Dr. Nichola Driver, Dr. Chul Hyun Park, and Dr. Robert C. Richards, Jr., are leading research and evaluation efforts for the first CenteringPregnancy program at the University of Arkansas for Medical Sciences Women’s Center in Little Rock, Ark.

CenteringPregnancy is a group-based model of prenatal care. Instead of seeing a doctor, nurse, or midwife individually, women participating in a Centering program attend organized group meetings.

The group meetings are designed to address all aspects of wellness during pregnancy, not just a woman’s physical health. CenteringPregnancy groups usually consist of eight to 12 moms-to-be with similar due dates, as well as their support partners.

During the group meetings, each woman has the opportunity to build community with other pregnant women, learn self-care skills, get assurance about the progression of her pregnancy, and gain knowledge about pregnancy, birth, and parenting.

The concept of CenteringPregnancy was initiated in the early 1990s by a nurse-midwife, Sharon Schindler Rising, who began holding centering groups in a hospital clinic, community health center, and private office in Waterbury, Conn. As she began to bring groups of women together to go through prenatal care, she discovered much better health outcomes for the women and their infants.

Driver, Park and Richards have been analyzing the outcomes from the first cohort of CenteringPregnancy patients at the UAMS Women’s Center in Little Rock. They found that compared to traditional individual prenatal care, CenteringPregnancy improved the access of women to prenatal care and lowered the rates of preterm birth and perinatal death.

“Its connection with the Open Governance Lab is that the group prenatal care process is very democratic,” said Richards. “The women are learning from one another; they’re sharing wisdom and insights, providing support. Women who have had children before are sharing their wisdom and insights with women in the group for whom this is their first child. They’re sharing ideas about nutrition and exercise and self-care, helping to change unhealthy habits to healthier habits, and it’s a very democratic process and involves a lot of personal growth and change, similar to what we see when citizens get together to deliberate problems in their communities.”

Virtual Dialogues for Healthcare Workers’ Pandemic Experiences

Park and Richards were the recipients of a grant from Villanova University’s Waterhouse Family Institute for the Study of Communication and Society (WFI) to study virtual dialogues for healthcare workers regarding their experiences of working through the COVID-19 pandemic in February and March 2021.

The grant funded the evaluation of online dialogues for healthcare workers in Arkansas and other states. The evaluation was conducted by a research team whose members included, in addition to Park and Richards, Nickolas Zaller of the University of Arkansas for Medical Sciences, Laura W. Black of Ohio University, Anna W. Wolfe of Texas A&M University, Carson Kay of Washburn University, and David L. Brinker of Tufts University.

Robert Stains, a Senior Associate with Essential Partners who has taught dialogue facilitation to Clinton School students, designed and served as the lead facilitator of the dialogues. Corrinne McClure, then a second-year Master of Public Service candidate at the Clinton School, who worked with Essential Partners on her final Capstone project, assisted in facilitating and evaluating the dialogues.

The grant-funded study drew on theories of dialogue, storytelling, framing, and communicative care to investigate how healthcare workers employed online dialogue to address their pandemic-related trauma and emotions, and the roles of storytelling, identity negotiation, and sense-making in those processes.

The study also examined how participation in dialogue can help healthcare workers address their emotions related to the disparate impact of the pandemic on People of Color, and the politicization of healthcare.

The dialogues served two purposes: to allow for the people who care for the health of others to process and connect about this time of profound disruption and the challenges to their work and the people they serve, and to allow them to reflect on how their past experiences provide strengths that they can lean into as they work to support their patients.

Dialogue participants were asked to talk about a challenge that they have overcome in their lives and the strength that they brought from that situation into their current situation. Participants were then asked to think about the challenges and disruptions caused by COVID-19, and in that context to consider what their needs were and what strengths they have that could be a resource for others.

This project will continue through studies of in-person dialogues among healthcare workers.