Top

Published in:

19-11-2023 | Premature Birth

Acceptability of Dyad Care Management After Preterm Birth: A Qualitative Study

Authors: Emily F. Gregory, Rinad S. Beidas, Alexander G. Fiks, Scott A. Lorch, Lisa D. Levine, David M. Rubin, Adya I. Maddox, Ann L. O’Sullivan, Katherine K. Wu, Peter F. Cronholm

Published in: Maternal and Child Health Journal | Issue 2/2024

Abstract

Objectives

Care management programs for medically complex infants interact with parents after complicated pregnancies, when gaps in maternal health care are well documented. These care managers may have the relationships and skills to promote postpartum and interconception health and health care access. It is unknown whether expanding these care management models to address maternal needs would be acceptable.

Methods

We conducted qualitative interviews with women with a history of preterm birth and clinicians. For women with a history of preterm birth, additional inclusion criteria were Medicaid-insured infant in one health system and English proficiency. We purposively oversampled women whose infants received care management. Clinicians worked in two geographically adjacent health systems. Interviews explored priorities after preterm birth and perceived acceptability of mother-infant dyad care management. Interviews were audio recorded, transcribed, and coded following an integrated approach in which we applied a priori codes and captured emergent themes.

Results

We interviewed 33 women (10/2018–7/2021) and 24 clinicians (3/2021–8/2021). Women were predominantly non-Hispanic Black, and 15 had infants receiving care management. Clinicians included physicians, nurses, and social workers from Pediatrics, Obstetrics, and Family Medicine. Subgroups converged thematically, finding care management acceptable. Tailoring programs to address stress and sleep, emphasizing care managers with strong interpersonal skills and shared experiences with care management users, and program flexibility would contribute to acceptability.

Conclusions for Practice

Dyad care management after preterm birth is acceptable to potential program end-users and clinicians. Dyad health promotion may contribute to improved birth outcomes, infant, and parent health.

Available only for authorised users

Admon, L. K., Winkelman, T. N. A., Moniz, M. H., Davis, M. M., Heisler, M., & Dalton, V. K. (2017). Disparities in chronic conditions among women hospitalized for delivery in the United States, 2005–2014. Obstetrics and Gynecology, 130(6), 1319–1326. https://doi.org/10.1097/AOG.0000000000002357CrossRefPubMed

Agency for Healthcare Research and Quality. (2015). Care Management Issue Brief Care Management: a Fundamental Vehicle for Managing the Health of Populations Overview. www.ahrq.gov

Barbour, R. S. (2001). Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ: British Medical Journal, 322(7294), 1115.CrossRefPubMedPubMedCentral

Bennett, W. L., Chang, H.-Y.Y., Levine, D. M., Wang, L., Neale, D., Werner, E. F., & Clark, J. M. (2014). Utilization of primary and obstetric care after medically complicated pregnancies: An analysis of medical claims data. Journal of General Internal Medicine, 29(4), 636–645. https://doi.org/10.1007/s11606-013-2744-2CrossRefPubMedPubMedCentral

Bennett, W. L., Ennen, C. S., Carrese, J. A., Hill-Briggs, F., Levine, D. M., Nicholson, W. K., & Clark, J. M. (2011). Barriers to and facilitators of postpartum follow-up care in women with recent gestational diabetes mellitus: A qualitative study. Journal of Women’s Health, 20(2), 239–245.CrossRefPubMedPubMedCentral

Bergman, D. A., Keller, D., Kuo, D. Z., Lerner, C., Mansour, M., Stille, C., Richardson, T., Rodean, J., & Hudak, M. (2020). Costs and use for children with medical complexity in a care management program. Pediatrics. https://doi.org/10.1542/PEDS.2019-2401/36941CrossRefPubMedPubMedCentral

Bradley, E. H., Curry, L. A., & Devers, K. J. (2007). Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Services Research, 42(4), 1758–1772.CrossRefPubMedPubMedCentral

