The anticipated challenges when implementing Centering-Based Group Care in three Belgian primary care sites, emphasising the inclusion of vulnerable families: results from context-analyses through Rapid Qualitative Inquiries

Astrid Van Damme

Keywords: Centering-Based Group Care; CenteringPregnancy; Implementation; stakeholder involvement; Rapid Qualitative Inquiry; vulnerable populations

Introduction:

Centering-Based Group Care (CBGC) is an evidence-based perinatal care model including three core components: health assessment, interactive learning, and community building. Greater patient and provider satisfaction, higher attendance rates, and positive outcomes on prematurity and birthweight are advantages of CBGC compared to individual perinatal care. Despite increasing interest in CBGC worldwide, its sustainable implementation is proving challenging. We aimed to identify the anticipated challenges when implementing CBGC in three Belgian primary care settings, emphasising the inclusion of vulnerable families in CBGC.

Method:

Rapid Qualitative Inquiries to conduct context analysis were applied in three participating sites. Different data collection sources were included, i.e. semi-structured interviews, focus group discussions, document analysis, and site visits. The results of the collected data were discussed during daily debriefings among the research teams, consisting of local researchers, project researchers, and community researchers. The Consolidated Framework for Implementation Research guided the debriefings to cover all implementation constructs. The views of health care providers, (vulnerable) pregnant families, and other key stakeholders were included.

Results:

The Rapid Qualitative Inquiries generated 48 interviews, one focus group discussion, and several site visits. The majority of the respondents considered CBGC to be a valuable model of pregnancy follow-up with many advantages compared to the current one-to-one care model. Challenges to achieve sustainable implementation of CBGC were expected on three levels: (1) site-specific challenges: such as session content, materials used, and healthcare providers involved; (2) challenges where collaboration with other organisations is often needed, such as finding a suitable venue and referral to the CBGC sessions; (3) challenges that go beyond the site-specific implementation, e.g. financials (nomenclature).

Conclusions:

The benefits of the CBGC model were acknowledged. Nevertheless, several challenges were expected to obtain sustainable implementation of CBGC. The importance of collaboration between different actors in primary care to achieve sustainable implementation of CBGC emerged prominently.

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