Minority women in the United States are at higher risk of adverse birth outcomes and have lower utilization of prenatal care. Hispanic/Latina women are less likely to initiate prenatal care in the first trimester or to receive adequate prenatal care. Immigrant and migrant women, and undocumented women in particular, face additional challenges that include reduced access to health facilities and behavioral health care, lack of health insurance, socioeconomic stressors and language barriers to communicating with primary care providers. To support providers in addressing this need, our organization began co-locating behavioral health therapists. After testing this approach for several years, we found that access was still limited and most patients could not come back for therapy. To better meet the needs of our population, we made the shift to full integration in which the BHC provides same day access and functions as part of the medical team. One example of BHC involvement is their collaboration in Centering Pregnancy which is an innovative model of group prenatal care and childbirth education. It consists of organizing healthcare delivery, identifying risk factors and addressing needs, providing health education, and peer support. Centering is conceptually grounded in self-efficacy theory, the idea of empowering women by actively involving them in their care will lead to better health outcomes. Numerous published studies show that Centering moms have healthier babies and that Centering nearly eliminates racial disparities in preterm birth. This presentation will provide interactive, round table discussion on shifting from co-location to full integration at a Federally Qualified Health Center to customize care to the needs of a high-risk pregnancy population. We will review practical strategies for how BHCs become part of the medical team and expanded to a whole array of prevention and intervention supports. The importance of education and training will be stressed and modeled through practical examples and implementation tips. Participants will be provided a worksheet to better customize services to the needs of their populations with high risk.
- Describe how shifting to full integration allowed BHCs to provide preventative services, meet the unique needs of the population and be incorporated into the medical teams.
- Identify key elements for integrating BHCs into preventative services and Centering Pregnancy Groups to support high risk pregnancies.
- Using population based strategies identified, develop one action item that can be applied to your own sub population.