Evaluating process fidelity during the implementation of Group Antenatal Care in Mexico
- Resource Type
- Authors
- Jacqueline Elizabeth Alcalde-Rabanal; Evelyn Fuentes-Rivera; Zafiro Andrade-Romo; Blair G. Darney; Laurie Jurkiewicz; Ileana Heredia-Pi; Lourdes Bravo
- Source
- BMC Health Services Research
BMC Health Services Research, Vol 20, Iss 1, Pp 1-8 (2020)
- Subject
- Adult
medicine.medical_specialty
media_common.quotation_subject
Vital signs
Fidelity
Model fidelity
Health informatics
Health administration
03 medical and health sciences
0302 clinical medicine
Nursing
Population Groups
Pregnancy
medicine
Humans
030212 general & internal medicine
Prospective Studies
Mexico
media_common
Group antenatal care
Process fidelity
030505 public health
CenteringPregnancy
Descriptive statistics
business.industry
Health Policy
Nursing research
Public health
lcsh:Public aspects of medicine
Process Assessment, Health Care
Infant, Newborn
lcsh:RA1-1270
Prenatal Care
G-ANC
Checklist
Implementation
Feasibility Studies
Female
0305 other medical science
business
Research Article
- Language
- ISSN
- 1472-6963
Background CenteringPregnancy (CP) is a group antenatal care (G-ANC) model that has proven beneficial for mothers and their newborns. We conducted a feasibility study beginning in 2016 as part of the Mexican effort to implement G-ANC locally. This study reports on fidelity to the essential elements of CP during its implementation in Mexico. Methods We collected prospective data using a standardized checklist at four primary-care centers that implemented our adapted G-ANC model. We performed a descriptive analysis of fidelity to 28 processes per G-ANC session (71 sessions made up of 10 groups and 129 women across 4 health centers). We calculated fidelity to each process as a proportion with 95% confidence intervals. We present overall results and stratified by health center and by facilitation team. Results Overall fidelity to the G-ANC intervention was 82%, with variability by health center (78–88%). The elements with the highest fidelity were having space for activities such as checking vital signs, conversation in a circle, and medical check-ups (100% each) and the element with the lowest fidelity was using music to enhance privacy (27.3%). Fidelity was not significantly different by center. Conclusions Our study suggests good model fidelity during the implementation of G-ANC in Mexico. Our findings also contribute useful information about where to focus efforts in the future to maintain and improve G-ANC model fidelity.