Evaluation of Virtual Prenatal Care for Obstetric Care Delivery During the COVID-19 Pandemic: A Mixed Method Research Study Using the Consolidated Framework in Implementation Research

Arlin Delgado, Chinyere Reid, Emma Hale, Jennifer Marshall, Kimberly Fryer
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Abstract

Background and Objective: Coronavirus 2 (SARS-CoV-2), a novel respiratory virus, rapidly spread, and placed patients at increased risk for short and potentially long-standing medical illnesses. The pandemic necessitated the rapid implementation of virtual prenatal care via telemedicine in obstetrics to maintain social distancing measures. The aim of this study was to assess and understand the patient perspectives of the rapidly implemented virtual prenatal care via a telemedicine model during the Coronavirus disease 2019 (COVID-19) pandemic utilizing the Consolidated Framework in Implementation Research (CFIR). Methods: Following the implementation of virtual prenatal care in March 2020, pregnant patients at a large urban clinic in the southeastern United States completed a 19-question anonymous survey that included open and closed-ended questions on their experience receiving virtual prenatal care via telemedicine or in-person prenatal care from May to December 2020. The survey and mixed-methods data analysis was guided by the CFIR framework. Results: A total of 59 patients completed the survey. One-third (31%, n=18) of the patients found virtual prenatal care to be an acceptable alternative model, and half (53%, n=31) found it acceptable only during a pandemic, preferring to return to in-person visits. Qualitative analysis found that some patients were deterred by limited in-person examinations and uncertainty with the virtual platform, while others appreciated the reduced need for transportation, childcare, and time spent. Conclusion and Global Health Implications: Most patients found virtual prenatal care to be easy to access and an acceptable alternative during the pandemic; however, most would prefer to return to in-person prenatal care visits. Future comparative research studies should examine how, among others, virtual prenatal care versus in-person prenatal care impacts specific maternal and fetal outcomes. Copyright © 2023 Delgado et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.
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COVID-19大流行期间产科护理交付的虚拟产前护理评估:在实施研究中使用统一框架的混合方法研究
背景与目的:冠状病毒2 (SARS-CoV-2)是一种新型呼吸道病毒,传播迅速,使患者面临短期和潜在长期医疗疾病的风险增加。大流行使得通过产科远程医疗迅速实施虚拟产前护理成为必要,以保持社会距离措施。本研究的目的是利用实施研究统一框架(CFIR),评估和了解在2019冠状病毒病(COVID-19)大流行期间通过远程医疗模型快速实施的虚拟产前护理的患者观点。方法:在2020年3月实施虚拟产前护理后,美国东南部一家大型城市诊所的孕妇完成了一项19个问题的匿名调查,其中包括关于他们在2020年5月至12月期间通过远程医疗或现场产前护理接受虚拟产前护理的体验的开放式和封闭式问题。调查和混合方法数据分析以CFIR框架为指导。结果:共59例患者完成调查。三分之一(31%,n=18)的患者认为虚拟产前护理是一种可接受的替代模式,一半(53%,n=31)的患者认为只有在大流行期间才可以接受,他们更愿意回到亲自就诊。定性分析发现,一些患者因有限的面对面检查和虚拟平台的不确定性而却步,而另一些患者则对减少交通、儿童保育和花费时间的需求表示赞赏。结论和全球卫生影响:大多数患者发现虚拟产前护理易于获得,并且在大流行期间是一种可接受的替代方案;然而,大多数人更愿意回到亲自产前护理访问。未来的比较研究应该考察虚拟产前护理与面对面产前护理对产妇和胎儿具体结局的影响。版权所有©2023 Delgado et al。由全球健康和教育项目公司出版。这是一篇基于知识共享署名许可协议CC BY 4.0的开放获取文章。
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