Brown, O., Kangovi, S., Wiggins, N., & Alvarado, C. S. (2020). Supervision strategies and community health worker effectiveness in health care settings. NAM Perspectives. https://doi.org/10.31478/202003CCrossRefPubMedPubMedCentral

Cohen, E., Kuo, D. Z., Agrawal, R., Berry, J. G., Bhagat, S. K., Simon, T. D., & Srivastava, R. (2011). Children with medical complexity: An emerging population for clinical and research initiatives. Pediatrics, 127(3), 529–538. https://doi.org/10.1542/peds.2010-0910CrossRefPubMedPubMedCentral

Coleman, K., Austin, B. T., Brach, C., & Wagner, E. H. (2009). Evidence on the chronic care model in the new millennium. Health Affairs, 28(1), 75–85. https://doi.org/10.1377/hlthaff.28.1.75CrossRefPubMed

Cunningham, S. D., Riis, V., Line, L., Patti, M., Bucher, M., Durnwald, C., & Srinivas, S. K. (2020). Safe start community health worker program: A multisector partnership to improve perinatal outcomes among low-income pregnant women with chronic health conditions. American Journal of Public Health, 110(6), 836–839. https://doi.org/10.2105/AJPH.2020.305630CrossRefPubMedPubMedCentral

Dopp, A. R., Parisi, K. E., Munson, S. A., & Lyon, A. R. (2019). A glossary of user-centered design strategies for implementation experts. Translational Behavioral Medicine, 9(6), 1057–1064. https://doi.org/10.1093/TBM/IBY119CrossRefPubMed

Esmaeilzadeh, P., & Sambasivan, M. (2017). Patients’ support for health information exchange: a literature review and classification of key factors. BMC Medical Informatics and Decision Making. https://doi.org/10.1186/S12911-017-0436-2CrossRefPubMedPubMedCentral

Feudtner, C., Feinstein, J. A., Zhong, W., Hall, M., & Dai, D. (2014). Pediatric complex chronic conditions classification system version 2: Updated for ICD-10 and complex medical technology dependence and transplantation. BMC Pediatrics, 14(1), 199.CrossRefPubMedPubMedCentral

Green, H. M., Carmona-Barrera, V., Diaz, L., Yeh, C., Williams, B., Davis, K., Kominiarek, M. A., Feinglass, J., Grobman, W. A., Zera, C., & Yee, L. M. (2023). Implementation of postpartum navigation for low-income individuals at an urban academic medical center. PloS One. https://doi.org/10.1371/JOURNAL.PONE.0282048CrossRefPubMedPubMedCentral

Gregory, E. F., Passarella, M., Levine, L. D., Fiks, A. G. A. G., & Lorch, S. A. (2020). Preventive health care utilization among mother-infant dyads with medicaid insurance in the year following birth. Medical Care, 58(6), 519–525. https://doi.org/10.1097/MLR.0000000000001310CrossRefPubMed

Gregory, E. F., Passarella, M., Levine, L. D., & Lorch, S. A. (2022). Interconception preventive care and recurrence of pregnancy complications for Medicaid-insured women. Journal of Women’s Health. https://doi.org/10.1089/JWH.2021.0355CrossRefPubMedPubMedCentral

Hagerman, T. K., McKernan, G. P., Carle, A. C., Yu, J. A., Stover, A. D., & Houtrow, A. J. (2022). The Mental and Physical Health of Mothers of Children with Special Health Care Needs in the United States. Maternal and Child Health Journal, 26(3), 500–510. https://doi.org/10.1007/S10995-021-03359-1CrossRefPubMed

Hoyert, D. L. (2020). Health E-stat, February 2022. https://doi.org/10.15620/cdc:103855

