et al. Perceptions about prenatal care: views of urban vulnerable groups. BMC Public Health. 2002;2:25. nal" href="http://dx.doi.org/10.1186/1471-2458-2-25" target="_blank" title="It opens in new window">CrossRef
29. Quinn GP, Detman LA, Bell-Ellison BA. Missed appointments in perinatal care: response variations in quantitative versus qualitative instruments. J Med Pract Manage. 2008;23:307鈥?3.
30. Reitmanova S, Gustafson DL. 鈥淭hey can鈥檛 understand it鈥? maternity health and care needs of immigrant Muslim women in St. John鈥檚, Newfoundland. Matern Child Health J. 2008;12:101鈥?1. nal" href="http://dx.doi.org/10.1007/s10995-007-0213-4" target="_blank" title="It opens in new window">CrossRef
31. Shaffer CF. Factors influencing the access to prenatal care by Hispanic pregnant women. J Am Acad Nurse Pract. 2002;14:93鈥?. nal" href="http://dx.doi.org/10.1111/j.1745-7599.2002.tb00097.x" target="_blank" title="It opens in new window">CrossRef
32. Sword W. Prenatal care use among women of low income: a matter of 鈥渢aking care of self鈥? Qual Health Res. 2003;13:319鈥?2. nal" href="http://dx.doi.org/10.1177/0095399702250128" target="_blank" title="It opens in new window">CrossRef
33. Downe S, Finlayson K, Walsh D, Lavender T. 鈥榃eighing up and balancing out鈥? a meta-synthesis of barriers to antenatal care for marginalised women in high-income countries. BJOG. 2009;116:518鈥?9. nal" href="http://dx.doi.org/10.1111/j.1471-0528.2008.02067.x" target="_blank" title="It opens in new window">CrossRef
34. Sword W. A socio-ecological approach to understanding barriers to prenatal care for women of low income. J Adv Nurs. 1999;29:1170鈥?. nal" href="http://dx.doi.org/10.1046/j.1365-2648.1999.00986.x" target="_blank" title="It opens in new window">CrossRef
35. Abrams LS, Dornig K, Curran L. Barriers to service use for postpartum depression symptoms among low-income ethnic minority mothers in the United States. Qual Health Res. 2009;19:535鈥?1. nal" href="http://dx.doi.org/10.1177/1049732309332794" target="_blank" title="It opens in new window">CrossRef
36. Cassata L, Dallas C. Nurses鈥?attitudes and childbearing adolescents: bridging the cultural chasm. ABNF J. 2005;16:71鈥?.
37. Proctor S. What determines quality in maternity care? Comparing the perceptions of childbearing women and midwives. Birth. 1998;25:85鈥?3. nal" href="http://dx.doi.org/10.1046/j.1523-536x.1998.00085.x" target="_blank" title="It opens in new window">CrossRef
38. Sword W, Heaman MI, Brooks S, Tough S, Janssen PA, Young D, et al. Women鈥檚 and care providers鈥?perspectives of quality prenatal care: a qualitative descriptive study. BMC Pregnancy Childbirth. 2012;12:29. nal" href="http://dx.doi.org/10.1186/1471-2393-12-29" target="_blank" title="It opens in new window">CrossRef
39. Aved BM, Irwin MM, Cummings LS, Findeisen N. Barriers to prenatal care for low-income women. West J Med. 1993;158:493鈥?.
40. Gazmararian JA, Schwarz KS, Amacker LB, Powell CL. Barriers to prenatal care among Medicaid managed care enrollees: patient and provider perceptions. HMO Pract. 1997;11:18鈥?4.
41. Gilbert P, Herzig K, Thakar D, Viloria J, Bogetz A, Danley DW, et al. How health care setting affects prenatal providers鈥?risk reduction practices: a qualitative comparison of settings. Women Health. 2007;45:41鈥?7. nal" href="http://dx.doi.org/10.1300/J013v45n02_03" target="_blank" title="It opens in new window">CrossRef
42. Smith D, Edwards N, Varcoe C, Martens PJ, Davies B. Bringing safety and responsiveness into the forefront of care for pregnant and parenting Aboriginal people. ANS Adv Nurs Sci. 2006;29:E27鈥?4. nal" href="http://dx.doi.org/10.1097/00012272-200604000-00014" target="_blank" title="It opens in new window">CrossRef
43. Johnson AA, Wesley BD, El-Khorazaty MN, Utter JM, Bhaskar B, Hatcher BJ, et al. African American and Latino patient versus provider perceptions of determinants of prenatal care initiation. Matern Child Health J. 2011;15 Suppl 1:S27鈥?4. nal" href="http://dx.doi.org/10.1007/s10995-011-0864-z" target="_blank" title="It opens in new window">CrossRef
44. Heaman MI, Moffatt M, Elliott L, Sword W, Helewa ME, Morris H, et al. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case鈥揷ontrol study. BMC Pregnancy Childbirth. 2014;14:227. nal" href="http://dx.doi.org/10.1186/1471-2393-14-227" target="_blank" title="It opens in new window">CrossRef
45. Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23:334鈥?0. nal" href="http://dx.doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G" target="_blank" title="It opens in new window">CrossRef
