Differences in digital prenatal service utilization by self‐reported race

Abstract

Abstract Objective The objective of this study was to understand the use of supplemental digital prenatal services by race and ethnicity among pregnant people utilizing a comprehensive, employer‐sponsored digital health platform. Materials and Methods We conducted a retrospective cohort study of pregnant people enrolled in a comprehensive, employer‐sponsored digital health platform, assessing utilization of app‐based supplemental digital prenatal services by race and ethnicity. Care utilization included three categories: asynchronous utilization (e.g., article reads, videos); interactions with a care advocate, a trained care navigator; and provider interactions (e.g., messages and visits with a medical provider). Differences in service utilization by race and ethnicity were assessed using basic descriptive statistics with between‐group comparisons. Results Of 5662 users, 2362 (41.7%) were White, 266 (4.7%) were Black, and 1411 (24.9%) reported ‘prefer not to say’ for their race. More Black and Asian users sent messages to a provider and had provider appointments than White and Hispanic users (messages: White: 33.7%, Hispanic: 33.6%, Asian: 44.9%, Black: 45.1%, p < 0.001; provider appointments: White: 49.8%, Hispanic: 43.3%, Asian: 52.4%, Black: 46.2%, p < 0.001). More Black users accessed doula and mental health appointments than other racial groups. Conclusions Our study demonstrates that pregnant people of historically marginalized groups use digital supplemental prenatal services as much or more than White patients. Digital prenatal services may be a promising avenue for improving care access and experience for patient groups that face the biggest barriers to care and worst maternity care outcomes.

Keywords

• health education
• health equity
• health systems
• maternal morbidity
• obstetrics
• prenatal care