Heaman - questionnaire development

Quality of prenatal care is a really important area.  To date there’s been no instrument developed or questionnaire to measure quality of prenatal care.  So all of the studies that have looked at the association between prenatal care and adverse outcomes have been limited to measures of the quantity of prenatal care; either did you start your care late or did you have a low number of visits or there’s also indices that take both of those in to account adjusting for the gestational age of the mom at the delivery.  But those are still measures of quantity; they don’t tell you anything about the content or the quality of the care.  So our research team decided that we should develop an instrument to measure quality of prenatal care and we thought the best way to go about doing this would be to develop an instrument that women completed themselves either late in pregnancy or early in the postpartum period.  So this was actually about a four to five year process of research inter-related projects and we started off by interviewing women and healthcare providers in five sites across Canada about what they thought constituted quality of prenatal care.  And their responses were largely very similar about what they thought was important. So then we went on to develop items for a potential questionnaire and went through a whole process of testing these items which took a few years but ultimately we came up with a 46 item questionnaire to measure quality of prenatal care.  And that questionnaire has now been published and is available for use.  It can be accessed through the McMaster University Intellectual Properties Office so that people can start using it for all sorts of studies related to looking at perhaps the quality of prenatal care and how that’s related to pregnancy outcomes; whether quality of prenatal care varies based on region of the country, type of model of prenatal care, type of provider, satisfaction; linking satisfaction with care to quality of prenatal care.  So I think it will be a useful instrument to help us learn more about prenatal care and what particular aspects of quality are most important.