Quantitative evaluation of Partners in Inner-city Integrated Prenatal Care in Winnipeg, Canada
Bibliographic record
Abstract
Background Our previous research demonstrated high rates of inadequate prenatal care (PNC) among women living in the inner-city in Winnipeg and identified barriers and facilitators related to their use of PNC. Building on these findings, service providers, policy makers, and researchers collaborated to develop the Partners in Inner-city Integrated Prenatal Care (PIIPC) Project with the goal of reducing inequities in use of PNC. The objective of this quantitative component of the larger mixed-methods study was to describe facilitators of PNC and compare use of PNC to a comparison group. Methods A descriptive comparative design was used. Questionnaires were administered by interview to 89 women participating in PIIPC from 2012 to 2015. Data were analyzed using SPSS. The retrospective comparison group consisted of 202 women with inadequate PNC living in the same inner-city neighborhoods who received usual care prior to implementation of PIIPC. Results The majority of women in both the PIIPC and comparison groups were single, low income, Indigenous, multigravid, with less than high school education and high rates of substance abuse. 61% of PIIPC clients reported initiating PNC at <13 weeks and 59% received 10 or more PNC visits, compared to 30% and 1.2% of comparison group respectively. Preterm birth rate was lower in the PIIPC group (10.4%) than comparison group (14.4%). PIIPC clients rated the following facilitators as helping them “a lot”: help finding a care provider (48%) or setting up appointments (41.6%), bus tickets/taxi slips (77.5%), convenient clinic hours (49.5%), staff easy to understand (77.5%), and incentives (36%). Conclusions The PIIPC project resulted in earlier initiation of PNC and more PNC visits for women at social and economic disadvantage, and may also improve pregnancy outcomes. This project exemplifies how building successful partnerships can contribute to health system improvements. Key messages The Partners in Inner-city Integrated Prenatal Care project applied an integrated knowledge translation approach to reduce inequities in use of prenatal care by inner-city women The quantitative evaluation results demonstrate an improvement in use of prenatal care by inner-city women, following implementation of initiatives to reduce barriers and enhance facilitators to care
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".