Increasing prenatal care engagement among patients with socioeconomic barriers

When family physician Allene Whitney, MD, first read about the AAFP Foundation’s Family Medicine Discovers Rapid Cycle Scientific Discovery and Innovation (FMD RapSDI) program, she was interested but had little time to consider a project and apply.

Then in 2021, while isolating at home in Anchorage, Alaska with COVID-19, she found her chance.

Each year, the AAFP Foundation awards two scholars up to $40,000 and mentorship to support a research project in family medicine. Whitney was selected as one of the two FMD RapSDI Cycle 3 scholars and began her research in January 2022.

Initially, she planned to study whether care delivery strategies developed during the COVID-19 pandemic could increase prenatal care engagement among pregnant women with substance use disorders, “which was a significant need in our community.”

The first phase of Whitney’s project entailed reaching out to patients through her safety net clinic to offer the option of flexible scheduling and virtual visits.

“At that point, the project pivoted away from a specific focus on women with substance use and focused more on women with a number of socioeconomic barriers that might include substance use,” she explained.

Next, Whitney’s team compared chart reviews for a pre-pandemic cohort of women from 2019, a pandemic-era cohort from 2021, and a cohort from 2022–2023, when the pandemic was winding down and patients had the option of virtual visits.

“What we found was that virtual visit use was accepted far less often than we expected,” Whitney said.

The final phase of her project involved interviews with five women from the most recent cohort. The conversations revealed that women valued in-person interactions with their providers.

“They expressed appreciation for the medical assistants who roomed them … for the front office people who greeted them and helped them schedule appointments,” Whitney said.

The women were especially grateful for the social workers who provided wraparound care, connecting them to financial resources when they had difficulty paying rent and to transportation when they could not get to a visit. They also expressed that in order to make use of options available to them, such as virtual visits, they needed proactive outreach from a clinic.

“The interviews with the women really highlighted the importance of a complete clinic staff and the importance of warm, welcoming in-person relationships,” Whitney said.

In addition to the information she gained from her research, the project provided Whitney with opportunities for professional growth.

“I was able to work with a medical student and a resident. I enjoy teaching; incorporating research as part of medical education was really a gratifying,” she said.

After the project was completed, the medical student presented a poster at NAPCRG (North American Primary Care Research Group) in 2023. Whitney presented a poster there the following year, and said interacting with others involved in family medicine research was “incredibly satisfying.”

That same year, Whitney participated in Starfield VI Summit, which also introduced her to people involved nationally in health care policy and leadership.

Her team is now finalizing a manuscript to submit to journals.

“The FMD RapSDI program gave me the opportunity to carve out time from my schedule for this work, and … the funding to support those hours of work,” Whitney said. It also helped with costs for patient supplies and sending her medical student to NAPCRG.

She also praised the AAFP Foundation and the DARTNet Institute’s support during the application process. “Even if you were not to become a RapSDI scholar, round two of the application is a mentorship period in which you will gain a number of research skills … and those skills can then translate into future opportunities.”

The Cycle 8 application window opens Oct. 1, 2026 and closes Jan. 16, 2027, at 5 p.m. CT. Learn more here.