Key Considerations for Implementing Group Prenatal Care: Lessons from 60 Practices.

Area of Science:

• Maternal Health
• Healthcare Implementation Science
• Public Health Interventions

Background:

• Group prenatal care integrates clinical services with peer support and education.
• Previous research shows neutral to positive outcomes compared to traditional prenatal care.
• The Strong Start II initiative aimed to assess group prenatal care's impact on preterm birth rates, health outcomes, and costs.

Purpose of the Study:

• To explore barriers encountered during the implementation and sustainability of group prenatal care.
• To identify strategies for overcoming these barriers and ensuring the long-term viability of group prenatal care models.

Main Methods:

• Qualitative case studies were conducted as part of the independent evaluation of the Strong Start initiative.
• Data collection involved 313 interviews with 441 key informants and 53 focus groups with 428 participants.
• Content analysis and grounded theory were used to analyze case study data.

Main Results:

• Implementation barriers were identified across patient, provider, administrator, system, and funding levels.
• Specific barriers included inflexible scheduling, lack of childcare, inadequate space, and resistance to new practices.
• Provider champions and opt-out enrollment were crucial for program buy-in and sustainability.

Conclusions:

• Successful group prenatal care implementation and sustainability necessitate coordinated strategies involving practices, payers, providers, patients, and policymakers.
• Addressing identified barriers can facilitate the adoption of group prenatal care, even in settings with graduate medical education or high-risk populations.