prenatal care powerpoint
TRANSCRIPT
1
Barriers to Attending a Prenatal Care Program and the Health Belief Model
Jessica L. Altice, MAEdNovember 09, 2011
2
What is Prenatal Care and the Purpose?
Prenatal care is care a woman receives while she is pregnant.
Is usually provided by an OB/GYN, family practice physician, nurse midwife, or other health professional.
Monitors how the pregnancy is progressing and identifies potential health problems.
Mothers are given information on prenatal tests, maternal vaccinations, healthy nutrition, alcohol and substance abuse, smoking, and environmental and reproductive hazards.
3
Role of Prenatal Care Prenatal care can
reduce:› Infant Mortality› Birth Defects› Preterm Birth› Low Birthweight
5
2011 Premature Birth Report Card
6
Women at Risk
7
Importance of Prenatal Care
Kelly Thorman was born at 21 ½ weeks after conception. This picture was taken three weeks later and Kelly later
died of pneumonia.
8
Health Belief Model Constructs
Perceived susceptibility Perceived severity Perceived threat Perceived benefits Perceived barriers Self-efficacy Cues to action
9
Health Belief Model
10
Health Belief Model Continued
11
Drug Use and Limited Prenatal Care: An Examination of Reponsible
Barriers(Schempf & Strobino, 2009)Cocaine Opiates Marijuana
Perceived financial barrier did not affect
care
Perceived financial barrier did not affect
care
Perceived financial barrier did not affect
care
Attitudes toward value of care was a
barrier
Attitudes toward value of care was a
barrier
Attitudes toward value of care was a barrier
Opiate use statistically
significant to explain lack of care
Negative provider perceptions were
related to little or no care
Negative provider perceptions were
related to little or no care
Negative provider perceptions were
related to little or no care
Efficacy of care related
Efficacy of care related
Efficacy of care related
Fear of being reported relate
Fear of being reported related
Fear of being reported related
12
Perceived Impediments to Prenatal Care among Low- Income Women
(Mikhail & Curry, 1999)Impediment to Care Statistically Significant
TransportationLong wait times at the clinicToo many additional problemsDid not have problems with other pregnancyAfraid doctor would find out about substance use
*
Afraid they would be asked to stop smoking or drinkingFear of medical examination *Felt prenatal care was not needed *Afraid to find out she was pregnant *Already knew she was pregnant *No babysitter for other children *
13
Initiation of Prenatal Care by Low-Income Hispanic Women in Houston
(Byrd, Mullen, Selwyn & Lorimor, 1996) Perceived barriers, age, country card
status, and benefits to baby explained 22% of variance in month of prenatal care initiation.
Women with fewer perceived barriers, were older, and had a country card were more likely to enter care earlier.
14
Prenatal Care Utilization Among Low-Income African American Women
(Mikhail, 2000) 49.2% of the women initiated care within
3-4 months. 34% had inadequate care that was
initiated after the fourth month. Negative experiences included waiting
time, waking up early to go to the doctor, not wanting to see the doctor, having motion sickness, having an examination, and waiting for transportation.
15
Access to Preventive Health Care: Is Method of Payment a Barrier for Immigrant Hispanic Women?
(Jones, Cason & Bond, 2002)
Women were divided into self-pay, commercial-pay, and government subsidized.
There were no significant differences between the three pay categories.
16
Not a Separate Health Issue
CHILD
MALTREATMEANT
Alcohol and Substance Abuse
HIV/AIDS
Cardiovascular Disease
Obesity
17
Moving In A New Direction
Reinvent prenatal care as a targeted intervention (risk appropriate intervention).
Factor in barriers and facilitators to care when planning interventions.
Provide prenatal care to the uninsured.