Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum
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Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum Emily C. Heberlein1 • Edward A. Frongillo2 • Amy H. Picklesimer3 Sarah Covington-Kolb3
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Published online: 10 December 2015 Ó Springer Science+Business Media New York 2015
Abstract Objective This study compared the effects of group to individual prenatal care in late pregnancy and early postpartum on (1) women’s food security and (2) psychosocial outcomes among food-insecure women. Methods and Results We recruited 248 racially diverse, low-income, pregnant women receiving CenteringPregnancyTM group prenatal care (N = 124) or individual prenatal care (N = 124) to complete surveys in early pregnancy, late pregnancy, and early postpartum, with 84 % completing three surveys. Twenty-six percent of group and 31 % of individual care participants reported food insecurity in early pregnancy (p = 0.493). In multiple logistic regression models, women choosing group versus individual care were more likely to report food security in late pregnancy (0.85 vs. 0.66 average predicted probability, p \ 0.001) and postpartum (0.89 vs. 0.78 average predicted probability, p = 0.049). Among initially food-insecure
& Emily C. Heberlein [email protected] Edward A. Frongillo [email protected] Amy H. Picklesimer [email protected] Sarah Covington-Kolb [email protected] 1
Department of Public Health Sciences, College of Health, Education, and Human Development, Clemson University, Clemson, SC 29634, USA
2
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
3
Department of Obstetrics and Gynecology, Greenville Health System, 890 W. Faris Road, Greenville, SC 29605, USA
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women, group participants were more likely to become food-secure in late pregnancy (0.67 vs. 0.35 individual care average predicted probability, p \ 0.001) and postpartum (0.76 vs. 0.57 individual care average predicted probability, p = 0.052) in intention-to-treat models. Group participants were more likely to change perceptions on affording healthy foods and stretching food resources. Group compared to individual care participants with early pregnancy food insecurity demonstrated higher maternal-infant attachment scale scores (89.8 vs. 86.2 points for individual care, p = 0.032). Conclusions Group prenatal care provides health education and the opportunity for women to share experiences and knowledge, which may improve food security through increasing confidence and skills in managing household food resources. Health sector interventions can complement food assistance programs in addressing food insecurity during pregnancy. Keywords Pregnancy Food insecurity Prenatal care CenteringPregnancy Group prenatal care
Significance CenteringPregnancy group prenatal care, compared to traditional individual prenatal care, has positive psychosocial benefits for high-stress women, but research is lacking on group prenatal care’s impact on food security
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