Browsing by Subject "access to health care"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Impact of Telehealth on the Delivery of Prenatal Care during the COVID-19 Pandemic: Mixed Methods Study of the Barriers and Opportunities to Improve Health Care Communication in Discussions about Pregnancy and Prenatal Genetic Testing
    (JMIR, 2022-12) Craighead, Caitlin G.; Collart, Christina; Frankel, Richard; Rose, Susannah; Misra-Hebert, Anita D.; Tucker Edmonds, Brownsyne; Michie, Marsha; Chien, Edward; Coleridge, Marissa; Goje, Oluwatosin; Ranzini, Angela C.; Farrell, Ruth M.; Obstetrics and Gynecology, School of Medicine
    Background: The COVID-19 pandemic brought significant changes in health care, specifically the accelerated use of telehealth. Given the unique aspects of prenatal care, it is important to understand the impact of telehealth on health care communication and quality, and patient satisfaction. This mixed methods study examined the challenges associated with the rapid and broad implementation of telehealth for prenatal care delivery during the pandemic. Objective: In this study, we examined patients’ perspectives, preferences, and experiences during the COVID-19 pandemic, with the aim of supporting the development of successful models to serve the needs of pregnant patients, obstetric providers, and health care systems during this time. Methods: Pregnant patients who received outpatient prenatal care in Cleveland, Ohio participated in in-depth interviews and completed the Coronavirus Perinatal Experiences-Impact Survey (COPE-IS) between January and December 2021. Transcripts were coded using NVivo 12, and qualitative analysis was used, an approach consistent with the grounded theory. Quantitative data were summarized and integrated during analysis. Results: Thematic saturation was achieved with 60 interviews. We learned that 58% (35/60) of women had telehealth experience prior to their current pregnancy. However, only 8% (5/60) of women had used both in-person and virtual visits during this pregnancy, while the majority (54/60, 90%) of women participated in only in-person visits. Among 59 women who responded to the COPE-IS, 59 (100%) felt very well supported by their provider, 31 (53%) were moderately to highly concerned about their child’s health, and 17 (29%) reported that the single greatest stress of COVID-19 was its impact on their child. Lead themes focused on establishing patient-provider relationships that supported shared decision-making, accessing the information needed for shared decision-making, and using technology effectively to foster discussions during the COVID-19 pandemic. Key findings indicated that participants felt in-person visits were more personal, established greater rapport, and built better trust in the patient-provider relationship as compared to telehealth visits. Further, participants felt they could achieve a greater dialogue and ask more questions regarding time-sensitive information, including prenatal genetic testing information, through an in-person visit. Finally, privacy concerns arose if prenatal genetic testing or general pregnancy conversations were to take place outside of the health care facility. Conclusions: While telehealth was recognized as an option to ensure timely access to prenatal care during the COVID-19 pandemic, it also came with multiple challenges for the patient-provider relationship. These findings highlighted the barriers and opportunities to achieve effective and patient-centered communication with the continued integration of telehealth in prenatal care delivery. It is important to address the unique needs of this population during the pandemic and as health care increasingly adopts a telehealth model.
  • Thumbnail Image
    Item
    A Multidisciplinary Health Project in Rural South Eastern Nigeria: Our Contribution to Sustainable Development Goal 3
    (Indiana University, 2019-04-24) Oruche, Ukamaka M.; Hone, Augustina; Okwuchukwu, Ifeanyi; Liu, Jenny; Otey, Tamara; Commodore-Mensah, Yvonne
    • Low- and middle-income countries (LMICs) have limited medical resources which contributes to high morbidity and mortality rates from non-communicable diseases (NCDs) such as diabetes and hypertension. • Globally, diabetes prevalence is expected to increase from 8.4% in 2017 to 9.9% by 2045 (1); hypertension rates from 26.4% in 2020 to 29.2% by 2030 (2; 3). • The largest increases are expected in sub-Saharan African countries like Nigeria (1; 4). • Private and non-profit organizations play a critical role in providing health education, screenings, and treatment to vulnerable populations through medical missions or health service projects, which contribute to Sustainable Development Goal 3: Ensure healthy lives.
  • Thumbnail Image
    Item
    Preconception and Interconception Health and Routine Health Service Use Among Women in a Rural Midwestern Community
    (2020-02) DiPietro Mager, Natalie Ann; Dixon, Brian E.; Turman, Jack E.; Zhang, Jianjun; Zollinger, Terrell W.
    Advancement of preconception and interconception health is a key element to improve women’s health as well as pregnancy outcomes. Little is known about the preconception and interconception health status of rural Midwestern populations in the United States. The primary objective of this study was to determine the preconception and interconception health status as well as behaviors of reproductive age women living in a rural Midwestern area. Secondary objectives were to quantify process measures of health care access and barriers to care, as well as determine disparities in preconception and interconception health status among women in this rural area as compared to statewide estimates. As existing national or state secondary data sources often have limitations in data derived from areas with low population densities or insufficient sample sizes to generate reliable estimates, a cross-sectional study was performed using a 34- item survey. Data were collected from February to May 2019 from 315 non-pregnant women ages 18-45 years in a rural county in northwestern Ohio. Nearly all women surveyed had at least one risk factor associated with poor pregnancy outcomes, many of which were modifiable. Nearly half of all respondents reported at least one barrier to receipt of health care services. Women in this rural county fared worse for several preconception and interconception health measures when compared to statewide estimates derived from Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey data. These findings illustrate the need for continued development of interventions to improve preconception and interconception health for rural women as well as improved methods to capture and analyze data on important subpopulations at risk.