Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/22367
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Engagement: an indicator of difference in the perceptions of antenatal care for pregnant women from diverse socioeconomic backgrounds
Authors: Docherty, Angela
Bugge, Carol
Watterson, Andrew
Contact Email: carol.bugge@stir.ac.uk
Keywords: antenatal care
case study
engagement
health inequalities
health literacy
socioeconomic deprivation
Issue Date: Jun-2012
Publisher: Wiley-Blackwell
Citation: Docherty A, Bugge C & Watterson A (2012) Engagement: an indicator of difference in the perceptions of antenatal care for pregnant women from diverse socioeconomic backgrounds, Health Expectations, 15 (2), pp. 126-138.
Abstract: BACKGROUND: Socioeconomically deprived women are at greater risk of adverse pregnancy outcomes. Research tends to focus on access of services. Yet access may not equate with the equity of services for women from different socioeconomic backgrounds. OBJECTIVES: To determine whether pregnant women's perceptions of antenatal provision differed in relation to their socioeconomic deprivation ranking (determined by the Scottish Index of Multiple Deprivation 2006). DESIGN: A longitudinal, qualitative study with comparative antenatal case studies between January 2007 and April 2009. SETTING/PARTICIPANTS: Cases were primigravida women from 'least deprived' (n=9) and 'most deprived' (n=12) geographical areas within one local authority in Scotland. ANALYSIS: Data were analysed using case study replication analysis. RESULTS: There was little difference in access to antenatal services between the 'least' and 'most' deprived groups. Perception of care differed in relation to the level of 'engagement' (defined using constructs of: language and personalization of care; power and relationships; and health literacy). Engagement was evidenced in most of the 'least deprived' cases and almost none of the 'most deprived' cases. Specifically, socioeconomically deprived women described less evidence of personal connection to their own care, effective communication and the opportunity for shared decision making. CONCLUSION:In women from socioeconomically deprived areas, access may be a less useful indicator than engagement when assessing antenatal service quality. As engagement levels may be one method by which to predict and improve health outcomes, a more equitable antenatal service may need to be developed through the early identification of those women at risk of non-engagement.
Type: Journal Article
URI: http://hdl.handle.net/1893/22367
DOI Link: http://dx.doi.org/10.1111/j.1369-7625.2011.00684.x
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: OHSU School of Nursing - Monmouth, USA
HS Research - Stirling
HS Research - Stirling

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