File(s) stored somewhere else

Please note: Linked content is NOT stored on Open Access Te Herenga Waka-Victoria University of Wellington and we can't guarantee its availability, quality, security or accept any liability.

Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: A continuous quality improvement initiative

journal contribution
posted on 23.03.2022, 03:15 authored by Melanie Gibson-HelmMelanie Gibson-Helm, AR Rumbold, HJ Teede, S Ranasinha, RS Bailie, JA Boyle
Background: Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women. Pregnancy care has a key role in identifying and addressing modifiable risk factors that contribute to adverse outcomes. We investigated whether participation in a continuous quality improvement (CQI) initiative was associated with increases in provision of recommended pregnancy care by primary health care centers (PHCs) in predominantly Indigenous communities, and whether provision of care was associated with organizational systems or characteristics. Methods: Longitudinal analysis of 2220 pregnancy care records from 50 PHCs involved in up to four cycles of CQI in Australia between 2007 and 2012. Linear and logistic regression analyses investigated associations between documented provision of pregnancy care and each CQI cycle, and self-ratings of organizational systems. Main outcome measures included screening and counselling for lifestyle-related risk factors. Results: Women attending PHCs after ≥1 CQI cycles were more likely to receive each pregnancy care measure than women attending before PHCs had completed one cycle e.g. screening for cigarette use: baseline = 73 % (reference), cycle one = 90 % [odds ratio (OR):3.0, 95 % confidence interval (CI):2.2-4.1], two = 91 % (OR:5.1, 95 % CI:3.3-7.8), three = 93 % (OR:6.3, 95 % CI:3.1-13), four = 95 % (OR:11, 95 % CI:4.3-29). Greater self-ratings of overall organizational systems were significantly associated with greater screening for alcohol use (β = 6.8, 95 % CI:0.25-13), nutrition counselling (β = 8.3, 95 % CI:3.1-13), and folate prescription (β = 7.9, 95 % CI:2.6-13). Conclusion: Participation in a CQI initiative by PHCs in Indigenous communities is associated with greater provision of pregnancy care regarding lifestyle-related risk factors. More broadly, these findings support incorporation of CQI activities addressing systems level issues into primary care settings to improve the quality of pregnancy care.

History

Preferred citation

Gibson-Helm, M. E., Rumbold, A. R., Teede, H. J., Ranasinha, S., Bailie, R. S. & Boyle, J. A. (2016). Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: A continuous quality improvement initiative. BMC Pregnancy and Childbirth, 16(1), 118-. https://doi.org/10.1186/s12884-016-0892-1

Journal title

BMC Pregnancy and Childbirth

Volume

16

Issue

1

Publication date

24/05/2016

Pagination

118

Publisher

Springer Science and Business Media LLC

Publication status

Published

Online publication date

24/05/2016

ISSN

1471-2393

eISSN

1471-2393

Article number

118

Language

en