Evidence map›Paper›PMID 33028319›Full record

ArticleBMC health services research2020

Group antenatal care (Pregnancy Circles) for diverse and disadvantaged women: study protocol for a randomised controlled trial with integral process and economic evaluations.

Meg Wiggins, Mary Sawtell, Octavia Wiseman, Christine McCourt, Sandra Eldridge, Rachael Hunter, Ekaterina Bordea, Connor Mustard, Ainul Hanafiah, Bethan Hatherall and 7 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
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  5. Improving Diversity in Recruitment: Lessons Learned During the REACH Pregnancy Circles Pilot Trial.Health expectations : an international journal of public participation in health care and health policy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 1 country.

Meg WigginsSocial Research Institute, University College London, 27 Woburn Square, London, WC1H 0AA, UK.
Mary SawtellSocial Research Institute, University College London, 27 Woburn Square, London, WC1H 0AA, UK. m.sawtell@ucl.ac.uk.ORCID http://orcid.org/0000-0002-4774-5566
Octavia WisemanSchool of Health Sciences, City, University of London, London, UK.
Christine McCourtSchool of Health Sciences, City, University of London, London, UK.
Sandra EldridgeQueen Mary University of London, Pragmatic Clinical Trials Unit, London, UK.
Rachael HunterResearch Department of Primary Care and Population Health, University College London, London, UK.
Ekaterina BordeaUniversity College London, Institute of Clinical Trials & Methodology, London, UK.
Connor MustardQueen Mary University of London, Pragmatic Clinical Trials Unit, London, UK.
Ainul HanafiahInstitute for Health and Human Development, University of East London, London, UK.
Bethan HatherallInstitute for Health and Human Development, University of East London, London, UK.
Vivian HolmesInstitute for Health and Human Development, University of East London, London, UK.
Anita MehayInstitute for Health and Human Development, University of East London, London, UK.
Helliner RobinsonBarts Health NHS Trust, London, UK.
Cathryn SalisburyInstitute for Health and Human Development, University of East London, London, UK.
Lorna SweeneyInstitute for Health and Human Development, University of East London, London, UK.
Kade MondehBarts Health NHS Trust, London, UK.
Angela HardenInstitute for Health and Human Development, University of East London, London, UK.
University of East London · GBBarts Health NHS Trust · GBCity, University of London · GBQueen Mary University of London · GBUniversity College London · GBEnergy Institute · GBMRC Clinical Trials Unit at UCL · GB

Funding

Department of Health RP-PG-1211-20015Programme Grants for Applied Research RP-PG-1211-20015
6 · The paper itself

Abstract

backgroundGroup antenatal care has been successfully implemented around the world with suggestions of improved outcomes, including for disadvantaged groups, but it has not been formally tested in the UK in the context of the NHS. To address this the REACH Pregnancy Circles intervention was developed and a randomised controlled trial (RCT), based on a pilot study, is in progress.

methodsThe RCT is a pragmatic, two-arm, individually randomised, parallel group RCT designed to test clinical and cost-effectiveness of REACH Pregnancy Circles compared with standard care. Recruitment will be through NHS services. The sample size is 1732 (866 randomised to the intervention and 866 to standard care). The primary outcome measure is a 'healthy baby' composite measured at 1 month postnatal using routine maternity data. Secondary outcome measures will be assessed using participant questionnaires completed at recruitment (baseline), 35 weeks gestation (follow-up 1) and 3 months postnatal (follow-up 2). An integrated process evaluation, to include exploration of fidelity, will be conducted using mixed methods. Analyses will be on an intention to treat as allocated basis. The primary analysis will compare the number of babies born "healthy" in the control and intervention arms and provide an odds ratio. A cost-effectiveness analysis will compare the incremental cost per Quality Adjusted Life Years and per additional 'healthy and positive birth' of the intervention with standard care. Qualitative data will be analysed thematically. DISCUSSION: This multi-site randomised trial in England is planned to be the largest trial of group antenatal care in the world to date; as well as the first rigorous test within the NHS of this maternity service change. It has a recruitment focus on ethnically, culturally and linguistically diverse and disadvantaged participants, including non-English speakers.

trial registrationTrial registration; ISRCTN, ISRCTN91977441 . Registered 11 February 2019 - retrospectively registered. The current protocol is Version 4; 28/01/2020.

Indexed as

Cultural DiversityGroup ProcessesPrenatal CareVulnerable PopulationsCost-Benefit AnalysisDelivery of Health Care, IntegratedEnglandEthnicityFemaleHumansLinguisticsMulticenter Studies as TopicPragmatic Clinical Trials as TopicPregnancyProcess Assessment, Health CareRandomized Controlled Trials as TopicGroup careInequalitiesMidwivesPregnancyPrenatalStatistics and research methods

Identifiers

PMID33028319
PMCPMC7541287
OpenAlexW3092247394

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.