CenteringPregnancy Plus

OVERVIEW

CenteringPregnancy Plus is a 10-week prenatal care program, delivered in a group setting, which targets pregnant adolescents.  The program begins when women are in their second trimester of pregnancy and is based on three primary components: assessment, education, and support.  Participants are provided with information about pregnancy and HIV/STIs.  An evaluation found an increase in the rate of condom use, and a lower rate of unprotected sexual intercourse at 12-month follow-up, relative to control-group rates.

 

DESCRIPTION OF PROGRAM

 

Target population: Pregnant women less than 24 weeks pregnant.

 

CenteringPregnancy Plus has the same structure as the CenteringPregnancy program.  There is a 10-week prenatal care program delivered in a group setting of approximately eight to 12 women with similar delivery dates.  This program serves pregnant adolescent girls, and is based on three primary components of care: health/physical assessment, education and skills building, and support.  The program begins when women are in their second trimester – approximately 16 weeks of pregnancy.  The group setting is facilitated by a trained practitioner, such as a midwife or obstetrician.  Women begin each two-hour session with a health assessment that may include a blood pressure screening, blood tests, and fetal heart rate monitoring – all of which can be completed in a group setting.  Women are encouraged to maintain copies of their own health information to increase their self-empowerment and self-efficacy.  Education sessions follow the health assessment and are led by the trained practitioners.  These educational discussions, based on a structured manual, typically center on prenatal care, preparation for childbirth, and caring for infants after birth.  Additionally, three sessions devote 40 minutes each to HIV-related information.  These sessions include video testimonials of adolescents living with HIV, to raise awareness of risk; discussing skills for communicating with sexual partners, and role-playing to reinforce safer sexual practices.  The sessions are based on social-cognitive theory and ecological models of development.  Except for the initial assessment, all prenatal care takes place in a group setting.  In these two-hour sessions women can receive “one-stop shopping,” with all services provided in a group setting of mutual support.  Group sessions can be provided at community centers or conference rooms, thereby reducing the need for medical examination rooms. 

 

The CenteringPregnancy handbook costs $150.  Materials for this program are available here: https://www.centeringhealthcare.org/Store/index.php

 

EVALUATION OF PROGRAM

Kershaw, T. S., Magriples, U., Westdahl, C., Schindler Rising, S., & Ickovis, J. (2007). Pregnancy as a window of opportunity for HIV prevention: Effects of an HIV intervention delivered within prenatal care. American Journal of Public Health, 99(11), 2079-2086.

 

Evaluated population: A total of 1,047 adolescent girls and young women (14-25 years) from one of two publicly-funded clinics in Atlanta, GA and New Haven, CT.  Participants’ mean age was 20 years, and they had a mean of 11 years of education.  Approximately 80 percent of the participants were black, and 15 percent were Latina.  Participants were less than 24 weeks pregnant.

 

Approach: Women entering one of two publicly-funded prenatal care clinics were enrolled and randomly assigned to the CenteringPregnancy Plus (CPP) intervention (n = 318), CenteringPregnancy (CP) intervention (n = 335) or the standard-care control group (n = 394).  Participants were assessed at post-test, six-month follow-up, 12-month follow-up (for chlamydia and gonorrhea infection), repeat pregnancy, condom use, safe-sex communication, HIV/STI risk, and HIV/STI knowledge.

 

Results: At post-test, there was significantly  better communication about safe sexual activity among the CPP group when compared with the control group.  There were no impacts on other outcomes at post-test.  At the six-month follow-up, there were significant positive effects on repeat pregnancy and in condom use.  There were no impacts on other outcomes at six months.  At the 12-month follow-up, there were significant positive effects on condom use and communication about safe sexual activity.  There was a significant positive effect on the number of acts of unprotected sexual intercourse.  There were no other impacts at 12 months.  Adolescents in the CPP group had significantly fewer cases of STIs at 12 months when compared with the control group.  There were no significant differences by race.

 

SOURCES FOR MORE INFORMATION

 

http://www.centeringhealthcare.org/

https://www.centeringhealthcare.org/Store/index.php

 

References

Kershaw, T. S., Magriples, U., Westdahl, C., Schindler Rising, S., & Ickovis, J. (2007). Pregnancy as a window of opportunity for HIV prevention: Effects of an HIV intervention delivered within prenatal care. American Journal of Public Health, 99(11), 2079-2086.

 

KEYWORDS: Adolescents, Youth, Young adults, Female-only, Black/African American, Adolescent mothers, Community-based, Parent training, Births, Sexual Activity, Condom use and contraception, STD/HIV/AIDS, Manual, Cost

 

 

Program information last updated on 11/8/10.

 

 

 

 

 

		© Child Trends 2004