Carol C. Korenbrot, PhD, Institute for Health Policy Studies, University of California San Francisco, Box 0936, San Francisco, CA 94143-0936, 415/476-3094, ckoren@itsa.ucsf.edu, Sabrina T. Wong, RN, PhD, Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, Box 0856, 3333 California Street, Suite 335, San Francisco, CA 94143, and Anita L. Stewart, PhD, Institute for Health & Aging, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118.

Objectives. If prenatal support services (health promotion and psychosocial) are to remain accessible to low income eligible women, evidence is needed as to whether the services improve care and benefit women in ways that matter to Medicaid health plans. The aims of this study were to determine whether women who reported receiving support services also reported they received higher quality interpersonal care, and whether the effects on interpersonal care help explain greater satisfaction with their care. Research Design. A telephone survey of 363 African-American, Latina (US and nonUS-born) and White women receiving prenatal care in four Medicaid health plans in California in 2001 was conducted. Multivariate regression models were constructed with adjustments for potentially confounding variables. Measures. Dichotomous variables for health promotion advice in 5 areas, composite scales for psychosocial assessment (in 6 areas) and satisfaction with care, and three indices for Communication, Decision-making, and Interpersonal Style by adding scales originally constructed with confirmatory factor analysis in each of the three dimensions, were all tested for reliability and construct validity in each ethnic group. Results. Women who report receiving health promotion or psychosocial services report receiving higher quality communication, decision-making and interpersonal style from their prenatal providers. The effects of the support services on interpersonal care in turn explained the higher satisfaction with care associated with receiving the support services. Conclusions. Prenatal health promotion and psychosocial services have associated benefits to enrollees that should matter to Medicaid health plans and their providers.

Learning Objectives:

• To know that Medicaid-eligible pregnant women of diverse racial and ethnic groups who report they receive health promotion and psychosocial services prenatally report better communication with their providers, better roles in making decisions that affect the health of their pregnancy, and better interpersonal relationships with their prenatal care provider.
• To know that Medicaid-eligible pregnant women of diverse racial and ethnic groups who report they receive health promotion and psychosocial services prenatally have higher satisfaction with their prenatal care.
• To understand that the higher satisfaction with prenatal care reported by these diverse, low income women who receive the health promotion and psychosocial services is explained by the effects of the health promotion and psychosocial services on communication and interpersonal relationships with their providers.

Keywords: Prenatal Care, Medicaid Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 81.5 kb)