title: The Impact of Introducing Centering Pregnancy in a Community Health Setting: A Qualitative Study of Experiences and Perspectives of Health Center Clinical and Support Staff.
abstract: Objectives Introducing new programming into an existing setting may be challenging. Understanding how staff and clinicians who are not directly involved in program delivery view the program can help support program implementation. This study aimed to understand how peripheral staff and clinicians perceived a newly implemented Centering Pregnancy group prenatal care program in a community-based health center and its impact on clinic operations. Methods Semi-structured interviews were conducted with a purposive sample of 12 staff members at a community-based health center. The interview guide covered topics such as perceptions of Centering Pregnancy and how the program impacted their work. An interpretive description approach was used to analyze the interview data. A coding framework was developed iteratively and all interview data were analyzed independently by multiple researchers. Results Staff had overall positive perceptions of Centering Pregnancy, but the level of understanding about the program varied widely. Most respondents viewed the Centering Pregnancy program as separate from other programs offered by the clinic, which created both opportunities and challenges. Opportunities included increased cross-referrals between established services and Centering Pregnancy. Challenges included a lack of communication about responsibilities of staff in relation to Centering Pregnancy patients. Impact on staff and overall clinic operations was perceived to be minimal to moderate, and most tensions related to roles and expectations were resolved. Conclusions for Practice Clear communication regarding fit within clinic structures and processes and expectations of staff in relation to the program was critical to the integration of Centering Pregnancy program into an established health center.
authors.affiliation: Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada.
authors.forename: Ania
authors.initials: A
authors.lastname: Kania-Richmond
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Hetherington
authors.affiliation: Population, Public and Aboriginal Health, Alberta Health Services, Calgary, Canada.|Faculty of Nursing, University of Calgary, Calgary, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: McNeil
authors.affiliation: Department of Family Practice, Midwifery Program, University of British Columbia, Vancouver, Canada.
authors.forename: Hamideh
authors.initials: H
authors.lastname: Bayrampour
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.|Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Tough
authors.affiliation: Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada. amy.metcalfe@albertahealthservices.ca.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. amy.metcalfe@albertahealthservices.ca.|Departments of Obstetrics & Gynecology and Community Health Sciences, University of Calgary, 4th Floor North Tower - Foothills Medical Centre, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada. amy.metcalfe@albertahealthservices.ca.
authors.forename: Amy
authors.initials: A
authors.lastname: Metcalfe
mesh_terms: D000328:Adult; D002170:Canada; D003151:Community Health Centers / Q000458:organization & administration*; D055812:Community-Based Participatory Research; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods*; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000379:methods* / Q000523:psychology; D015397:Program Evaluation; D036301:Qualitative Research
keywords: Centering pregnancy; Communication; Prenatal care; Program evaluation