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| Name | Class |
|---|---|
| Patient-Centered Outcomes Research Institute | OTHER |
| California State University, Fresno Foundation | OTHER |
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This is a randomized comparative effectiveness study of two forms of enhanced prenatal care among 657 Medi-Cal eligible pregnant individuals in Fresno, California. The goal is to see whether group prenatal care with wrap around services versus individual prenatal care supplemented by services covered by the California Department of Public Health Comprehensive Perinatal Services Program (CPSP) results in less depression and anxiety, and more respectful, more person-centered maternity care and lower rates of preterm birth.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Glow! Group Prenatal Care | Active Comparator | Group prenatal care with wrap around services. |
|
| Individual Prenatal Care- CPSP | Active Comparator | Individual prenatal care with supplemental services covered by CPSP. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glow! Group Prenatal Care | Other | Glow! is an enhanced group prenatal care model that offers co-located social services provided by established community programs with independent funding streams targeting low-income families. The Glow! group prenatal care model pairs a trained facilitator with a licensed prenatal care practitioner from a practice site to provide billable prenatal care to the practice's own patients. Over the course of 8-10 sessions, 10-12 women (within a 6- week gestational age range) receive prenatal medical care, risk assessments, and social support, and gain knowledge and skills related to pregnancy, birth, and parenting. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in Patient Health Questionnaire (PHQ-9) Score | Changes in depressive symptom severity from baseline to postpartum. Assessed using the Patient Health Questionnaire (PHQ-9), administered in-person at baseline and during telephone interview at three months postpartum. Total score ranges from 0-27 with higher scores indicating more severe depression. | Collected from study enrollment to three months postpartum |
| Person-centered prenatal care | This outcome focuses on the extent to which the participants feels their prenatal care was person centered. The title of the measure is Person Centered Prenatal Care (primary). This measurement tool is a questionnaire that includes series of items that were developed in collaboration with community members to measure their experience of care. In addition to the overall score, the scale includes three subscales identified as important by community members: dignity and respect, communication and autonomy, and responsive and supportive care. The measures have been validated in several languages. The total scores range from 0-100 with higher scores indicating the receipt of more person centered care. | Collected during third trimester |
| Preterm birth | Whether the participant had a baby born less than 37 weeks gestation, as noted in the participant's medical record. | 0-12 weeks after delivery |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in anxiety symptom severity | Changes in anxiety symptom severity from baseline to postpartum. Assessed using the 7-item Generalized Anxiety Disorder (GAD-7) scale, administered in-person at baseline and during telephone interview at three months postpartum. The total scores range from 0-21 with higher scores indicating more severe anxiety. | Collected from study enrollment to three months postpartum |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Miriam Kuppermann, PhD, MPH | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Central Valley Health Policy Institute | Fresno | California | 93710 | United States | ||
| UCSF |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11556941 | Background | Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x. | |
| 16717171 | Background | Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Mar 17, 2026 | |
| Reset | Apr 3, 2026 |
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|
| Individual Prenatal Care with CPSP | Other | Comprehensive Perinatal Services Program (CPSP) is a state-funded program for Medi-Cal eligible families to receive enhanced care and service coordination. Participants assigned to CPSP individual care may participate in the CPSP assessments with a Comprehensive Perinatal Health Worker at their prenatal care site, where individual prenatal care will be provided |
|
| Perceptions of respectful/disrespectful maternity care | Extent to which the participant feels that the maternity care they received was respectful. Assessed using the Mothers on Respect Index (MORi), administered during telephone interview or in-person at third trimester and three months postpartum. The total scores range from 14-84 with higher scores indicating a higher level of respect. | Collected at three months postpartum |
