CenteringPregnancy: an integrative literature review.

INTRODUCTION: A critical analysis of the CenteringPregnancy model of care research has not been conducted across studies. The aims of this project were to describe 1) the conceptual components of the CenteringPregnancy practice model, 2) the characteristics of the CenteringPregnancy literature, and 3) the research methods and outcomes across the CenteringPregnancy research literature.
METHODS: An integrative literature review methodology was used to assess the CenteringPregnancy literature published between 1994 and 2009.
RESULTS: The sample consisted of 26 articles (14 narrative descriptions, 10 quantitative studies, 1 mixed methods study, and 1 qualitative study) published predominantly in nursing and midwifery journals. The majority of quantitative studies were exploratory or quasi-experimental and longitudinal designs with the exception of 1 large, federally funded, randomized, controlled trial. Variables were individual and community level outcomes, which were not uniformly operationally defined or measured consistently across studies. Significant results for prenatal care attendance rates, adequate prenatal care, and breastfeeding rates were reported in a number of studies. Other results were often mixed or nonsignificant. DISCUSSION: Positive outcomes for the CenteringPregnancy model have been suggested by research findings to date but require more systematic approaches to developing knowledge about the factors inherent in this model that promote participant behavior changes, which lead to better perinatal outcomes as well as circumstances that maximize the effectiveness of this model. Areas for improving the strength of the evidence are discussed. Building consistently demonstrated relationships across studies is essential for creating the evidence base on which practice decisions can be made. Further research is required for developing clarity and understanding about this model's effectiveness.