142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Building a Community Collaborative Prenatal Education Model to Improve Birth Outcomes

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Diane Daldrup , Greater Kansas Chapter, March of Dimes, Overland Park, KS
Shalae Harris, BSN, MPA , Greater Kansas Chapter of March of Dimes, Overland Park, KS
Nikki Keene Woods, PhD, MPH , Public Health Sciences, Wichita State University, Wichita, KS
Amy Chesser, PhD, MA , Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS
Background:  Collective community-based efforts are needed to improve maternal and infant health outcomes. One strategy to improve health outcomes is to increase access to prenatal education. Although prenatal education programs have become more frequently used, systematic descriptions of community collaborative models are lacking.

Methods: A prenatal education curriculum was developed in with national partners in 1998, in English and Spanish versions. The standard program has since been used in 13 states and Puerto Rico serving more than 13,000 pregnant women. The program included six sessions facilitated by trained health educators. In 2010, the use of community collaboratives was added to the program and combined prenatal education and clinical prenatal care. The collaborative program was launched through partnerships with the state health department, county health departments, federally qualified health centers, private obstetric practices and hospitals in four counties with high birth disparities. The goal was to implement and evaluate the program while improving knowledge and health behaviors that promote healthy pregnancies among women at highest risk for poor birth outcomes. Program evaluation tools were developed in partnership with two universities and refined for improved outcome measurement. 

Results: Pre- and post-test survey (N=400) analysis demonstrated statistically significant change in identification of  signs/symptoms of preterm labor (49% to 85%), normal postpartum symptoms (50% to 73%), safe sleep practices (81% to 98%), smoking during pregnancy harm (68% to 89%), early prenatal care (51% to 66%) and baby brain development (81% to 95%).

Eighty four percent of participants rated their experience as excellent; 98% said that they learned new information. Preliminary birth outcome data (n=30) showed improvements including fewer preterm births (10% versus 11% in Kansas) and fewer low-birth weight babies (3% versus 7%).  One site increased breastfeeding initiation rates by 10% and lowered infant mortality from 10/1,000 live births to 8.3.

The study was able to implement and evaluate the community collaborative prenatal education program in diverse settings. The improvement in participants' knowledge and behaviors indicated this model is an effective strategy to promote prenatal and postpartum health and it improved birth outcomes. The collaborative program helped ensure improved outcomes for mothers and promoted collective action within communities to provide prenatal services to mothers with the highest need.

Conclusion: Implementing the community collaborative prenatal education model is a strategy to improve maternal and infant health outcomes.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain the importance of a community collaborative prenatal education model and improving birth outcomes. Identify potential barriers and solutions to community-based work.

Keyword(s): Prenatal Care, Community-Based Partnership & Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the State Director for Programs for the Greater Kansas Chapter of the March of Dimes for numerous years. My experience overseeing the development of a collaborative community model to improve birth outcomes qualifies me to be an abstract author.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
March of Dimes Birth Outcomes Employment (includes retainer)

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.