scholarly journals A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249419
Author(s):  
Elaine Y. L. Chan ◽  
Carolyn Smullin ◽  
Stephanie Clavijo ◽  
Melissa Papp-Green ◽  
Eunhee Park ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Congenital Syphilis ◽  
The United States ◽  
Qualitative Assessment ◽  
Kern County ◽  
Care Providers ◽  
Structural Barriers ◽  
Care Access ◽  
Prenatal Care Providers ◽  
In Pregnancy

Congenital syphilis is the result of placental transmission from mother to fetus of Treponema pallidum. Although congenital syphilis is preventable through timely treatment, the rate of new infections in the United States (US) has increased each year since 2013, and is increasing at a noticeably greater pace in California (CA). Most research into congenital syphilis has focused on individual psychosocial and behavioral factors that contribute to maternal vulnerability for syphilis. The aim of this study was to evaluate structural barriers to prenatal care access and utilization and congenital syphilis prevention in Kern County, CA. Transcripts from 8 in-depth interviews with prenatal care providers and 5 focus group discussions with 42 pregnant and postpartum persons were examined using thematic analysis. Structural barriers experienced by pregnant and postpartum persons to prenatal care access and utilization included (1) burdens of poverty; (2) stigma around substance use in pregnancy; (3) citizenship status; (4) lack of healthcare coverage; (5) low sexual health literacy; and (6) gender inequality Structural barriers experienced by prenatal care providers in congenital syphilis prevention included (1) limited guidance on clinical management of syphilis in pregnancy; (2) decay in public health infrastructure; and (3) inadequate support for managing patients’ social comorbidities. The response to congenital syphilis prevention will require an examination of the complex context of social determinants of health in which persons diagnosed with syphilis live in.

scholarly journals Gaps in the Congenital Syphilis Prevention Cascade: Qualitative Findings from Kern County, California

2021 ◽  
Author(s):  
Eunhee Park ◽  
Julie Yip ◽  
Emily Harville ◽  
Marlene Nelson ◽  
Gloria Giarratano ◽  
...  
Keyword(s):  
Substance Use ◽  
Focus Group ◽  
Prenatal Care ◽  
Congenital Syphilis ◽  
Postpartum Women ◽  
Kern County ◽  
Care Providers ◽  
Prenatal Care Providers ◽  
Syphilis Screening ◽  
Prenatal Substance Use

Abstract Background. Congenital syphilis is preventable through timely access to prenatal care, syphilis screening and treatment of pregnant women diagnosed as infected. In 2018, California had the second highest number of congenital syphilis cases in the United States (U.S.), a nearly 2-fold increase in cases since 2014. This study assessed gaps in preventing congenital syphilis in the high morbidity region of Kern County, California. Methods. Between May 2018 and January 2019, we conducted five focus group discussions with pregnant/postpartum women and ten semi-structured interviews with prenatal care providers in Kern County. Focus group and interview data were recorded, transcribed, and analyzed to identify emergent themes pertaining to facilitators and barriers at each step (prenatal care, syphilis screening and treatment) in the congenital syphilis prevention cascade.Results. Gaps in congenital syphilis prevention discussed in focus group discussions with pregnant/postpartum women were related to limited prenatal care access, social-, economic-, and cultural-barriers, and substance use and co-occurring intimate partner/domestic violence. The gaps identified from interviews with prenatal care providers included social economic vulnerabilities of pregnant women and stigma and shame around the vulnerabilities, distrust in medical system, prenatal substance use, limited prenatal substance use disorder treatment facilities, and inadequate provider training on context-specific congenital syphilis management strategies. Gaps in partner notification, screening and treatment for syphilis were brought up by pregnant/postpartum women and prenatal care providers. Conclusions. Congenital syphilis continues to increase in Kern County and throughout the U.S. In high syphilis morbidity areas, comprehensive and tailored public health approaches addressing setting-specific gaps in prenatal screening and treatment are needed.

scholarly journals Preventing Excessive Weight Gain in Pregnancy: How Do Prenatal Care Providers Approach Counseling?

