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Julia F. Switzer, BA, Department of Family Practice and Community Medicine, University of Pennsylvania, 3400 Spruce Street, 2-Gates, Philadelphia, PA 19104-4283, 215-615-0356, switzerj@uphs.upenn.edu, Ian Bennett, MD, PhD, Family Practice and Community Medicine, University of Pennslyvania, 2nd Floor Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, and Abigail Calkins Aguirre, MPA, Family Practice and Community Medicine, University of Pennsylvania, 3508 Market St., Suite 251, Philadelphia, PA 19104.
Purpose: To identify and explore patient-defined obstacles to the utilization of prenatal care among women with low literacy.
Methods: This data represents the qualitative component of a prospective, parallel, mixed methods study investigating literacy and maternal-child health. A total of 237 low income, primarily African American women were enrolled in the immediate postpartum period in a prospective observational study. Literacy was measured and dichotomized into low literacy (< 6th grade) and higher literacy groups (> 8th grade). Four focus groups, two with each of the literacy categories, were carried out. Open ended questions designed to elicit unbiased responses were utilized. Focus groups were taped and transcribed for analysis.
Results: Focus groups were not significantly different based on demographic variables. Three primary themes characterize the low literacy groups in contrast to the higher literacy groups: 1) lack of trust of the providers, 2) perceived poor communication with prenatal providers, and 3) difficulties with health system navigation. The lower literacy group further identified characteristics of “good” doctors, in contrast to “bad” doctors, as those who 1) spoke to them clearly (“broke it down for me”) 2) developed a strong relationship with them, and 3) maintained continuity through the pregnancy and delivery.
Conclusions: African American, inner city women receiving maternal health care identify areas of communication which interfere with their utilization of prenatal care. These findings may help identify intervention targets which could reduce obstacles to this care. Triangulation of these results with the quantitative outcomes will be described.
Learning Objectives: "At the conclusion of the session, the participant in this session will be able to
Keywords: Literacy, Prenatal 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.