Introduction: Aboriginal and Torres Strait Islander (indigenous) women are at greater risk of adverse pregnancy outcomes than non-indigenous women. Pregnancy care has a key role in identifying and addressing lifestyle-related risk factors that contribute to adverse pregnancy outcomes. With a focus on lifestyle-related risk factors, this study investigated whether provision of pregnancy care by primary health centres, in predominantly indigenous communities, increased after participation in a continuous quality improvement (CQI) initiative. Methods: Maternal health records (n = 2592) were audited at primary health centres (n = 76) participating in a CQI initiative, across five Australian states/territories, 2007–2012. Regression analysis investigated associations between provision of pregnancy care measures and number of CQI cycles, and selfratings of organisational systems. Key outcome measures included screening for cigarette and alcohol use, counselling regarding cigarette cessation, alcohol, nutrition, physical activity, food security and folate prescription. Results: Women attending health centres with ≥1 completed CQI cycles were more likely to receive all investigated pregnancy care measures than women attending health centres yet to complete one cycle e.g. screening for cigarette use: no cycles = 78%, 1 cycle = 90% [odds ratio (OR):2.8, 95% confidence interval (CI):2.1–3.8], 2 = 91% (OR:4.8, 95% CI: 3.1–7.4), 3 = 93% (OR:6.0, 95% CI: 3.0–12), 4 = 95% (OR:11, 95% CI: 4.1–28). Greater self-ratings of overall organisational systems were associated with greater counselling regarding cigarettes and nutrition, and folate prescription; self-ratings of some systems components were positively associated with provision of alcohol screening and counselling regarding cigarette cessation, alcohol and nutrition, and folate prescription (P-values <0.05). Conclusion: These findings support incorporation of CQI activities, focussing on organisational systems, into primary care settings in Indigenous communities to improve pregnancy care.
|Number of pages||2|
|Journal||BJOG: an International Journal of Obstetrics and Gynaecology|
|Publication status||Published - 15 Apr 2015|
|Event||Royal College of Obstetricians and Gynaecologists World Congress 2015 - Brisbane Convention and Exhibition Centre, Brisbane, Australia|
Duration: 12 Apr 2015 → 15 Apr 2015