2010 ◽  
Vol 19 (4) ◽  
pp. 807-814 ◽  
Author(s):  
Naomi E. Stotland ◽  
Paul Gilbert ◽  
Alyssa Bogetz ◽  
Cynthia C. Harper ◽  
Barbara Abrams ◽  
...  
Keyword(s):  
Weight Gain ◽  
Prenatal Care ◽  
Care Providers ◽  
Excessive Weight Gain ◽  
Excessive Weight ◽  
Prenatal Care Providers ◽  
In Pregnancy

scholarly journals Congenital syphilis in East Baton Rouge parish, Louisiana: providers’ and women’s perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emily W. Harville ◽  
Gloria P. Giarratano ◽  
Pierre Buekens ◽  
Eurydice Lang ◽  
Jennifer Wagman
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Health Care Providers ◽  
Baton Rouge ◽  
Congenital Syphilis ◽  
The United States ◽  
Care Providers ◽  
Sources Of Information ◽  
Effective Prevention ◽  
East Baton Rouge Parish

Abstract Background Congenital syphilis is completely preventable through screening and treatment, but rates have been rising in the United States. Certain areas are at particularly high risk. We aimed to assess attitudes, knowledge, and barriers around effective prevention of congenital syphilis among health care providers and community women potentially at risk. Methods Two parallel studies were conducted: in-depth interviews with health care providers and focus groups with community women in the area of Baton Rouge, Louisiana. Each group was questioned about their experience in providing or seeking prenatal care, knowledge and attitudes about congenital syphilis, sources of information on testing and treatment, perceptions of risk, standards of and barriers to treatment. Results were transcribed into QSR NVivo V10, codes developed, and common themes identified and organized. Results Providers identified delays in testing and care, lack of follow-through with partner testing, and need for community connection for prevention, as major contributors to higher rates of congenital syphilis. Women identified difficulties in accessing Medicaid contributing to delayed start of prenatal care, lack of transportation for prenatal care, and lack of knowledge about testing and prevention for congenital syphilis. Conclusions Providers and community members were in broad agreement about factors contributing to higher rates of congenital syphilis, although some aspects were emphasized more by one group or another. Evidence-based interventions, likely at multiple levels, need to be tested and implemented to eliminate congenital syphilis.

scholarly journals Perceived barriers to Chagas disease screening among a diverse group of prenatal care providers

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246783
Author(s):  
Helen Mahoney West ◽  
Carly E. Milliren ◽  
Olivera Vragovic ◽  
Julia R. Köhler ◽  
Christina Yarrington
Keyword(s):  
Family Medicine ◽  
Prenatal Care ◽  
Chagas Disease ◽  
Safety Net ◽  
The United States ◽  
Disease Screening ◽  
Perceived Barriers ◽  
Care Providers ◽  
Safety Net Hospital ◽  
Prenatal Care Providers

Background Chagas disease is a vector borne infection of poverty endemic to Latin America which affects an estimated 40,000 women of child-bearing age in the United States (US). In the US Chagas disease is concentrated among individuals who have lived in endemic areas. Prenatal diagnosis and treatment are needed to prevent congenital transmission. The objective of this study was to assess perceived barriers to Chagas disease screening among prenatal care providers in Obstetrics/Gynecology and Family Medicine Departments of a tertiary care safety-net hospital caring for a significant at-risk population. Methodology/Principal findings An anonymous survey was distributed to 178 Obstetrics/Gynecology and Family Medicine practitioners. Of the 66 respondents, 39% thought Chagas screening was very important, and 48% somewhat important as a public health initiative. One third judged screening patients during clinic visits as very important. Most respondents (64%) reported being familiar with Chagas disease. However, only 32% knew how to order a test and only 22% reported knowing what to do if a test was positive. Conclusions/Significance These findings will be incorporated into measures to facilitate full implementation of Chagas screening, and can inform initiatives at other centers who wish to address this deeply neglected infection among their patient families. Greater integration of information on Chagas disease screening and treatment in medical and nursing education curricula can contribute to addressing this disease with the focus that its potentially fatal sequelae merit.

scholarly journals Should prenatal care providers offer pregnancy options counseling?

