Providers' perspectives on barriers to care, system constraints and piloting the HIV-modified Centering Pregnancy Model among HIV-positive pregnant women
HIV-positive pregnant women can often face socioeconomic, behavioral, and psychosocial issues associated with receiving prenatal care, postnatal care and HIV treatment. These barriers can hinder expectant mothers from receiving proper care which is vital to preventing mother-to-child HIV transmission. Hence, addressing these barriers is imperative to preventing adverse maternal and infant outcomes. ^ The parent study (conducted by Baylor College of Medicine) investigated the intervention pilot program, Special Beginnings, which used the HIV-modified CenteringPregnancy Model as the curriculum adaptation of the trademarked CenteringPregnancy Model. This model introduced a group-setting approach (Centering) uniquely tailored for HIV-positive pregnant women in order to educate, empower, support, and encourage active participation in obtaining and maintaining prenatal care and HIV treatment. ^ The role of HIV providers is critical in delivering prenatal care to HIV-positive expectant mothers; therefore, their viewpoints can serve as recommendations and can substantiate modifications needed to further improve the Special Beginnings intervention pilot program. Because HIV providers worked directly with the patients and were also the program implementers during the piloting phase, in-depth qualitative interviews were conducted with a diverse group of clinicians and non-clinicians (n=20). This supplemental study used in-depth interviews to capture HIV providers' perspectives on the experiences and challenges they faced providing care to HIV-positive expectant mothers as well as their stance on using the HIV-modified CenteringPregnancy Model as the central educational curriculum for delivering prenatal group care. The audio recordings from the interviews were transcribed verbatim and data analysis was conducted using ATLAS.ti (version 7.0) qualitative software. ^ The providers pinpointed which types of socioeconomic and psychosocial barriers they deemed as major disparities hindering prenatal care, postnatal care and long-term HIV treatment (retention in care) among HIV-positive pregnant women. Therefore, obtaining the providers' perspectives on these issues provided an insider's look into the types of major barriers that needed to be addressed in order for HIV-positive pregnant women to obtain and maintain infant care and HIV treatment. The providers also indicated what they felt were the pertinent systemic constraints within the health care system that exacerbated issues related to linkage-to-care, transitioning care, retention in care, navigating the health system, and coverage options among this population. In short, policy development and implementation would be most beneficial in addressing these larger systemic health system challenges. Lastly, the providers articulated their viewpoints on the Special Beginnings intervention program. They expressed the piloting of the HIV-modified CenteringPregnancy Model appeared to have a positive impact on HIV-positive pregnant women adherence to prenatal care and long-term HIV treatment and could also serve as a plausible method of delivering prenatal care to these patients.^
Women's Studies|Health Sciences, Public Health|Sociology, Public and Social Welfare|Health Sciences, Health Care Management
Aigbe, Aitebureme Oare, "Providers' perspectives on barriers to care, system constraints and piloting the HIV-modified Centering Pregnancy Model among HIV-positive pregnant women" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3665069.