Felicia Collins, MD, MPH¹, Barbara A. Bartman, MD, MPH², Amy C Chanlongbutra, MPH¹, Latecia Engram, MSPH³, Amisha Pandya, MHS⁴, Charles Daly, MHA, FACHE⁴, Richard C. Lee⁴, and John T. Wulu, PhD⁵. (1) Division of Clinical Quality/ Clinical Quality Systems Branch, Health Resources and Services Administration/Bureau of Primary Health Care, 4350 East West Highway, 11th Floor, Bethesda, MD 20814, 301-594-1202, AChanlongbutra@hrsa.gov, (2) Division of Clinical Quality/Clinical Quality Systems Branch, Health Resources and Services Administration/Bureau of Primary Health Care, 4350 East-West Highway, 11th Floor, Bethesda, MD 20814, (3) Health Care Systems Branch of the Division of State and Community Assistance, Bureau of Primary Health Care, HRSA/DHHS, East West Towers, 4350 East West Highway, Bethesda, MD 20814, (4) Office of Policy, Evaluation and Data, Health Resources and Services Administration/Bureau of Primary Health Care, 4350 East West Highway, 11th Floor, Bethesda, MD 20814, (5) Office of Policy, Evaluation, and Data, Bureau of Primary Health Care, HRSA/DHHS, 4350 East West Highway, 7th floor, Bethesda, MD 20814

Objectives: This study examines the relationship between patient satisfaction with prenatal care (PNC) and rates of LBW in HCs funded by the Health Resources and Services Administration's Bureau of Primary Health Care (HRSA/BPHC) in African-American, Hispanic, and Caucasian women. Methods: As part of the Low Birth Weight Best Practices Project, a 48-item satisfaction questionnaire was administered to 564 women in eight HCs nationwide. Stratifying by race and ethnicity, responses from model HCs (LBW < 5.5%) and comparison HCs (LBW rate > 5.5%) were studied with respect to satisfaction with the environment of care and the patient-provider interaction. The generalized estimating equation (GEE) controlled for individual risk factors for LBW, while adjusting for clustering within HCs. Results: Women were universally satisfied with the PNC received, but the nature of the relationship between satisfaction and LBW rates varied by race and ethnicity. For Hispanic women, greater satisfaction with clean facilities, parking, and transportation was associated with model HCs. For African-American (AA) women, friendliness, courtesy, and privacy provided by the HC reception staff were associated with model HCs. A significant association between greater satisfaction with the patient-provider interaction and model centers was observed for Hispanic, but not for AA or White women. Patients reported better health status at model centers regardless of race or ethnicity. Findings: This study suggests that further reduction in LBW rates may be possible for HCs by modifying certain environmental and provider factors. Such modifications could be targeted efficiently based on the racial and ethnic composition of the HC.

Learning Objectives:

(
• To identify the specific environmental and patient-provider factors associated with greater satisfaction and better birth outcomes in a sample of federally supported health centers. (
• To describe ways that health centers and provider systems can target resources to potentially reduce rates of low birth weight in African-American and Hispanic populations.

Keywords: Community Health Centers, Low Birthweight

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.