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Nancy F. Berglas ◽  
Valerie Williams ◽  
Katrina Mark ◽  
Sarah C. M. Roberts
Keyword(s):  
Prenatal Care ◽  
Care Providers ◽  
Prenatal Care Providers

scholarly journals Lessons from prenatal care provider-based recruitment into the National Children’s Study

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
James M. Robbins ◽  
Melissa D. Bridges ◽  
Elizabeth M. Childers ◽  
Roseanne M. Harris ◽  
Pearl A. McElfish
Keyword(s):  
Prenatal Care ◽  
Care Providers ◽  
Recruitment Method ◽  
Equivalent Number ◽  
Prenatal Care Providers ◽  
Status Number ◽  
Public Clinics ◽  
Benton County ◽  
Birth Records ◽  
Successes And Challenges

In response to recruitment difficulties experienced by the National Children’s Study, alternatives to the door-to-door recruitment method were pilot tested. This report describes outcomes, successes, and challenges of recruiting women through prenatal care providers in Benton County, Arkansas, USA. Eligible women residing in 14 randomly selected geographic segments were recruited. Data were collected during pregnancy, at birth, and at 3, 6, 9, 12, 18, and 24 months <em>postpartum</em>. Participants were compared to non-enrolled eligible women through birth records. Of 6402 attempts to screen for address eligibility, 468 patients were potentially eligible. Of 221 eligible women approached to participate, 151 (68%) enrolled in the 21-year study. Enrolled women were similar to non-enrolled women in age, marital status, number of prenatal care visits, and gestational age and birth weight of the newborn. Women enrolled from public clinics were more likely to be Hispanic, lower educated, younger and unmarried than those enrolled from private clinics. Sampling geographic areas from historical birth records failed to produce expected equivalent number of births across segments. Enrollment of pregnant women from prenatal care providers was successful.

Patient Report of Guideline-Congruent Gestational Weight Gain Advice From Prenatal Care Providers: Differences by Prepregnancy BMI

Birth ◽  
2014 ◽  
Vol 41 (4) ◽  
pp. 353-359 ◽  
Author(s):  
Molly E. Waring ◽  
Tiffany A. Moore Simas ◽  
Katharine C. Barnes ◽  
Daniel Terk ◽  
Inna Baran ◽  
...  
Keyword(s):  
Weight Gain ◽  
Prenatal Care ◽  
Gestational Weight Gain ◽  
Care Providers ◽  
Patient Report ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Prenatal Care Providers

Improving Prenatal Health

2013 ◽  
Vol 7 (6) ◽  
pp. 523-526 ◽  
Author(s):  
Marie Guadagno ◽  
Michael Mackert ◽  
Aaron Rochlen
Keyword(s):  
United States ◽  
Health Education ◽  
Infant Mortality ◽  
Pregnancy Outcomes ◽  
The United States ◽  
Infant Mortality Rate ◽  
Birth Preparedness ◽  
Care Providers ◽  
Prenatal Health ◽  
In Pregnancy

The U.S. infant mortality rate is among the highest in the developed world, with recent vital statistics reports estimating 6.14 infant deaths per 1,000 live births. Traditional health education and promotion to improve maternal, infant, and child health in the United States has focused only on women, leaving men out of important health messages that may affect pregnancy outcomes as well as family well-being. Recently, public health scholars have suggested that men be included in prenatal health education in an effort to improve birth outcomes and reduce infant mortality. Incorporating men in prenatal health promotion and education has been found to improve overall birth preparedness, reduce the risk of maternal–infant HIV transmission, and reduce perinatal mortality in less-developed nations. Although these results are positive, research on paternal impact in pregnancy outcomes in the United States to date is lacking. This article proposes a U.S.-specific research agenda to understand the current role of men in pregnancy health, as well as actual involvement, barriers, and the influence men can have in prenatal health. A discussion of culture, individual motivations, health care providers, and social marketing is also considered.

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