46. Patton M. Qualitative evaluation and research methods. Newbury Park, CA: Sage; 1990.
47. Kuzel AJ. Sampling in qualitative inquiry. In: Crabtree BF, Miller WL, editors. Doing qualitative research. Thousand Oaks: Sage Publications Inc; 1999. p. 33鈥?5.
48. Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. 3r0064th ed. Thousand Oaks, CA: Sage; 2008.
49. Field P, Morse J. Qualitative research methods for health professionals. Thousand Oaks, CA: Sage; 1995.
50. Manning P, Cullum-Swan B. Narrative, content, and semiotic analysis. In: Denzin N, Lincoln Y, editors. Handbook of Qualitative Research. London: Sage; 1994. p. 463鈥?3.
51. Priest H, Roberts P, Woods L. An overview of three different approaches to the interpretation of qualitative data. Part 1: Theoretical issues. Nurse Res. 2002;10:30鈥?2. nal" href="http://dx.doi.org/10.7748/nr2002.10.10.1.30.c5877" target="_blank" title="It opens in new window">CrossRef
52. Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park, CA: Sage; 1990.
53. Meadows LM, Morse JM. Constructing evidence within the qualitative project. In: Morse J, Swanson JM, Kuzel AJ, editors. The Nature of Qualitative Evidence. Thousand Oaks, CA: Sage Publications; 2001. p. 187鈥?00.
54. Koch T. Establishing rigour in qualitative research: the decision trail. J Adv Nurs. 1994;19:976鈥?6. nal" href="http://dx.doi.org/10.1111/j.1365-2648.1994.tb01177.x" target="_blank" title="It opens in new window">CrossRef
55. Government of Manitoba: Healthy Child Manitoba. [ndex.html" class="a-plus-plus">http://www.gov.mb.ca/healthychild/index.html]
56. Heaman M, Chalmers K, Woodgate R, Brown J. Early childhood home visiting programme: factors contributing to success. J Adv Nurs. 2006;55:291鈥?00. nal" href="http://dx.doi.org/10.1111/j.1365-2648.2006.03914.x" target="_blank" title="It opens in new window">CrossRef
57. Statistics Canada: Aboriginal Peoples in Canada in 2006: Inuit, Metis and First Nations, 2006 Census. [n.ca/census-recensement/2006/as-sa/97-558/pdf/97-558-XIE2006001.pdf" class="a-plus-plus">http://www12.statcan.ca/census-recensement/2006/as-sa/97-558/pdf/97-558-XIE2006001.pdf] - 刊物主题：Reproductive Medicine; Maternal and Child Health; Gynecology;
- 出版者：BioMed Central
- ISSN：1471-2393
文摘
Background Socioeconomic disparities in the use of prenatal care (PNC) exist even where care is universally available and publicly funded. Few studies have sought the perspectives of health care providers to understand and address this problem. The purpose of this study was to elicit the experiential knowledge of PNC providers in inner-city Winnipeg, Canada regarding their perceptions of the barriers and facilitators to PNC for the clients they serve and their suggestions on how PNC services might be improved to reduce disparities in utilization. Methods A descriptive exploratory qualitative design was used. Semi-structured interviews were conducted with 24 health care providers serving women in inner-city neighborhoods with high rates of inadequate PNC. Content analysis was used to code the interviews based on broad categories (barriers, facilitators, suggestions). Emerging themes and subthemes were then developed and revised through the use of comparative analysis. Results Many of the barriers identified related to personal challenges faced by inner-city women (e.g., child care, transportation, addictions, lack of support). Other barriers related to aspects of service provision: caregiver qualities (lack of time, negative behaviors), health system barriers (shortage of providers), and program/service characteristics (distance, long waits, short visits). Suggestions to improve care mirrored the facilitators identified and included ideas to make PNC more accessible and convenient, and more responsive to the complex needs of this population. Conclusions The broad scope of our findings reflects a socio-ecological approach to understanding the many determinants that influence whether or not inner-city women use PNC services. A shift to community-based PNC supported by a multidisciplinary team and expanded midwifery services has potential to address many of the barriers identified in our study.