| Satisfaction with prenatal care | Extent to which the participant feels satisfied with the prenatal care they received. Assessed using the Prenatal Care Satisfaction Scale, administered during telephone interview or in-person interview at third trimester and three months postpartum. The total scores range from 0-100 with higher scores indicating higher levels of satisfaction. | Collected during third trimester and at three months postpartum |
| Gestational age at delivery | The gestation age at which the baby was born (number of weeks), as noted in the participant's medical record. | 0-12 weeks after delivery |
| Person Centered Maternity Care as measured at 3 months postpartum. | Extent to which birthing person feels their prenatal and birthing experience was person centered, as measured by the Person-Centered Maternity Care scale. This measure focuses on the extent to which the participants feels their prenatal and maternity/birthing care was person centered. The title of the measure is Person Centered Maternity Care. This measurement tool is a questionnaire that includes series of items that were developed in collaboration with community members to measure their experience of care. In addition to the overall score, the scale includes three subscales identified as important by community members: dignity and respect, communication and autonomy, and responsive and supportive care. The measures have been validated in several languages. The total scores range from 0-100 with higher scores indicating the receipt of more person centered care. | 3 months postpartum |
| San Francisco |
| California |
| 94143 |
| United States |
| 10728256 | Background | Raube K, Handler A, Rosenberg D. Measuring satisfaction among low-income women: a prenatal care questionnaire. Matern Child Health J. 1998 Mar;2(1):25-33. doi: 10.1023/a:1021841508698. |
| 29349217 | Background | Vedam S, Stoll K, Rubashkin N, Martin K, Miller-Vedam Z, Hayes-Klein H, Jolicoeur G; CCinBC Steering Council. The Mothers on Respect (MOR) index: measuring quality, safety, and human rights in childbirth. SSM Popul Health. 2017 Jan 19;3:201-210. doi: 10.1016/j.ssmph.2017.01.005. eCollection 2017 Dec. |
| 22428358 | Background | Peek ME, Nunez-Smith M, Drum M, Lewis TT. Adapting the everyday discrimination scale to medical settings: reliability and validity testing in a sample of African American patients. Ethn Dis. 2011 Autumn;21(4):502-9. |
| 16005789 | Background | Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM. Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Soc Sci Med. 2005 Oct;61(7):1576-96. doi: 10.1016/j.socscimed.2005.03.006. Epub 2005 Apr 21. |
| 41818754 | Derived | Afulani PA, Leon-Martinez D, Carraway K, Curry VC, Chambers Butcher BD, Simard B, Blat C, Coleman-Phox K, Blebu BE, Felder JN, Karasek D, Tesfalul MA, Garza MA, Mcculloch CE, Kuppermann M. Comparative Effect of Two Enhanced Prenatal Care Models on Care Experiences: A Randomized Controlled Trial. Obstet Gynecol. 2026 Jul 1;148(1):121-131. doi: 10.1097/AOG.0000000000006237. Epub 2026 Mar 12. |
| 41697697 | Derived | Felder JN, Leon-Martinez D, Karasek D, Curry V, Carraway K, Afulani PA, Blebu B, Chambers-Butcher B, Coleman-Phox K, Simard BJ, Blat C, Garza MA, McCulloch CE, Kuppermann M. Enhanced Prenatal Care Models and Postpartum Depression: The EMBRACE Randomized Clinical Trial. JAMA Netw Open. 2026 Feb 2;9(2):e2559883. doi: 10.1001/jamanetworkopen.2025.59883. |
| 38750950 | Derived | Kuppermann M, Pressman A, Coleman-Phox K, Afulani P, Blebu B, Carraway K, Butcher BC, Curry V, Downer C, Edwards B, Felder JN, Fontenot J, Garza MA, Karasek D, Lessard L, Martinez E, McCulloch CE, Oberholzer C, Ramirez GR, Tesfalul M, Wiemann A. A randomized comparative-effectiveness study of two enhanced prenatal care models for low-income pregnant people: Engaging Mothers & Babies; Reimagining Antenatal Care for Everyone (EMBRACE). Contemp Clin Trials. 2024 Aug;143:107568. doi: 10.1016/j.cct.2024.107568. Epub 2024 May 14. |
| 36459760 | Derived | Felder JN, Afulani PA, Coleman-Phox K, Omowale SS, McCulloch CE, Lessard L, Kuppermann M. Pregnancy-related COVID worry, depressive symptom severity, and mediation through sleep disturbance in a low-income, primarily Latinx population in California's Central valley. J Psychiatr Res. 2023 Jan;157:96-103. doi: 10.1016/j.jpsychires.2022.11.019. Epub 2022 Nov 23. |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Mar 17, 2026 | Apr 3, 2026 | |||
| Jun 30, 2026 |
| ID | Term |
|---|---|
| D047928 | Premature Birth |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| D019052 | Depression, Postpartum |
| D017060 | Patient Satisfaction |
| ID | Term |
|---|---|
| D007752 | Obstetric Labor, Premature |
| D007744 | Obstetric Labor Complications |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001523 | Mental Disorders |
| D011644 | Puerperal Disorders |
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
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