Pregnant Women’s Perceptions of Patient-Provider Communication for Health Behavior Change during Pregnancy

摘要

Aim: The primary aim of the project was to conduct focus groups with pregnant women to examine their perceptions on patient and health care provider (HCP) communication during prenatal visits pertaining to health behavioral change. In particular, to determine what types of communication facilitate or prevent patient engagement and adherence to certain health behaviors related to smoking cessation, engagement in physical activity, healthy eating and healthy weight gain, and stress management. Methods: Participants were recruited from the obstetric and midwifery clinics at the University of Colorado Hospital. Twenty-four pregnant, English-speaking women between the ages of 18 and 46 years old, the majority of which had full health insurance coverage, participated in one of three focus groups that were conducted. The transcripts were coded for themes and patterns. Results identified numerous current practices of HCPs, facilitators and barriers in care, and patient recommendations related to effective patient-provider communication. Results: Overall many women received basic information about most health behaviors (i.e. healthy eating, physical activity, and smoking cessation) with the exception of stress management from their HCPs via their introductory information packet. However, typically there was no follow-up beyond receipt of the packet. As a result, women sought information online from numerous sources. Unfortunately, this information often conflicted with HCP provided information, as did the information provided from multiple HCPs in group care settings. A major facilitator of behavioral change pertained to building trust and rapport as it directly enhanced the perceived quality of patient-provider communication on prenatal health behaviors. Across all behaviors, women voiced the need for available resources that were credible and referenced by their HCPs. Conclusions: These findings provide a better understanding of what facilitates and prevents women from engaging in healthy behaviors during their pregnancy, in addition to improving patient and provider communication.