Kuo, D. Z., Rossignol, L., McAllister, J. W., Stille, C. J., & Turchi, R. M. (2018). Care coordination for children with medical complexity: Whose care is it, anyway? Pediatrics, 141(Supplement 3), S224–S232. https://doi.org/10.1542/peds.2017-1284gCrossRefPubMed

Lewey, J., Levine, L. D., Yang, L., Triebwasser, J. E., & Groeneveld, P. W. (2020). Patterns of postpartum ambulatory care follow-up care among women with hypertensive disorders of pregnancy. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.120.016357CrossRefPubMedPubMedCentral

Louis, J. M., Menard, M. K., & Gee, R. E. (2015). Racial and ethnic disparities in maternal morbidity and mortality. Obstetrics and Gynecology, 125(3), 690–694. https://doi.org/10.1097/AOG.0000000000000704CrossRefPubMed

Lyon, A. R., & Bruns, E. J. (2019). User-centered redesign of evidence-based psychosocial interventions to enhance Implementation—Hospitable soil or better seeds? JAMA Psychiatry, 76(1), 3–4. https://doi.org/10.1001/JAMAPSYCHIATRY.2018.3060CrossRefPubMed

Mosca, L., Benjamin, E. J., Berra, K., Bezanson, J. L., Dolor, R. J., Lloyd-Jones, D. M., Newby, L. K., Piña, I. L., Roger, V. L., Shaw, L. J., Zhao, D., Beckie, T. M., Bushnell, C., D’Armiento, J., Kris-Etherton, P. M., Fang, J., Ganiats, T. G., Gomes, A. S., Gracia, C. R., American Heart Association. (2011). Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women—2011 Update. Journal of the American College of Cardiology, 57(12), 1404–1423. https://doi.org/10.1016/j.jacc.2011.02.005CrossRefPubMedPubMedCentral

Olds, D. L. (2006). The nurse–family partnership: An evidence-based preventive intervention. Infant Mental Health Journal, 27(1), 5–25. https://doi.org/10.1002/IMHJ.20077CrossRefPubMed

Osterman, M. J., Hamilton, B. E., Martin, J. A., Driscoll, A. K., & Valenzuela, C. P. (2023). Births: Final data for 2021. National Vital Statistics Report, 72(1), 1–53.

Patrick, H., & Williams, G. C. (2012). Self-determination theory: Its application to health behavior and complementarity with motivational interviewing. International Journal of Behavioral Nutrition and Physical Activity, 9(1), 18. https://doi.org/10.1186/1479-5868-9-18CrossRefPubMedPubMedCentral

Rankin, K. M., Haider, S., Caskey, R., Chakraborty, A., Roesch, P., & Handler, A. (2016). Healthcare utilization in the postpartum period among illinois women with medicaid paid claims for delivery, 2009–2010. Maternal and Child Health Journal, 20(Suppl 1), 144–153. https://doi.org/10.1007/s10995-016-2043-8CrossRefPubMedPubMedCentral

Rodin, D., Silow-Carroll, S., Cross-Barnet, C., Courtot, B., & Hill, I. (2019). Strategies to promote postpartum visit attendance among medicaid participants. Journal of Women’s Health, 28(9), 1246–1253. https://doi.org/10.1089/jwh.2018.7568CrossRefPubMed

Shah, N. R., Kim, K. M., Wong, V., Cohen, E., Rosenbaum, S., Cahan, E. M., Milstein, A., Sørensen, H. T., & Horvath-Puho, E. (2021). Mothers of children with major congenital anomalies have increased health care utilization over a 20-year post-birth time horizon. PloS One. https://doi.org/10.1371/JOURNAL.PONE.0260962CrossRefPubMedPubMedCentral

Shapiro-Mendoza, C. K. (2016). CDC grand rounds: public health strategies to prevent preterm birth. MMWR Morbidity and Mortality Weekly Report, 65, 826–830.CrossRefPubMed

