Other Titles
Community Building in Group Antenatal Care in Blantyre, Malawi [Title Slide]
Other Titles
PechaKucha Presentation
Abstract
In US-based studies, group antenatal care (GANC) is associated with lower risk for prematurity and low birth weight and improved mental health; and resulted in higher satisfaction with care for clients and providers.1,2 Evidence from recent clinical trials globally found that GANC improve key outcomes, including facility birth, antenatal and postpartum care attendance, quality of care, breastfeeding, and health literacy.3–8 In GANC, cohorts of 8-12 pregnant clients attend their ANC visits together. Centering-inspired GANC models adhere to three core components: healthcare in a group space, interactive learning, and community building.8–10 However, community building is poorly understood.
The purpose of this study is to explore the evidence on community building as a core component of GANC and develop a conceptual framework. In doing so, this will create a a foundational understanding of the component and better understand its impact on outcomes.
A search of published research on GANC or group well-childcare was conducted using multiple databases, that resulted in 4,239 articles. After screening and review, data were extracted using Covidence and analyzed using atlas.ti.11 Quality assessments were conducted using Critical Appraisal Skills Programme checklists.12 Expert consultations were conducted.
Ninety-three (n=93) studies met eligibility and included qualitative (n = 65), quantitative (n = 37), mixed methods (n=) and reviews (n =11). The studies were conducted globally, with the majority in high-income countries (n = 68) with few in low-income countries (n = 19) The studies explored theoretical aspects of community building, including facilitation requirements to enhance community building, and participants’ experience of community building. Group dynamics, relationship building among peers and providers, and social support provided by the group are important building blocks of community building. A conceptual framework for community building in group care was developed by the identified themes.
The conceptual framework provides guidance and advances understanding of factors that influence community building among GANC participants and providers. With the expansion of group antenatal care models in the US and globally, the findings from the study provide critical insights into community building, one of the key components of GANC and essential for adapting and scaling this innovative intervention.
Notes
References:
1. Ickovics JR, Reed E, Magriples U, Westdahl C, Schindler Rising S, Kershaw TS. Effects of group prenatal care on psychosocial risk in pregnancy: Results from a randomised controlled trial. Psychology & Health. 2011;26(2):235-250. doi:10.1080/08870446.2011.531577
2. Picklesimer AH, Billings D, Hale N, Blackhurst D, Covington-Kolb S. The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population. American Journal of Obstetrics and Gynecology. 2012;206(5):415.e1-415.e7. doi:10.1016/j.ajog.2012.01.040
3. Lori JR, Ofosu-Darkwah H, Boyd CJ, Banerjee T, Adanu RMK. Improving health literacy through group antenatal care: a prospective cohort study. BMC Pregnancy Childbirth. 2017;17(1):228. doi:10.1186/s12884-017-1414-5
4. Grenier L, Suhowatsky S, Kabue MM, et al. Impact of group antenatal care (G-ANC) versus individual antenatal care (ANC) on quality of care, ANC attendance and facility-based delivery: A pragmatic cluster-randomized controlled trial in Kenya and Nigeria. Gutman J, ed. PLoS ONE. 2019;14(10):e0222177. doi:10.1371/journal.pone.0222177
5. Liu Y, Wang Y, Wu Y, Chen X, Bai J. Effectiveness of the CenteringPregnancy program on maternal and birth outcomes: A systematic review and meta-analysis. International Journal of Nursing Studies. 2021;120:103981. doi:10.1016/j.ijnurstu.2021.103981
6. World Health Organization. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. World Health Organization; 2016. Accessed June 17, 2022. https://apps.who.int/iris/handle/10665/250796
7. Ickovics JR, Kershaw TS, Westdahl C, et al. Group Prenatal Care and Perinatal Outcomes: A Randomized Controlled Trial. Obstetrics & Gynecology. 2007;110(2):330-339. doi:10.1097/01.AOG.0000275284.24298.23
8. Patil CL, Abrams ET, Klima C, et al. CenteringPregnancy-Africa: A pilot of group antenatal care to address Millennium Development Goals. Midwifery. 2013;29(10):1190-1198. doi:10.1016/j.midw.2013.05.008
9. Rising SS, Quimby CH. The CenteringPregnancy Model: The Power of Group Health Care. Springer Publishing Company; 2017.
10. Rising SS, Kennedy HP, Klima CS. Redesigning prenatal care through CenteringPregnancy. Journal of Midwifery & Women’s Health. 2004;49(5):398-404. doi:10.1016/j.jmwh.2004.04.018
11. ATLAS.ti Scientific Software Development GmbH [ATLAS.ti 22 Mac]. Published online 2022. https://atlasti.com
12. Critical Appraisal Skills Programme. CASP Checklist. https://casp-uk.net/aboutus/
Sigma Membership
Nu Beta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Primary Care, Implementation Science, Group Antenatal Care, Malawi
Recommended Citation
Batchelder, Anne; Chavez, Celeste; Gresh, Ashley; Geibel, Hayden; Patil, Crystal; and Glass, Nancy, "Community Building in Group Antenatal Care: A Scoping Review and Conceptual Framework" (2025). International Nursing Research Congress (INRC). 196.
https://www.sigmarepository.org/inrc/2025/presentations_2025/196
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
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.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Community Building in Group Antenatal Care: A Scoping Review and Conceptual Framework
Seattle, Washington, USA
In US-based studies, group antenatal care (GANC) is associated with lower risk for prematurity and low birth weight and improved mental health; and resulted in higher satisfaction with care for clients and providers.1,2 Evidence from recent clinical trials globally found that GANC improve key outcomes, including facility birth, antenatal and postpartum care attendance, quality of care, breastfeeding, and health literacy.3–8 In GANC, cohorts of 8-12 pregnant clients attend their ANC visits together. Centering-inspired GANC models adhere to three core components: healthcare in a group space, interactive learning, and community building.8–10 However, community building is poorly understood.
The purpose of this study is to explore the evidence on community building as a core component of GANC and develop a conceptual framework. In doing so, this will create a a foundational understanding of the component and better understand its impact on outcomes.
A search of published research on GANC or group well-childcare was conducted using multiple databases, that resulted in 4,239 articles. After screening and review, data were extracted using Covidence and analyzed using atlas.ti.11 Quality assessments were conducted using Critical Appraisal Skills Programme checklists.12 Expert consultations were conducted.
Ninety-three (n=93) studies met eligibility and included qualitative (n = 65), quantitative (n = 37), mixed methods (n=) and reviews (n =11). The studies were conducted globally, with the majority in high-income countries (n = 68) with few in low-income countries (n = 19) The studies explored theoretical aspects of community building, including facilitation requirements to enhance community building, and participants’ experience of community building. Group dynamics, relationship building among peers and providers, and social support provided by the group are important building blocks of community building. A conceptual framework for community building in group care was developed by the identified themes.
The conceptual framework provides guidance and advances understanding of factors that influence community building among GANC participants and providers. With the expansion of group antenatal care models in the US and globally, the findings from the study provide critical insights into community building, one of the key components of GANC and essential for adapting and scaling this innovative intervention.
Description
This scoping review provides crucial insight into community building, one of the core concepts of group antenatal and well child care. Exploring the evidence base on community building to create a conceptual framework and developed a foundational understanding of community building and its effect on outcomes.