Cargando…
Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities
Preconception care can improve maternal and infant outcomes by identifying and modifying health risks before pregnancy and reducing unplanned pregnancies. However, information about how preconception care is provided to persons living with HIV (PLWH) is lacking. This study uses qualitative interview...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034389/ https://www.ncbi.nlm.nih.gov/pubmed/29870269 http://dx.doi.org/10.1089/apc.2017.0299 |
_version_ | 1783337873040211968 |
---|---|
author | Simone, Joanne Hoyt, Mary Jo Storm, Deborah S. Finocchario-Kessler, Sarah |
author_facet | Simone, Joanne Hoyt, Mary Jo Storm, Deborah S. Finocchario-Kessler, Sarah |
author_sort | Simone, Joanne |
collection | PubMed |
description | Preconception care can improve maternal and infant outcomes by identifying and modifying health risks before pregnancy and reducing unplanned pregnancies. However, information about how preconception care is provided to persons living with HIV (PLWH) is lacking. This study uses qualitative interviews with HIV care providers to describe current models of preconception care and explore factors influencing services. Single, anonymous, telephone interviews were conducted with 92 purposively selected HIV healthcare providers in Atlanta, Baltimore, Houston, Kansas City, Newark, Philadelphia, and San Francisco in 2013–2014. Content analysis and a grounded theory approach were used to analyze data. Participants included 57% physicians with a median of 10 [interquartile range (IQR) = 5–17] years HIV care experience; the mean proportion of female patients was 45%. Participants described Individual Provider (48.9%), Team-based (43.2%), and Referral-only (7.6%) models of preconception care, with 63% incorporating referrals outside their clinics. Thematic analysis identified five key elements influencing the provision of preconception care within and across models: consistency of delivery, knowledge and attitudes, clinic characteristics, coordination of care, and referral accessibility. Described models of preconception care reflect the complexity of our healthcare system. Qualitative analysis offers insights about how HIV clinicians provide preconception care and how key elements influence services. However, additional research about the models and outcomes of preconception care services are needed. To improve preconception care for PLWH, research and quality improvement initiatives must utilize available strengths and tackle existing barriers, identified by our study and others, to define and implement effective models of preconception care services. |
format | Online Article Text |
id | pubmed-6034389 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Mary Ann Liebert, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-60343892018-07-06 Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities Simone, Joanne Hoyt, Mary Jo Storm, Deborah S. Finocchario-Kessler, Sarah AIDS Patient Care STDS Clinical and Epidemiologic Research Preconception care can improve maternal and infant outcomes by identifying and modifying health risks before pregnancy and reducing unplanned pregnancies. However, information about how preconception care is provided to persons living with HIV (PLWH) is lacking. This study uses qualitative interviews with HIV care providers to describe current models of preconception care and explore factors influencing services. Single, anonymous, telephone interviews were conducted with 92 purposively selected HIV healthcare providers in Atlanta, Baltimore, Houston, Kansas City, Newark, Philadelphia, and San Francisco in 2013–2014. Content analysis and a grounded theory approach were used to analyze data. Participants included 57% physicians with a median of 10 [interquartile range (IQR) = 5–17] years HIV care experience; the mean proportion of female patients was 45%. Participants described Individual Provider (48.9%), Team-based (43.2%), and Referral-only (7.6%) models of preconception care, with 63% incorporating referrals outside their clinics. Thematic analysis identified five key elements influencing the provision of preconception care within and across models: consistency of delivery, knowledge and attitudes, clinic characteristics, coordination of care, and referral accessibility. Described models of preconception care reflect the complexity of our healthcare system. Qualitative analysis offers insights about how HIV clinicians provide preconception care and how key elements influence services. However, additional research about the models and outcomes of preconception care services are needed. To improve preconception care for PLWH, research and quality improvement initiatives must utilize available strengths and tackle existing barriers, identified by our study and others, to define and implement effective models of preconception care services. Mary Ann Liebert, Inc. 2018-07-01 2018-07-01 /pmc/articles/PMC6034389/ /pubmed/29870269 http://dx.doi.org/10.1089/apc.2017.0299 Text en © Joanne Simone, et al., 2018; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
spellingShingle | Clinical and Epidemiologic Research Simone, Joanne Hoyt, Mary Jo Storm, Deborah S. Finocchario-Kessler, Sarah Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities |
title | Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities |
title_full | Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities |
title_fullStr | Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities |
title_full_unstemmed | Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities |
title_short | Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities |
title_sort | models of hiv preconception care and key elements influencing these services: findings from healthcare providers in seven us cities |
topic | Clinical and Epidemiologic Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034389/ https://www.ncbi.nlm.nih.gov/pubmed/29870269 http://dx.doi.org/10.1089/apc.2017.0299 |
work_keys_str_mv | AT simonejoanne modelsofhivpreconceptioncareandkeyelementsinfluencingtheseservicesfindingsfromhealthcareprovidersinsevenuscities AT hoytmaryjo modelsofhivpreconceptioncareandkeyelementsinfluencingtheseservicesfindingsfromhealthcareprovidersinsevenuscities AT stormdeborahs modelsofhivpreconceptioncareandkeyelementsinfluencingtheseservicesfindingsfromhealthcareprovidersinsevenuscities AT finocchariokesslersarah modelsofhivpreconceptioncareandkeyelementsinfluencingtheseservicesfindingsfromhealthcareprovidersinsevenuscities |