Heidi Preis1,2, Clare Whitney3, Christina Kocis2, Marci Lobel1,2. 1. Department of Psychology, Stony Brook University, Stony Brook, NY 11794, USA. 2. Department of Obstetrics and Gynecology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA. 3. School of Nursing, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Abstract
Objectives: Comprehensive screening of psychosocial vulnerabilities and substance use in prenatal care is critical to promote the health and well-being of pregnant patients. Effective implementation of new screening procedures and instruments should be accompanied by an in-depth investigation to assess their feasibility and impact on care delivery. Methods: In 2020, following implementation of the Profile for Maternal and Obstetric Treatment Effectiveness (PROMOTE) an innovative self-report screening instrument developed for outpatient prenatal clinics in the U.S., we conducted individual interviews and focus groups with twenty-two midwives, nurse practitioners, and obstetric residents focused on the PROMOTE and its impacts on care delivery. We used interpretive description for the qualitative analysis of the interviews. Results: Five themes were identified: Guiding Time Efficiently: "The Time I Don't Have," Preventing Missed Care, Signaling Trustworthiness, Establishing Trauma-Informed Foundations, and Promoting "Honest" Patient Disclosure. Conclusion: Interviews suggest that patient completion of the PROMOTE before the medical encounter helps reduce previously reported barriers, is more time-effective, and makes history-taking easier. It also facilitates the patient-provider relationship. Innovation: Findings offer insight into the breadth and depth of clinical impact resulting from the PROMOTE, and provide guidance for the implementation of such tools to optimize health outcomes.
Objectives: Comprehensive screening of psychosocial vulnerabilities and substance use in prenatal care is critical to promote the health and well-being of pregnant patients. Effective implementation of new screening procedures and instruments should be accompanied by an in-depth investigation to assess their feasibility and impact on care delivery. Methods: In 2020, following implementation of the Profile for Maternal and Obstetric Treatment Effectiveness (PROMOTE) an innovative self-report screening instrument developed for outpatient prenatal clinics in the U.S., we conducted individual interviews and focus groups with twenty-two midwives, nurse practitioners, and obstetric residents focused on the PROMOTE and its impacts on care delivery. We used interpretive description for the qualitative analysis of the interviews. Results: Five themes were identified: Guiding Time Efficiently: "The Time I Don't Have," Preventing Missed Care, Signaling Trustworthiness, Establishing Trauma-Informed Foundations, and Promoting "Honest" Patient Disclosure. Conclusion: Interviews suggest that patient completion of the PROMOTE before the medical encounter helps reduce previously reported barriers, is more time-effective, and makes history-taking easier. It also facilitates the patient-provider relationship. Innovation: Findings offer insight into the breadth and depth of clinical impact resulting from the PROMOTE, and provide guidance for the implementation of such tools to optimize health outcomes.
Entities:
Keywords:
Prenatal care; Psychosocial screening; Qualitative implementation research
Authors: Chantal Quispel; Mieke J van Veen; Christianne Zuijderhoudt; Eric A P Steegers; Witte J G Hoogendijk; Erwin Birnie; Gouke J Bonsel; Mijke P Lambregtse-van den Berg Journal: Matern Child Health J Date: 2014-11
Authors: Heidi Preis; Petar M Djurić; Marzieh Ajirak; Tong Chen; Vibha Mane; David J Garry; Cassandra Heiselman; Joseph Chappelle; Marci Lobel Journal: Arch Womens Ment Health Date: 2022-08-20 Impact factor: 4.405