title: Barriers to women's participation in inter-conceptional care: a cross-sectional analysis.
abstract: BACKGROUND
  We describe participation rates in a special interconceptional care program that addressed all commonly known barriers to care, and identify predictors of the observed levels of participation in this preventive care service.
  
  
  METHODS
  A secondary analysis of data from women in the intervention arm of an interconceptional care clinical trial in Philadelphia (n = 442). Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services (herein called Andersen model) was used as a theoretical base. We used a multinomial logit model to analyze the factors influencing women's level of participation in this enhanced interconceptional care program.
  
  
  RESULTS
  Although common barriers were addressed, there was variable participation in the interconceptional interventions. The Andersen model did not explain the variation in interconceptional care participation (Wald ch sq = 49, p = 0.45). Enabling factors (p = 0.058), older maternal age (p = 0.03) and smoking (p = < 0.0001) were independently associated with participation.
  
  
  CONCLUSIONS
  Actively removing common barriers to care does not guarantee the long-term and consistent participation of vulnerable women in preventive care. There are unknown factors beyond known barriers that affect participation in interconceptional care. New paradigms are needed to identify the additional factors that serve as barriers to participation in preventive care for vulnerable women.
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. vijaya_hogan@unc.edu
authors.forename: Vijaya K
authors.initials: VK
authors.lastname: Hogan
authors.forename: M Ahinee
authors.initials: MA
authors.lastname: Amamoo
authors.forename: Althea D
authors.initials: AD
authors.lastname: Anderson
authors.forename: David
authors.initials: D
authors.lastname: Webb
authors.forename: Leny
authors.initials: L
authors.lastname: Mathews
authors.forename: Diane
authors.initials: D
authors.lastname: Rowley
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Culhane
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007407:Interviews as Topic; D016015:Logistic Models; D010342:Patient Acceptance of Health Care; D015143:Philadelphia / Q000453:epidemiology; D047928:Premature Birth / Q000517:prevention & control; D011295:Prenatal Care / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult