Enabling Factors Associated with Receipt of Interconception Health Care.

TitleEnabling Factors Associated with Receipt of Interconception Health Care.
Publication TypeJournal Article
Year of Publication2019
AuthorsGregory EF, Upadhya KK, Cheng TL, Psoter KJ, Mistry KB
JournalMatern Child Health J
Date Published2019 Dec 14
ISSN1573-6628
Abstract

OBJECTIVES: Preventive health care between pregnancies may benefit future pregnancies and women's long-term health, yet such care is frequently incomplete. We used Andersen's Model of Health Services Use to identify factors associated with receipt of interconception care.

METHODS: This secondary analysis uses data from a trial that recruited women from four health centers in the Baltimore metropolitan area. We used data on factors associated with Andersen's model reported up to 15 months postpartum. Factors included health history (diabetes, hypertension, prematurity), self-rated health, demographics (age, race/ethnicity, education, marital status, employment, income, parity), predisposing factors (depression, stress, social support), and enabling factors (usual place of care, personal doctor or nurse, insurance). Relative risk regression modeled the relationship between these factors and a dependent variable defined as completing both a postpartum visit and one subsequent health care visit. Models also accounted for time since birth, clustering by site, and trial arm.

RESULTS: We included 376 women followed a mean of 272 days postpartum (SD 57), of whom 226 (60%) completed a postpartum and subsequent visit. Women were predominantly non-Hispanic Black (84%) and low income (50% household income < $20,000/year). In regression, two enabling factors were associated with increased receipt of care: having a personal doctor or nurse (RR 1.38, 95% CI 1.11-1.70) and non-Medicaid insurance (RR 1.64, 95% CI 1.09-2.56).

CONCLUSIONS FOR PRACTICE: Enabling factors were associated with receipt of recommended care following birth. These factors may be modifiable components of efforts to improve care during this critical life course period.

DOI10.1007/s10995-019-02850-0
Alternate JournalMatern Child Health J
PubMed ID31838666
Grant ListP20 MD000198 / MD / NIMHD NIH HHS / United States