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Centering Healthcare Institute Research and Evaluation on the Centering Model of Care

The Centering Healthcare Institute views research and evaluation of the model to be an integral part of implementation and promotion of Centering. There are several avenues for this activity for CHI.

  1. CHI conducts on-going evaluation of challenges, strengths, and outcomes encountered by sites implementing the model. This is done through informal mechanisms of phone and email support and through the formal Site Approval process. Based on these results changes have been made to the materials and training programs offered by CHI.
  2. CHI works directly with academic and professional organizations and individuals to encourage inquiry on the model and to offer consultation. This work includes consultation on focus and design of the study, participation in analysis/interpretation of data, and participation in writing for publication.
  3. CHI has a Research Policy that outlines its relationship to individuals/agencies doing research.
  4. CHI provides guidance to students interested in exploring the Centering model for papers, thesis or dissertation requirements.
  5. CHI identifies potential areas for further research exploration and may solicit dialogue with those interested in submitting grants in areas of potential benefit to CHI.

Published Research/Evaluation Studies

The only published research to date is on the CenteringPregnancy model. Those articles include:

Baldwin K. (2006) Comparison of selected outcomes of CenteringPregnancy versus traditional prenatal care. JMWH, 51(4): 266-272.

Grady MA, Bloom K. (2004) Pregnancy outcomes of adolescents enrolled in a CenteringPregnancy program. JMWH, 49(5): 412-20.

Ickovics J, Kershaw T, Westdahl C, Rising SS, Klima C, Reynolds H, Magriples U. (2003) Group prenatal care and preterm birth weight: results from a matched cohort study at public clinics. (2003) Ob & Gyn, 102 (5, part 1): 1051-57.

IckovicsJ, Kershaw T, Westdahl C, Magriples U, Massey Z, Reynolds H, Rising, S. (2007) Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstetrics and Gynecology, 110(2), part 1: 330-39.

Kennedy H, Farrell T, Paden R, Hill S, Jolivet R, Willetts J, Rising SS. (2009). “I wasn’t alone” – A study of group prenatal care in the military. JMWH. In press.

Kershaw TS, Magriples U, Westdahl C, Rising SS & Ickovics J. Pregnancy as a window of opportunity for HIV prevention: effects of an HIV intervention delivered within prenatal care. American Journal of Public Health. In Press.

Klima C, Norr K, Vonderheid S, Handler A. (2009) Introduction of CenteringPregnancy in a public health clinic. J of Midwif & Women’s Health, 54 (1): 27-34.

Robertson B, Aycock D, Darnell L. (2008) Comparison on CenteringPregnancy to traditional care in hispanic mothers. Matern Child Health J DOI 10.1007/s10995-008-0353-1

Skelton J, Mullins R, Todd L, Womack S, Ebersole J, Rising SS, Kovarik R. (2009) CenteringPregnancy Smiles: Implementation of a small group prenatal care model with oral health. J of Poor and Underserved, 20:545-553.

Westdahl C, Kershaw TS, Rising SS & Ickovics JR (2008) Group prenatal care improves breastfeeding initiation and duration: results from a two-site randomized controlled trial. Found in Journal of human lactation ILCA abstracts, 24(1). Affiliation: Gyn Ob, Emory University, Atlanta GA.

Another randomized trial is underway in New York City with principle investigators: Dr. Jeannette Ickovics from Yale University and Dr. Jonathan Tobin, Clinical Directors’ Network. This 5 year study involves 14 prenatal sites and focuses on women 21 years and under.

 

Suggested Topics for Further Study

CHI encourages studies that will duplicate some of the completed studies and also those that will address other issues. Some of the suggestions include:

  1. Behavior change in groups such as: smoking, dietary shifts, exercise, methods of stress management including Mindfulness Based Stress Reduction
  2. Biologic/physiologic stress markers
  3. Labor and delivery experience
  4. Birth outcomes for mother and baby
  5. Mother/baby attachment; breastfeeding
  6. Pregnancy spacing including contraceptive use
  7. Postpartum maternal achievement of weight goals
  8. Family dynamics
  9. Provider satisfaction, role change
  10. Prevention issues: diabetes, PTL
  11. Influence of cultural beliefs and values on behavior and outcomes
  12. System issues: staff roles, satisfaction; patient enrollment and retention, triage calls, unscheduled or missed visits, use of the ED
  13. Cost benefit effectiveness

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