title: Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum.
abstract: OBJECTIVE
  This study compared the effects of group to individual prenatal care in late pregnancy and early postpartum on (1) women's food security and (2) psychosocial outcomes among food-insecure women.
  
  
  RESULTS
  We recruited 248 racially diverse, low-income, pregnant women receiving CenteringPregnancy™ group prenatal care (N = 124) or individual prenatal care (N = 124) to complete surveys in early pregnancy, late pregnancy, and early postpartum, with 84 % completing three surveys. Twenty-six percent of group and 31 % of individual care participants reported food insecurity in early pregnancy (p = 0.493). In multiple logistic regression models, women choosing group versus individual care were more likely to report food security in late pregnancy (0.85 vs. 0.66 average predicted probability, p < 0.001) and postpartum (0.89 vs. 0.78 average predicted probability, p = 0.049). Among initially food-insecure women, group participants were more likely to become food-secure in late pregnancy (0.67 vs. 0.35 individual care average predicted probability, p < 0.001) and postpartum (0.76 vs. 0.57 individual care average predicted probability, p = 0.052) in intention-to-treat models. Group participants were more likely to change perceptions on affording healthy foods and stretching food resources. Group compared to individual care participants with early pregnancy food insecurity demonstrated higher maternal-infant attachment scale scores (89.8 vs. 86.2 points for individual care, p = 0.032).
  
  
  CONCLUSIONS
  Group prenatal care provides health education and the opportunity for women to share experiences and knowledge, which may improve food security through increasing confidence and skills in managing household food resources. Health sector interventions can complement food assistance programs in addressing food insecurity during pregnancy.
authors.affiliation: Department of Public Health Sciences, College of Health, Education, and Human Development, Clemson University, Clemson, SC, 29634, USA. heberleine@gmail.com.
authors.forename: Emily C
authors.identifier: http://orcid.org/0000-0001-6812-3742
authors.initials: EC
authors.lastname: Heberlein
authors.affiliation: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Frongillo
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health System, 890 W. Faris Road, Greenville, SC, 29605, USA.
authors.forename: Amy H
authors.initials: AH
authors.lastname: Picklesimer
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health System, 890 W. Faris Road, Greenville, SC, 29605, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Covington-Kolb
mesh_terms: D000328:Adult; D005191:Family Characteristics; D005260:Female; D063105:Food Assistance; D005523:Food Supply / Q000706:statistics & numerical data*; D006126:Group Processes; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D049590:Postpartum Period; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications; D011295:Prenatal Care / Q000379:methods*; D013315:Stress, Psychological / Q000453:epidemiology*; D055815:Young Adult
keywords: CenteringPregnancy; Food insecurity; Group prenatal care; Pregnancy; Prenatal care