Shen, N., Bernier, T., Sequeira, L., Strauss, J., Silver, M. P., Carter-Langford, A., & Wiljer, D. (2019). Understanding the patient privacy perspective on health information exchange: A systematic review. International Journal of Medical Informatics, 125, 1–12. https://doi.org/10.1016/J.IJMEDINF.2019.01.014CrossRefPubMed

Srinivas, S. K. (2020). As maternal mortality rises, the solutions are complex and difficult for physicians to manage alone. NEJM Catalyst Innovations in Care Delivery. https://doi.org/10.1056/CAT.20.0008CrossRef

Srinivasan, S., Schlar, L., Rosener, S. E., Frayne, D. J., Hartman, S. G., Horst, M. A., Brubach, J. L., & Ratcliffe, S. (2018). Delivering interconception care during well-child visits: An IMPLICIT network study. Journal of the American Board of Family Medicine : JABFM, 31(2), 201–210. https://doi.org/10.3122/jabfm.2018.02.170227CrossRefPubMed

Tully, K. P., Stuebe, A. M., & Verbiest, S. B. (2017). The fourth trimester: A critical transition period with unmet maternal health needs. American Journal of Obstetrics and Gynecology, 217(1), 37–41. https://doi.org/10.1016/j.ajog.2017.03.032CrossRefPubMed

Upadhya, K. K., Psoter, K. J., Connor, K. A., Mistry, K. B., Levy, D. J., & Cheng, T. L. (2020). Cluster randomized trial of a pre/interconception health intervention for mothers in pediatric visits. Academic Pediatrics, 20(5), 660–669. https://doi.org/10.1016/j.acap.2019.10.003CrossRefPubMed

Venkataramani, M., Cheng, T. L., Solomon, B. S., & Pollack, C. E. (2017). Caregiver health promotion in pediatric primary care settings: Results of a national survey. Journal of Pediatrics, 181, 254-260.e2. https://doi.org/10.1016/j.jpeds.2016.10.054CrossRefPubMed

Verbiest, S., Tully, K., Simpson, M., & Stuebe, A. (2018). Elevating mothers’ voices: Recommendations for improved patient-centered postpartum. Journal of Behavioral Medicine, 41(5), 577–590. https://doi.org/10.1007/s10865-018-9961-4CrossRefPubMed

Wise, P. H. (2007). The future pediatrician: the challenge of chronic illness. The Journal of Pediatrics. https://doi.org/10.1016/J.JPEDS.2007.08.013CrossRefPubMed

Title: Acceptability of Dyad Care Management After Preterm Birth: A Qualitative Study
Authors: Emily F. Gregory
Rinad S. Beidas
Alexander G. Fiks
Scott A. Lorch
Lisa D. Levine
David M. Rubin
Adya I. Maddox
Ann L. O’Sullivan
Katherine K. Wu
Peter F. Cronholm
Publication date: 19-11-2023
Publisher: Springer US
Keyword: Premature Birth
Published in: Maternal and Child Health Journal / Issue 2/2024
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-023-03848-5

ERS Congress 2024

Springer Medicine

Acceptability of Dyad Care Management After Preterm Birth: A Qualitative Study

Abstract

Objectives

Methods

Results

Conclusions for Practice

ERS Congress 2024

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions for Practice

Please log in to get access to this content

Other articles of this Issue 2/2024

Assessing the Feasibility of Partnering with a Home Visiting Program for Early Childhood Obesity Prevention

Cannabis Smoking and Storage within the Home: A Cross-Sectional Survey of Pregnant Women and Women with Young Children

Developing Workforce Skills and Capacity in Telehealth: What LEND Trainees Need to Know

Evaluating Standard of Care and Obstetrical Outcomes in a Reduced Contact Prenatal Care Model in the COVID-19 Pandemic

A Qualitative Investigation of the Experiences of Women with Perinatal Depression and Anxiety during the COVID-19 Pandemic

Stress During Pregnancy Associated with Newborn Low Birth Weight: Experiences from the State of Rhode Island