Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients.

Catherine Daily, Ashley Gresh, Elizabeth R Hamilton, Christina X Marea
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Abstract

The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care. Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling. The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.

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为远程医疗调整集体产前护理:COVID 时代的创新,解决拉丁裔客户的护理障碍。
在 2019 年冠状病毒病(COVID-19)大流行期间,远程保健产前护理的使用成倍增加,但没有文献描述在此期间将其用于集体产前护理。COVID-19 大流行还加剧了医疗保健的结构性障碍,而这些障碍对黑人和拉丁裔人群的影响尤为严重。远程医疗使孕妇能够获得医疗保健服务,并将感染风险降至最低。远程保健产前团体护理(T-GPNC)结合了远程保健的 "以孕为中心"(CenteringPregnancy)的基本要素,是 COVID-19 大流行期间应运而生的一种创新护理方法,具有减轻结构性护理障碍的潜力。玛丽中心(Mary's Center)是华盛顿特区和马里兰州的一家联邦合格医疗中心(FQHC),在大流行初期迅速转向个人远程保健产前护理。玛丽中心利用我们在团体护理方面的经验以及中心医疗保健研究所在虚拟中心化方面的指导,推出了 T-GPNC。这一新模式包括家庭自我监测设备和视频教室,以及个人护理访问。我们与护士、助产士和社区卫生工作者采用团队合作的方式,为孕妇提供整体护理。我们强大的护理协调团队还将她们与家访、心理健康服务和营养咨询联系起来。本文旨在介绍玛丽中心是如何根据 CenteringPregnancy 的特点,将 CenteringPregnancy 的产前团体护理模式修改为远程医疗模式,并满足讲西班牙语的客户(以下简称拉丁裔客户)的需求的。另一个目的是展示远程医疗如何扩大医疗服务的可及性,以及如何消除可能阻碍孕妇亲自赴约的结构性障碍。我们还讨论了在项目实施过程中数字访问和扫盲方面的结构性不平等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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