Table 2.
Longitudinal recorded provision of pregnancy care measures regarding lifestyle-related risk factors, after each CQI cycle and compared to baseline
| CQI cycle | ||||||
|---|---|---|---|---|---|---|
| Number of women receiving each outcome measure | Baseline n = 829 | End of cycle 1 n = 758 | End of cycle 2 n = 388 | End of cycle 3 n = 135 | End of cycle 4 n = 110 | p-value for trend |
| Screened for cigarette use (%) | 603 (73) | 679 (90) | 352 (91) | 125 (93) | 105 (95) | |
| OR (95 % CI) | ref | 3.0* (2.2 to 4.1) | 5.1* (3.3 to 7.8) | 6.3* (3.1 to 13) | 11* (4.3 to 29) | n.s. |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 3.0* (2.2 to 4.1) | 5.2* (3.3 to 8.0) | 6.3* (3.1 to 13) | 11* (4.3 to 29) | n.s. |
| Cigarette cessation advice (%) | 185/357 (52) | 280/403 (69) | 161/238 (68) | 63/92 (68) | 49/67 (73) | |
| OR (95 % CI) | ref | 2.0* (1.5 to 2.8) | 2.6* (1.7 to 4.0) | 5.8* (3.1 to 11) | 11* (5.2 to 22) | <0.001 |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 2.1* (1.5 to 2.9) | 2.7* (1.8 to 4.2) | 7.0* (3.7 to 13) | 14* (6.5 to 28) | <0.001 |
| Screened for alcohol use (%) | 539 (65) | 633 (84) | 328 (85) | 111 (82) | 91 (83) | |
| OR (95 % CI) | ref | 2.6* (2.0 to 3.4) | 3.7* (2.6 to 5.4) | 3.0* (1.7 to 5.1) | 3.8* (2.1 to 6.9) | n.s. |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 2.6* (2.0 to 3.5) | 3.9* (2.7 to 5.7) | 3.0* (1.8 to 5.2) | 3.9* (2.2 to 7.1) | n.s. |
| Brief alcohol counselling (%) | 87/172 (51) | 135/191 (71) | 42/63 (67) | 23/40 (58) | 17/24 (71) | |
| OR (95 % CI) | ref | 2.8* (1.7 to 4.6) | 2.0 (1.0 to 4.0) | 2.2 (0.9 to 5.2) | 4.5* (1.6 to 13) | n.s. |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 2.8 (1.7 to 4.5) | 2.0* (1.0 to 4.1) | 3.1* (1.3 to 7.2) | 6.7* (2.3 to 20) | <0.001 |
| Nutrition counselling (%) | 337 (41) | 436 (58) | 227 (59) | 68 (50) | 71 (65) | |
| OR (95 % CI) | ref | 1.9* (1.5 to 2.4) | 2.7* (2.0 to 3.6) | 3.5* (2.3 to 5.5) | 8.5* (5.2 to 14) | <0.001 |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 1.9* (1.5 to 2.4) | 2.7* (2.0 to 3.6) | 3.6* (2.3 to 5.6) | 8.6* (5.2 to 14) | <0.001 |
| Food security counselling (%) | 40 (4.8) | 144 (19) | 75 (19) | 16 (12) | 10 (9.1) | |
| OR (95 % CI) | ref | 4.6* (3.1 to 7.0) | 3.2* (1.9 to 5.4) | 7.9* (3.5 to 18) | 11* (4.2 to 28) | n.s. |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 4.6* (3.1 to 7.0) | 3.1* (1.9 to 5.2) | 8.7* (3.8 to 20) | 12* (4.7 to 33) | n.s. |
| Physical activity counselling (%) | 162 (20) | 232 (31) | 125 (32) | 30 (22) | 17 (15) | |
| OR (95 % CI) | ref | 1.7* (1.3 to 2.2) | 1.9* (1.4 to 2.7) | 3.2* (1.8 to 5.6) | 3.3* (1.7 to 6.5) | <0.001 |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 1.7* (1.3 to 2.2) | 2.0* (1.4 to 2.8) | 3.9* (2.2 to 6.9) | 4.0* (2.0 to 7.9) | <0.001 |
| Folate prescription < 20 weeks (%) | 234 (28) | 329 (43) | 143 (37) | 57 (42) | 37 (34) | |
| OR (95 % CI) | ref | 2.0* (1.6 to 2.5) | 2.3* (1.7 to 3.2) | 5.3* (3.2 to 8.6) | 4.7* (2.8 to 8.2) | n.s. |
| OR (95 % CI) adjusted for mean baseline provisiona | ref | 2.0* (1.6 to 2.6) | 2.4* (1.7 to 3.3) | 6.0* (3.7 to 9.9) | 5.5* (3.2 to 9.6) | n.s. |
*p < 0.05, CQI continuous quality improvement, OR odds ratio, CI confidence interval, ref reference group, n.s. not significant for trend. Using each health record as the unit of analysis, random effects logistic regression analysis assessed any associations between provision of pregnancy care measures and completion of 1–4 CQI cycles, with adjustment for clustering of health records within PHCs. aadjusted for mean baseline provision per total cycles completed (given in Table 1)