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Dissertation/Thesis Abstract

Exploring The JJ Way®: A Model of Care for Reducing Disparities and Improving Perinatal Health
by Day, Sarah J., M.S.M.W., Bastyr University, 2014, 38; 1562616
Abstract (Summary)

Extreme racial disparities exist in birth outcomes in the U.S. "The JJ Way®" is a model of prenatal care designed by midwife Jennie Joseph to reduce health disparities and adverse birth outcomes, such as preterm birth and low birth weight infants. This study compared the outcomes of patients who participated in The JJ Way® to outcomes in a matched comparison group from Florida Vital Statistics of women who took part in standard prenatal care. A historical comparison group was created by matching age, race, and zip code; outcome measures included gestational age at birth and infant birth weight. The results show that the women who had The JJ Way ® model of care had marginally statistically significantly higher gestational age (38.9 weeks versus 37.9 weeks, p=0.07) than the women who went through standard prenatal care, but their infants' birth weights were not significantly higher (3359.4 grams versus 3265.9 grams, p=0.41). The JJ Way® women also had fewer preterm infants (4.5% overall) than the women who had standard prenatal care (14.9%, p=0.04). When outcomes were analyzed by race, there were no statistically significant differences between White women in the two groups in gestational age (38.7 weeks in The JJ Way® group versus 38.5 weeks in the standard care group, p=0.60) or birth weight (3373.6 grams in The JJ Way® group versus 3419.0 grams in the standard care group, p=0.20). There were statistically significant differences for Women of Color for mean gestational age and preterm birth rate. The JJ Way® Women of Color group had higher gestational age than their counterparts who had standard prenatal care: 39.0 weeks versus 37.4 weeks, p=0.03. They also had no preterm births versus 17.1% in the standard care group (p=0.01). A secondary analysis was conducted comparing White women to African American women only. The sample size was small, although the magnitude of differences were striking, none of them were statistically significant. In the group receiving standard prenatal care, rates of preterm birth were 12.5% for White women versus 15.0% for African American women (p=0.10), and rates of low birth weight were 3.1% for White women versus 5.0% for African American women (p=1.00). In the group receiving The JJ Way® model of prenatal care, differences were also non-significant but in the opposite direction: rates of preterm birth and low birth weight were both 9.4% for White women and 0% for African American women, (p=0.28). According to the results of the primary study, the care that Women of Color, in particular, are receiving in The JJ Way® model results in outcomes that are superior to those of their counterparts who are experiencing standard prenatal care. Given the decades of unsuccessful progress on reducing rates of preterm birth, low birth weight, and infant mortality in the U.S., The JJ Way® model's success is noteworthy. It should be supported, funded, and larger studies should be conducted.

Indexing (document details)
Advisor: Gordon, Wendy
Commitee: Martzen, Mark, Parker Dominguez, Tyan
School: Bastyr University
Department: Department of Midwifery
School Location: United States -- Washington
Source: MAI 53/04M(E), Masters Abstracts International
Subjects: African American Studies, Medicine, Alternative Medicine, Public health
Keywords: Access, Florida, Health disparities, Maternity care, Midwifery, Model of care, Racism
Publication Number: 1562616
ISBN: 978-1-321-10081-5
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