5266.0: Wednesday, November 15, 2000 - 5:30 PM

Abstract #11010

Determinants of Prenatal Care Initiation Among African American Women in Washington, DC

Allan A. Johnson, PhD1, Margaret Rodan, RN, ScD2, Nabil El-Khorazaty, PhD3, Barbara Hatcher, RN, PhD, MPH4, Barbara Wingrove, MPH5, Renee Milligan, RNC, PhD2, Cynthia Harris, MSW1, Amoke Alakoye, MHS3, Julie Utter, BA3, Barbara Wesley, MD, MPH1, Leslie Richards, PhD6, and Haziel Laryea, MSc1. (1) Department of Nutritional Sciences, Howard University, Washington, DC 20059, 202-806-5666, ajohnson@howard.edu, (2) Georgetown University, (3) Research Triangle Institute, (4) American Public Health Association, (5) National Institute of Child Health and Human Development, (6) University of the District of Columbia

In Washington, DC, inadequate prenatal care (PNC) utilization is one of several factors found to be associated with low birth weight (LBW). Therefore, improved PNC utilization may lead to a reduction in LBW, which, in turn, may lower the DC infant mortality rate, currently the highest in the nation. In order to improve PNC utilization in DC, more must be known about factors influencing PNC initiation. The purpose of this study was to identify barriers, motivators and facilitators of PNC initiation, an important component of PNC utilization. Three hundred and three DC-resident, African American women appearing for their first prenatal care visits at four hospital-based clinics, five community-based clinics, and five private practices were interviewed to determine their perceptions of barriers, motivators and facilitators influencing PNC initiation. Three risk groups for inadequate PNC initiation (after the 20th week of gestation) were identified using Classification and Regression Trees analysis. These included women considering abortion, not employed outside their homes, and receiving help paying for transportation; women not considering abortion, with no previous abortions, and participating in the WIC Program; and women not considering abortion, with previous abortions, and lacking money to pay for PNC. Recommended interventions included early identification and counseling of women ambivalent about their pregnancies, linking health programs to work, strengthening presumptive Medicaid eligibility, and promoting early PNC initiation among WIC Program participants.

Supported by a grant from NIH NICHD and the NIH Office of Research on Minority Health.

Learning Objectives: At the conclusion of the presentation, the learner will be able to: 1. Describe the barriers, motivators and facilitators of prenatal care (PNC) initiation perceived by African American women living in Washington, DC. 2. List the barriers, motivators and facilitators significantly related to PNC initiation by African American women living in Washington, DC. 3. Identify African American women in DC at risk of inadequate PNC initiation. 4. Make recommendations of interventions to increase early PNC initiation by African American women living in Washington, DC

Keywords: Prenatal Care, Ethnic Minorities

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA