UT SON Dissertations (Open Access)

Date of Award

Spring 5-2017

Degree Name

Doctor of Philosophy in Nursing (PhD)

Advisor(s)

Diane Wardell, PhD - Chair

Second Advisor

Geri LoBiondo-Wood, PhD

Third Advisor

Ruth Buzi, MSW

Abstract

Background: Teenage mothers are less likely to obtain postpartum examinations and contraception, increasing risks for negative social and health outcomes. The CenteringPregnancy® prenatal care model has been found to improve outcomes. However, little is known about factors influencing CenteringPregnancy® attendance or how this attendance impacts future pregnancy rates among teenagers.

Aim: The purpose of this study was to explore the association between CenteringPregnancy® attendance, postpartum return, contraception initiation and method selection. Additionally, the Group Care and Perinatal Behaviors Framework was used to assess the association between food insecurity, housing insecurity, intimate partner violence relationship status, partner group attendance and total CenteringPregnancy® sessions attended.

Methods: A retrospective record review was conducted on a consecutive sample of (n=83) pregnant and parenting teenagers, between the ages of 13-19 years, seen at a community based teen health clinic.

Analysis: Bivariate relationships between variables were analyzed using Fisher’s exact test, independent t-test and one-way ANOVA.

Results: Housing insecurity, food insecurity, intimate partner violence, marital status and partner session attendance were not significant factors associated with participant CenteringPregnancy® attendance. Total CenteringPregnancy® attendance was significantly (p=.04) associated with return for postpartum exam, but not contraception initiation or effectiveness of selected methods. Attendance at session 9 appears to be significantly (p=.041) linked to postpartum contraceptive initiation, with attendance at sessions 9 and 10 also significantly linked to postpartum return (p=.032 and p=.033 respectively).

Discussion: While the complex social and economic factors addressed within this study did not impact CenteringPregnancy® attendance in this group of teens, the identification of overall attendance and specific session attendance as significant factors influencing postpartum exam utilization and contraceptive uptake, allows for CenteringPregnancy® delivery sites to make accommodations that may promote teenage patient retention.

Keywords

CenteringPregnancy®, birth control, teenagers

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Nursing Commons

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