Building a framework explaining the determinants and effects of the perinatal group care model “CenteringPregnancy”

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International research has shown promising results of CenteringPregancy (CP) on perinatal outcomes, women’s well-being and experiences. However, the biological, behavioral and social mechanisms by which CP group care may have its effects as well as the specific underlying determinants that maximize this effectiveness are still unknown.

To identify possible effective mechanisms within the CP care model interviews with care providers are undertaken. In addition an indicator list is developed for professionals to register care provision, group activities in the CP care model and group behavior. The indicator list is implemented in all organizations providing CP and is completed by each CP provider after each group session. Women who receive CP will be asked to fill out a client version of the indicator list after the first, fourth and last CP session. Data from the professional and client’s indicator lists will be analyzed to determine the level of fidelity to the CP model, level of care provision, level of facilitative leadership and group behavior and the relation between those determinants. Within the Connect-In study, quantitative data analyses will be performed to assess the relation between level of delivery of the CP model measured with the indicator list, client and group characteristics and intermediate outcomes.


To identify behavioral and social mechanisms by which CP group care may have its effects as well as the specific underlying determinants that maximize this effectiveness.


What are the behavioral, social and organizational mechanisms by which CP group care may have its effects?


By identifying ‘active ingredients’ of CP we can better understand the impact of CP on outcomes, efficiency, cost-effectiveness, women’s experience of care, clinicians and settings, and long-term sustainability. This is important because sites and clinicians may modify Centering either in response to challenges they confront in implementing Centering or for a variety of other reasons and some versions of group prenatal care may not follow the CP protocol.


Dr. Marlies Rijnders


Dr. Marlies Rijnders


Drs. Inger Aalhuizen KNOV
Dr. Matty Crone LUMC
Karin van der Pal TNO
Birgit van Zwicht-Bruinsma promovenda LUMC

This research is part of a fellowship funded by the Royal Dutch Organisation of Midwives.


Dr. M. Rijnders (TNO)


Begindatum: september 2014
Einddatum: september 2016

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