Other Titles
Rising Star Poster/Presentation
Abstract
Pregnancy resource centers (PRCs) play a critical role in supporting women from underserved communities but often struggle to consistently meet clients’ emotional, cultural, and psychological needs. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the impact of implementing the Person-Centered Care and Communication Continuum (PC4) Model—an evidence-based framework designed to enhance respect, communication, and individualized attention in maternal healthcare—on client satisfaction and service engagement at a local PRC.
Guided by Watson’s Theory of Human Caring, this mixed-methods quality-improvement project assessed antenatal client satisfaction and service delivery before and after PC4 implementation. Surveys and structured observations captured quantitative and qualitative outcomes, with 15 clients participating pre-implementation and 21 post-implementation. Pre-intervention findings indicated moderate variation in satisfaction: 40% reported that their needs were always considered, just over half felt comfortable asking questions, and only 33% accessed multiple PRC services, with a mean quality-of-care score of 4.1 (SD = 0.7). Observation checklists revealed inconsistent demonstration of person-centered communication among staff.
Following 10 weeks of PC4 implementation and comprehensive staff training, post-intervention results demonstrated substantial improvement across all domains. All clients (100%) reported that their needs were always addressed, felt comfortable communicating with staff, and rated care and communication as excellent (mean scores of 5.0, SD = 0.0). Most clients (86%) engaged with a broader spectrum of services, and observation findings confirmed consistent, high-quality person-centered behaviors among staff. Qualitative feedback highlighted enhanced respect, emotional support, and an increased sense of community.
This project demonstrates that structured, theory-driven models such as PC4 can significantly improve client engagement and perceived quality of care within community-based maternal health settings. The findings underscore the importance of staff training, continuous feedback, and organizational commitment to sustaining person-centered practices. The PC4 Model offers a replicable approach for PRCs seeking to advance equity, client satisfaction, and optimal maternal health outcomes, with important implications for nursing practice in similar community contexts.
Notes
References:
1. Afulani, P. A., Altman, M. R., Castillo, E., Bernal, N., Jones, L., Camara, T. L., Carrasco, Z., Williams, S., Sudhinaraset, M., & Kuppermann, M. (2021). Development of the person-centered prenatal care scale for people of color. American Journal of Obstetrics and Gynecology, 225(4), 427.e1–427.e13. https://doi.org/10.1016/j.ajog.2021.04.216
2. Afulani, P. A., Coleman-Phox, K., Leon-Martinez, D., Fung, K. Z., Martinez, E., Garza, M. A., … Kuppermann, M. (2023). Psychometric assessment of the US person-centered prenatal and maternity care scales in a low-income predominantly Latinx population in California. BMC Women’s Health, 23(1), 616.
3. Altman, M. R., Afulani, P. A., Melbourne, D., & Kuppermann, M. (2023). Factors associated with person-centered care during pregnancy and birth for Black women and birthing people in California. Birth, 50(2), 329–338. https://doi.org/10.1111/birt.12675
4. Charlotte Lozier Institute. (2021, July 19). Fact sheet: Pregnancy centers – Serving women and saving lives (2020 study). https://lozierinstitute.org/fact-sheet-pregnancy-centers-serving-women-and-saving-lives-2020/
5. Ebinghaus, M., Agricola, C. J., Schmittinger, J., Makarova, N., & Zyriax, B. (2024). Assessment of women’s needs, wishes and preferences regarding interprofessional guidance on nutrition in pregnancy: A qualitative study. BMC Pregnancy and Childbirth, 24, 154. https://doi.org/10.1186/s12884-024-06351-z
6. Goh, A. H., Altman, M. R., Canty, L., & Edmonds, J. K. (2024). Communication between pregnant people of color and prenatal care providers in the United States: An integrative review. Journal of Midwifery & Women’s Health, 69(2), 202–223. https://doi.org/10.1111/jmwh.13580
7. Heartbeat International. (2025). Life trends report. https://heartbeatinternational.org/about/life-trends-report
8. Kissling, A., Gursahaney, P., Norris, A. H., Bessett, D., & Gallo, M. F. (2022). Free, but at what cost? How US crisis pregnancy centres provide services. Culture, Health & Sexuality, 25(8), 1024–1038. https://doi.org/10.1080/13691058.2022.2116489
9. Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse–patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20, 158. https://doi.org/10.1186/s12912-021-00684-2
10. Pullyblank, K. (2023). Watson’s authentic presence: Philosophical and theoretical approaches. Nursing Science Quarterly, 36(2), 158–163. https://doi.org/10.1177/08943184221150259
11. Stein, D., Cannity, K., Weiner, R., Hichenberg, S., Leon-Nastasi, A., Banerjee, S., & Parker, P. (2022). General and unique communication skills challenges for advanced practice providers: A mixed-methods study. Journal of the Advanced Practitioner in Oncology, 13(1), 32–42. https://doi.org/10.6004/jadpro.2022.13.1.3
