204272 Designing a Group Prenatal Care model for Phoenix's refugee population: Does it improve birth outcomes?

Monday, November 9, 2009: 12:50 PM

Sharry Veres, MD, MHSM , Department of Family Medicine, St. Joseph's Hospital and Medical Center, Phoenix, AZ
Diane Mary Zipley, MS , State Director of Program Services and Public Affairs, March of Dimes Arizona Chapter, Phoenix, AZ
Jennifer Doran , Family and Youth Services Manager, International Rescue Committee, Phoenix, AZ
A program was funded by the March of Dimes Arizona Chapter (MOD) to introduce CenteringPregnancy®, a group prenatal care program, at St. Joseph's Hospital Family Medicine Residency Clinic in Phoenix, AZ. Out of 14 patients in the program, 4 were refugees. Clinic providers expressed concern with how best to provide care for refugee patients, noting poor outcomes within our current system. As a preliminary investigation, 2007 Arizona birth records were reviewed. Babies born to women from Somalia had an 11.4% admission rate to the Newborn Intensive Care Unit (NICU), compared to babies of other foreign-born women (4.8%). The odds ratio for NICU admissions for Somali mothers was 2.54 (p-value < 0.001). There was no difference in pre-term birth. Burmese refugees have recently immigrated to Arizona and only 23 birth records were captured in 2007 data. Burmese births included (5) 22% pre-term deliveries and (3) 13% admissions to the NICU, a concerning trend. There may be additional poor outcomes not recorded in the birth records. In response to these numbers MOD asked the International Rescue Committee (IRC) refugee relief organization to submit a proposal to coordinate group prenatal care for refugees through St. Joseph's. IRC will provide transportation and interpretation services, culturally appropriate training for providers, and interface with St. Joseph's and MOD to implement the program. St. Joseph's will conduct focused interviews with refugee patients, followed by a plan to implement targeted improvements in care. Results will include better coordinated maternity care with Phoenix-area refugee assistance organizations and improved outcomes.

Learning Objectives:
Describe three common concerns the four groups of refugee women have with receiving prenatal care. Identify two culturally specific concerns from individual interviews/survey of refugee women.

Keywords: Refugees, Maternal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director of Research and Assistant Program Director for the Department of Family Medicine at St. Joseph's Hospital and have been working on a group prenatal project over the past year in collaboration with the March of Dimes, and that we are in the process of tailoring for pregnant refugees. I have been reviewing the statistics regarding birth outcomes among refugee groups that deliver at St. Joseph's and believe this program will improve birth outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.