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Date Available

4-24-2026

Year of Publication

2026

Document Type

Graduate Capstone Project

Degree Name

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

College

Public Health

Department/School/Program

Public Health

Faculty

Paula Arnett

Committee Member

Keith Knapp

Faculty

Sarah Cpreke

Abstract

Delayed initiation of prenatal care remains a significant public health concern in rural Appalachian communities, including Perry County, Kentucky, where structural barriers such as limited provider availability, transportation challenges, and fragmented referral systems contribute to inadequate access to timely care. This capstone project proposes the Perry County Prenatal Access Navigator Program (PC-PANP), a community-based patient navigation model designed to improve initiation of prenatal care in the first trimester. The program is led by the local health department and leverages partnerships with healthcare providers, the University of Kentucky College of Public Health, WIC, Extension services, and community organizations to support early identification of pregnancy and coordinated referral to care. Navigators provide individualized support, including appointment scheduling, follow-up, and connection to social services. An evaluation plan guided by the Centers for Disease Control and Prevention Framework for Program Evaluation includes both process and outcome measures, such as timeliness of navigator contact, referral volume, and missed appointment rates. The program aims to increase first-trimester prenatal care initiation by 10 percentage points within three years and reduce missed prenatal appointments by 20 percent. By addressing system-level barriers and improving care coordination, this model has the potential to reduce maternal health disparities and serve as a scalable approach for improving prenatal care access in rural communities.

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