Implementation of CenteringPregnancy®  in the Netherlands: Investigating Relationships between  Model Fidelity, Social Support, Group  Cohesion, and Satisfaction with Care

CenteringPregnancy® (CP) is a prenatal care model that provides all aspects of prenatal care in a group setting. This retrospective cohort study investigated how the CP group facilitators’ fidelity to the CP model, social support (as perceived by the CP participants), group cohesion (as perceived by the CP group facilitators), and the CP participants’ satisfaction with care were related. Additionally, it was assessed how the perceived social support and the observed group cohesion developed over time, and to what extent these were related to each other. 637 women (mean age 30.44) and 69 groups were included. Questionnaires were used to measure perceived social support at the 28th week and 36th week of pregnancy, and satisfaction with care (PPSQ) at the 36th week. Model fidelity and group cohesion were measured by a questionnaire filled in by the group facilitators after each session. A parallel mediation analysis, a dependent samples t-test, and a one way repeated measures ANOVA...Show moreCenteringPregnancy® (CP) is a prenatal care model that provides all aspects of prenatal care in a group setting. This retrospective cohort study investigated how the CP group facilitators’ fidelity to the CP model, social support (as perceived by the CP participants), group cohesion (as perceived by the CP group facilitators), and the CP participants’ satisfaction with care were related. Additionally, it was assessed how the perceived social support and the observed group cohesion developed over time, and to what extent these were related to each other. 637 women (mean age 30.44) and 69 groups were included. Questionnaires were used to measure perceived social support at the 28th week and 36th week of pregnancy, and satisfaction with care (PPSQ) at the 36th week. Model fidelity and group cohesion were measured by a questionnaire filled in by the group facilitators after each session. A parallel mediation analysis, a dependent samples t-test, and a one way repeated measures ANOVA were conducted. The results showed that women that felt more supported by their peers were generally more satisfied with CP care (95% CI [.15, .22]). In contrast, group facilitators’ perceptions of the groups’ cohesiveness did not predict how satisfied the women were with CP care (95% CI [-.17, .12]). It was also found that the group facilitators’ fidelity to the CP model did not predict the participants’ satisfaction with care (95% CI [-0.01, 0.00]). Further, the results showed that the participants felt increasingly supported by their peers over the course of the program (p < .001, d = .82). Similarly, the group facilitators’ perceived the CP groups to be increasingly cohesive over time (p = .001, η 2 = .02). Finally, the participants’ and group facilitators’ perceptions of social support and group cohesion were found to be weakly related (p < .001). These findings highlight that the implementation of CP in the Netherlands shows promise in enhancing maternal social support, and consequently, satisfaction with care. This study also adds unique knowledge to the evidence base of CP by assessing the cohesiveness of the groups. Future research is called upon to examine the presented relationships by applying different instruments regarding the group facilitators’ (in)fidelity to the CP model.Show less

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Implementation of CenteringPregnancy® in the Netherlands: Investigating Relationships between Model Fidelity, Social Support, Group Cohesion, and Satisfaction with Care