Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Steven Browning

Committee Member

Dr. Anna Kucharska-Newton

Committee Member

Dr. Kathleen Winter



Aim: To identify maternal demographic and psychosocial risk factors associated with poor attendance of CenteringPregnancy group prenatal care, and whether past or current experience of intimate partner violence is related to poor attendance.

Methods: Data from the EMPOWR (Efforts to Maximize Perinatal Outcomes in Women at risk) were used in a cross-sectional study design. Self-reported data from 607 high-risk pregnant women from Kentucky was used. Poor-attendance or non-compliance was defined as attending less than 6 out of the 10 group prenatal care session. Multivariable logistic regression was performed to assess the association between risk factors and compliance with the program.

Results: In the fully adjusted regression model, women who had experienced physical abuse had 1.38 times the odds of being non-compliant with the program in comparison to those who had not (95% CI :0.89-2.14). Employment status showed a statistically significant difference in compliance with women who were unemployed, having 1.61 times the odds of non-compliance compared to those who were employed (95% CI:1.05-2.47). Women who had previously had a preterm delivery had 2.25 times the odds of non-compliance compared to those who did not (95% CI:1.24-4.08). Women for whom this pregnancy was unplanned had 1.33 times the odds of non-compliance compared to those who had intended for the pregnancy (95 % CI 0.88-2.01).

Conclusion: Compliance with group prenatal care sessions is affected by maternal demographic, behavioral, and psychosocial risk factors, notable, unemployment, unintentional pregnancy, and history with physical abuse. History of preterm delivery was also strongly associated with low compliance. While further research is needed, these findings indicate that maternal risk factors are important to consider when planning GPC, in order to ensure that women adequately use the program.

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