Program

Nov 08, 2010

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.

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

The CenteringPregnancy handbook costs $150. Materials can be purchased here:

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.