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Table 2 Longitudinal recorded provision of pregnancy care measures regarding lifestyle-related risk factors, after each CQI cycle and compared to baseline

From: Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative

 

CQI cycle

 

Number of women receiving each outcome measure

Baseline n = 829

End of cycle 1 n = 758

End of cycle 2 n = 388

End of cycle 3 n = 135

End of cycle 4 n = 110

p-value for trend

Screened for cigarette use (%)

603 (73)

679 (90)

352 (91)

125 (93)

105 (95)

 

OR (95 % CI)

ref

3.0* (2.2 to 4.1)

5.1* (3.3 to 7.8)

6.3* (3.1 to 13)

11* (4.3 to 29)

n.s.

OR (95 % CI) adjusted for mean baseline provisiona

ref

3.0* (2.2 to 4.1)

5.2* (3.3 to 8.0)

6.3* (3.1 to 13)

11* (4.3 to 29)

n.s.

Cigarette cessation advice (%)

185/357 (52)

280/403 (69)

161/238 (68)

63/92 (68)

49/67 (73)

 

OR (95 % CI)

ref

2.0* (1.5 to 2.8)

2.6* (1.7 to 4.0)

5.8* (3.1 to 11)

11* (5.2 to 22)

<0.001

OR (95 % CI) adjusted for mean baseline provisiona

ref

2.1* (1.5 to 2.9)

2.7* (1.8 to 4.2)

7.0* (3.7 to 13)

14* (6.5 to 28)

<0.001

Screened for alcohol use (%)

539 (65)

633 (84)

328 (85)

111 (82)

91 (83)

 

OR (95 % CI)

ref

2.6* (2.0 to 3.4)

3.7* (2.6 to 5.4)

3.0* (1.7 to 5.1)

3.8* (2.1 to 6.9)

n.s.

OR (95 % CI) adjusted for mean baseline provisiona

ref

2.6* (2.0 to 3.5)

3.9* (2.7 to 5.7)

3.0* (1.8 to 5.2)

3.9* (2.2 to 7.1)

n.s.

Brief alcohol counselling (%)

87/172 (51)

135/191 (71)

42/63 (67)

23/40 (58)

17/24 (71)

 

OR (95 % CI)

ref

2.8* (1.7 to 4.6)

2.0 (1.0 to 4.0)

2.2 (0.9 to 5.2)

4.5* (1.6 to 13)

n.s.

OR (95 % CI) adjusted for mean baseline provisiona

ref

2.8 (1.7 to 4.5)

2.0* (1.0 to 4.1)

3.1* (1.3 to 7.2)

6.7* (2.3 to 20)

<0.001

Nutrition counselling (%)

337 (41)

436 (58)

227 (59)

68 (50)

71 (65)

 

OR (95 % CI)

ref

1.9* (1.5 to 2.4)

2.7* (2.0 to 3.6)

3.5* (2.3 to 5.5)

8.5* (5.2 to 14)

<0.001

OR (95 % CI) adjusted for mean baseline provisiona

ref

1.9* (1.5 to 2.4)

2.7* (2.0 to 3.6)

3.6* (2.3 to 5.6)

8.6* (5.2 to 14)

<0.001

Food security counselling (%)

40 (4.8)

144 (19)

75 (19)

16 (12)

10 (9.1)

 

OR (95 % CI)

ref

4.6* (3.1 to 7.0)

3.2* (1.9 to 5.4)

7.9* (3.5 to 18)

11* (4.2 to 28)

n.s.

OR (95 % CI) adjusted for mean baseline provisiona

ref

4.6* (3.1 to 7.0)

3.1* (1.9 to 5.2)

8.7* (3.8 to 20)

12* (4.7 to 33)

n.s.

Physical activity counselling (%)

162 (20)

232 (31)

125 (32)

30 (22)

17 (15)

 

OR (95 % CI)

ref

1.7* (1.3 to 2.2)

1.9* (1.4 to 2.7)

3.2* (1.8 to 5.6)

3.3* (1.7 to 6.5)

<0.001

OR (95 % CI) adjusted for mean baseline provisiona

ref

1.7* (1.3 to 2.2)

2.0* (1.4 to 2.8)

3.9* (2.2 to 6.9)

4.0* (2.0 to 7.9)

<0.001

Folate prescription < 20 weeks (%)

234 (28)

329 (43)

143 (37)

57 (42)

37 (34)

 

OR (95 % CI)

ref

2.0* (1.6 to 2.5)

2.3* (1.7 to 3.2)

5.3* (3.2 to 8.6)

4.7* (2.8 to 8.2)

n.s.

OR (95 % CI) adjusted for mean baseline provisiona

ref

2.0* (1.6 to 2.6)

2.4* (1.7 to 3.3)

6.0* (3.7 to 9.9)

5.5* (3.2 to 9.6)

n.s.

  1. *p < 0.05, CQI continuous quality improvement, OR odds ratio, CI confidence interval, ref reference group, n.s. not significant for trend. Using each health record as the unit of analysis, random effects logistic regression analysis assessed any associations between provision of pregnancy care measures and completion of 1–4 CQI cycles, with adjustment for clustering of health records within PHCs. aadjusted for mean baseline provision per total cycles completed (given in Table 1)