12. Watson, J., & Woodward, T. (2020). Jean Watson’s theory of human caring. SAGE Publications.
13. Woofter, R., Clarke, R., Diala, P. C., Altman, M. R., & Afulani, P. A. (2025). Person-centered perinatal health care and empowerment during pregnancy, birth, and postpartum: A cross-sectional mixed-methods analysis. Journal of Midwifery & Women’s Health, 70(3), 476–485. https://doi.org/10.1111/jmwh.13760
Sigma Membership
Alpha Alpha Epsilon
Type
Poster
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Mixed/Multi Method Research
Keywords:
Doctorally Prepared Nurses, Nursing Students, Patient Centered Care, Maternal Health Services, Communication, Quality of Health Care
Recommended Citation
Outlaw, Priscilla A., "DNP Student Implementation of PC4 Model in a Pregnancy Resource Center to Improve Quality of Care" (2026). International Nursing Research Congress (INRC). 140.
https://www.sigmarepository.org/inrc/2026/posters_2026/140
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Date of Issue
2026-10-01
DNP Student Implementation of PC4 Model in a Pregnancy Resource Center to Improve Quality of Care
Toronto, Ontario, Canada
Pregnancy resource centers (PRCs) play a critical role in supporting women from underserved communities but often struggle to consistently meet clients’ emotional, cultural, and psychological needs. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the impact of implementing the Person-Centered Care and Communication Continuum (PC4) Model—an evidence-based framework designed to enhance respect, communication, and individualized attention in maternal healthcare—on client satisfaction and service engagement at a local PRC.
Guided by Watson’s Theory of Human Caring, this mixed-methods quality-improvement project assessed antenatal client satisfaction and service delivery before and after PC4 implementation. Surveys and structured observations captured quantitative and qualitative outcomes, with 15 clients participating pre-implementation and 21 post-implementation. Pre-intervention findings indicated moderate variation in satisfaction: 40% reported that their needs were always considered, just over half felt comfortable asking questions, and only 33% accessed multiple PRC services, with a mean quality-of-care score of 4.1 (SD = 0.7). Observation checklists revealed inconsistent demonstration of person-centered communication among staff.
Following 10 weeks of PC4 implementation and comprehensive staff training, post-intervention results demonstrated substantial improvement across all domains. All clients (100%) reported that their needs were always addressed, felt comfortable communicating with staff, and rated care and communication as excellent (mean scores of 5.0, SD = 0.0). Most clients (86%) engaged with a broader spectrum of services, and observation findings confirmed consistent, high-quality person-centered behaviors among staff. Qualitative feedback highlighted enhanced respect, emotional support, and an increased sense of community.
This project demonstrates that structured, theory-driven models such as PC4 can significantly improve client engagement and perceived quality of care within community-based maternal health settings. The findings underscore the importance of staff training, continuous feedback, and organizational commitment to sustaining person-centered practices. The PC4 Model offers a replicable approach for PRCs seeking to advance equity, client satisfaction, and optimal maternal health outcomes, with important implications for nursing practice in similar community contexts.
Description
This DNP quality-improvement project evaluated the Person-Centered Care and Communication Continuum (PC4) Model at a pregnancy resource center serving underserved women. After a 10-week implementation and staff training, client satisfaction, communication, and engagement with services improved markedly, demonstrating that structured, theory-driven person-centered care can enhance equity, quality, and maternal health outcomes in community settings.