3055.0: Monday, October 22, 2001 - Board 6

Abstract #30472

Understanding the Reasons for Inadequate Prenatal Care Utilization by African American Women in Washington, DC: A Multivariate Analysis

Allan A. Johnson, PhD1, Barbara Hatcher, RN, PhD, MPH2, Nabil El-Khorazaty, PhD3, Barbara Wingrove, MPH4, Renee Milligan, PhD5, Cynthia Harris, MSW1, Brinda Bhaskar, MS3, Barbara Wesley, MD, MPH1, Margaret Rodan, RN, ScD5, Leslie Richards, PhD6, and Haziel Laryea, MSc1. (1) Department of Nutritional Sciences, Howard University, Washington, DC 20059, 202-806-5666, ajohnson@howard.edu, (2) American Public Health Association, (3) Research Triangle Institute, (4) National Institute of Child Health and Human Development, (5) Georgetown University, (6) University of the District of Columbia

In an effort to understand why African American women in Washington, DC continue to display high levels on inadequate prenatal care (PNC) utilization, a study was conducted to identify the determinants of PNC utilization. A convenience sample of 246 minority women with varying levels of PNC utilization was interviewed during their postpartum hospitalization at five institutions with delivery facilities located in Washington, D.C. Data obtained from the women addressed their perceptions of barriers, motivators, and facilitators of PNC initiation and adherence to their scheduled prenatal visits for their most recent pregnancies, reproductive history, substance use, and socio-economic background. Kotelchuck’s Adequacy of Prenatal Care Utilization Index was used to classify adequacy of PNC utilization. Using factor analysis, three factors were constructed from the barriers significantly related to PNC utilization: (1) psychosocial problems, (2) financial/insurance constraints, and (3) substance use. Multiple logistic regression and Classification and Regression Trees (CART) methodologies were used to identify the determinants of PNC utilization. Independent variables investigated included psychosocial problems, financial/insurance constraints, substance use, WIC Program participation, consideration of abortion, a woman’s belief that she can take care of herself, childcare problems, and age. Of the 246 women interviewed, 60% (147) had inadequate PNC utilization (Intermediate and Inadequate groups combined). The following variables were identified as increasing the risk of inadequate PNC utilization: psychosocial problems, financial/insurance constraints, substance use, nonparticipation in the WIC Program, a woman’s belief that she can take care of herself, and child care problems.

Learning Objectives: At the conclusion of this session, the participant (learner) will be able to: 1. List the barriers, motivators and facilitators of prenatal care utilization perceived by African American women in Washington, DC 2. Identify the determinants of prenatal care utilization by African American women in Washington, DC

Keywords: Barriers to Care, Ethnic Minorities

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.

The 129th Annual Meeting of APHA