Adaptation of the person-centered maternity care scale for women of color in the U.S.

Summary: 
Given the stark disparities in maternal mortality and adverse birth outcomes impacting Black, Indigenous, and other people of color, there is a need to better understand and measure how individuals from these communities experience prenatal and maternity care.

Black woman's hands on her pregnant belly

Principal Investigators:
Patience Afulani, MBChB, MPH, PhD | Department of Epidemiology & Biostatistics | Bixby Center for Global Reproductive Health


Background

Given the stark disparities in maternal mortality and adverse birth outcomes impacting Black, Indigenous, and other people of color, there is a need to better understand and measure how individuals from these communities experience prenatal and maternity care.

Objective

To adapt an existing scale to measure person-centered maternity care (PCMC) and person-centered prenatal pare (PCPC) that reflects the experiences of people of color using community-engaged approaches.

Method

We used standard procedures for developing measurement tools combined with community engagement to adapt the PCMC scale that had been validated in low resource countries for use in the US—with particular attention to addressing the needs and experiences of people of color. We conducted cognitive interviews with potential respondents to assess clarity, appropriateness, and relevance of the questions. The questions were then refined and administered in an online survey open to people who live in California and had given birth in the past year.

Results

With feedback from the community, we created two separate scales to reflect two phases of care—prenatal and maternity care. We created a 35-item PCMC-US scale and a 34-item PCPC scale as well as shorter 26-item PCPC scale, all scales have high validity and reliability in a sample made up predominantly of Black women.

Conclusion

This scale will facilitate measurement to improve person-centered prenatal and maternity care for people of color, which will contribute to reducing the disparities in birth outcomes among people of color.


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Project team: 

Patience Afulani, PhD, MD, MPH

Assistant Adjunct Professor
Epidemiology & Biostatistics

My research focuses on the social and health system factors underlying disparities in reproductive, maternal, neonatal, and child health (RMNCH). I am particularly interested in how RMNCH outcomes are shaped by quality of care in health facilities as well as by social determinants. I also seek to contribute to improved measurement of quality of care, particularly person-centered care, and to the development of evidence-based interventions to improve RMNCH outcomes and reduce disparities.