VALIDATING A MODEL DEVELOPED TO PREDICT PRENATAL-CARE UTILIZATION

Background. Many pregnant women in the United States do not obtain ade quate prenatal care. While it is essential to provide women with acces s to prenatal care, access alone is insufficient to guarantee that all women will receive adequate prenatal care. Previous research has iden tified a number of personal and cultural barriers to prenatal care. We have integrated these barriers into an explanatory model called the S ocial Pregnancy Interaction Model, the centerpiece of which is the con cept of a ''social pregnancy identity'' as distinct from the physiolog ic reality of pregnancy. The purpose of this study was to validate the dimensions of this model. Methods. Based on previous qualitative work , a questionnaire was developed. It was administered by interview to a convenience sample of 287 pregnant women receiving prenatal care in 1 1 practices in central Missouri. Item analysis and factor analysis wer e used to define scales and validate the relationships predicted by th e model. Results. With some modifications, the following dimensions of the model were confirmed as distinct and significant: awareness of pr egnancy, acceptance of pregnancy, self-care, communication with family , communication with partner, social attitudes toward prenatal care, a nd attitudes toward the health care provider. Conclusions. The model h as potential for predicting the utilization of prenatal care. The resu lts also suggest that a woman's relationship with her prenatal care pr ovider is important to obtaining adequate prenatal care.