Overview. CenteringPregnancy is a multifaceted model of group maternity care that incorporates health assessment, education, and support. Eight to ten women with similar gestational ages meet to learn care skills, participate in a facilitated discussion, and develop a support network with other group members.[1]
Evidence. Scientifically Rigorous Evidence.
Strategies with this rating are most likely to be effective. These strategies have been tested in multiple robust studies in a variety of populations and settings with consistently positive results, both on their own and in combination with other strategies. (Clarifying Note: The WWFH database calls this "scientifically supported evidence").
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
- Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
- Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.
Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).
Intervention Level. Community-Focused
Examples from the Field.
Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of healthcare providers trained to facilitate Centering Pregnancy groups. (Measures workforce capacity building to support the model.)
- Number of prenatal care sites offering Centering Pregnancy groups. (Quantifies the availability and accessibility of the group care model.)
- Number of community partners promoting Centering Pregnancy to expectant parents (e.g., WIC, home visiting programs). (Tracks cross-sector collaboration and referral networks.)
- Number of expectant parents who enroll in Centering Pregnancy groups. (Measures the reach and scale of the group care model.)
- Number of Centering Pregnancy sessions provided to expectant parents. (Assesses the volume and frequency of group care services delivered.)
- Number of expectant parents who complete a full cycle of Centering Pregnancy (10 sessions). (Tracks retention and dosage of the intervention.)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of Centering Pregnancy facilitators who adhere to the model's essential elements and curriculum. (Assesses fidelity to the evidence-based group care model.)
- Percent of Centering Pregnancy groups that maintain recommended group size (8-10 participants). (Measures adherence to group composition standards for optimal outcomes.)
- Percent of Centering Pregnancy participants who receive education on breastfeeding benefits and techniques. (Tracks integration of breastfeeding promotion into group content.)
- Percent of Centering Pregnancy participants who report high satisfaction with their group prenatal care experience. (Assesses participant perception of the quality and value of group care.)
- Percent of Centering Pregnancy participants who initiate breastfeeding after delivery. (Measures the model's impact on a key breastfeeding outcome.)
- Percent of Centering Pregnancy participants who attend their postpartum follow-up appointment. (Captures the model's influence on continuity of care and preventive health behaviors.)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of Centering Pregnancy groups that include a family support person or partner at sessions. (Measures the program's engagement of fathers and support networks.)
- Number of Centering Pregnancy sites that offer groups in multiple languages or with interpreter services. (Assesses the language accessibility of the group care model.)
- Number of quality improvement initiatives implemented to enhance Centering Pregnancy delivery and outcomes. (Tracks continuous improvement efforts to refine the model.)
- Number of Centering Pregnancy participants who establish a postpartum contraceptive plan. (Captures the model's impact on family planning and birth spacing.)
- Number of Centering Pregnancy participants who access recommended prenatal and postpartum mental health services. (Assesses linkages to behavioral health supports.)
- Number of healthcare systems that sustain Centering Pregnancy after initial grant funding or pilot period. (Measures long-term adoption and institutionalization of the model.)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- - Percent of Centering Pregnancy groups held in communities with high rates of adverse birth outcomes. (Assesses strategic implementation to address perinatal health disparities.)
- - Percent of Centering Pregnancy facilitators who reflect the cultural and linguistic diversity of the patient population. (Measures workforce cultural congruence with participants.)
- - Percent of Centering Pregnancy curriculum adaptations that incorporate input from participants and community members. (Tracks community and participant engagement in tailoring the model.)
- - Percent reduction in low birthweight and preterm birth rates among Centering Pregnancy participants, compared to individual care. (Captures the model's impact on birth equity.)
- - Percent of Medicaid-enrolled women in prenatal care who participate in Centering Pregnancy. (Assesses penetration and uptake of the model among low-income populations.)
- - Percent of Centering Pregnancy participants who maintain breastfeeding at 6 and 12 months postpartum. (Measures the model's long-term impact on breastfeeding duration.)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
References
1 Centering Healthcare Institute (CHI). Centering Pregnancy overview. https://centeringhealthcare.org/about
