Individual Policy Research Articles

Language policy and planning for English-medium instruction in higher education

AbstractThis article presents English-medium instruction (EMI) in higher education (HE) from a language policy and planning (LPP) perspective. Based on a review of EMI policy research in diverse higher education contexts, we address several key contemporary policy tensions in EMI such as English native-speakerism, English monolingualism, and language education with attention to corpus, status and acquisition planning as well as the role of individual policy actors. In light of this review, we argue for an orientation to policymaking for EMI-HE institutions that acknowledges the value of individuals as policy arbiters and aligns institutional goals with “on the ground” needs and practices. We also point to areas of future research that would benefit all EMI stakeholders, in particular critical engagement with the nature of language competence in EMI settings and the enhanced development of evidence-based EMI learning outcomes. Finally, we propose an ecological framework for EMI-HE policy development that could be employed as a heuristic to guide universities in designing concrete EMI policies for their local contexts. As an extension, we also offer an inventory of reflective questions to guide key university stakeholders in effectively engaging in EMI policy processes.

Intimate Relationships in Times of COVID-19: A Descriptive Study of Belgian Partners and their Perceived Well-Being.

How did couples in Belgium cope during the early phases of the COVID-19 pandemic? In this study, grounded in relationship science, we investigated in a descriptive manner several factors that could affect how couples perceived individual and relational wellbeing during this time. Specifically, we examined the associations between gender, sexual orientation, parental status, and relationship duration on participants’ self-reported individual and relational well-being after the first lockdown (more generally and more specific in response to COVID-19). Additionally, we investigated if relational well-being predicted perceived change in individual well-being from pre- to post-COVID-19 regulations. To test these hypotheses, self-report data was collected during the Summer of 2020 in both the Dutch and French speaking part of Belgium. Data from 679 participants suggested that individual and relational well-being only differed based on parental status (and not by gender nor sexual orientation). Importantly, parents reported lower relational well-being than participants without children, while participants without children reported higher perceived increases in depression. People that had been in a relationship for longer also reported lower relational well-being, but this relationship was explained by other confounding factors. Relational well-being buffered increases in individual distress that people perceived to have occurred pre-COVID-19 regulations to after COVID-19 regulations went into effect. These findings might inform practice and policy for individuals in a romantic relationship during the COVID-19 pandemic.

Factors for Late Initiation of Antenatal Care in Kahama Municipal, Tanzania

Background: Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern, 295 000 women died of pregnancy or childbirth related complications in 2017. Late initiation of Antenatal Care (ANC) services in most low-income countries like Tanzania has been reported as a major problem which increase maternal mortality rate (MMR). However, different factors for late initiation of antenatal care are not well identified. Therefore, this study aimed to identify factors for late initiation of antenatal care both individual factors and health policy factors as per pregnant women and health care providers opinions in Kahama Municipal, Tanzania. 
 Broad Objective: The study focused on assessment of factors for late initiation of Antenatal Care (ANC) in Kahama Municipal, Tanzania. 
 Materials and Methods: This study was conducted using a qualitative method with exploratory approach which was carried out to explore factors for late initiation of antenatal care in Kahama Municipal. An in-depth interview (IDI) and Focus Group Discussion (FGD) were methods used to collect data. The study comprised of 14 in-depth interviews (IDIs) with pregnant women with age range of 18 years to 49 years attending antenatal care clinics in two health facilities and 4 in-depth interviews (IDIs) with health care providers attending pregnant women during antenatal care clinic visit. Furthermore, two Focus Group Discussions (FGDs), one from each health facility with pregnant women were conducted. 
 Data Analysis: Thematic analysis was conducted through use of inductive approach. The audio recordings were conducted using the Swahili language then transcribed and translated into the English language where themes were obtained after translation. 
 Results: Findings obtained from this study were factors for late initiation of antenatal care as reported by both pregnant women and health care providers. Factors for late initiation of antenatal care were under guidance of Health Behavioral Modal (HBM): Factors mentioned by pregnant women included pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications, , unfriendly services and unequal gender power relation within a family. Factors mentioned by health care providers based on health policy and managerial factors such as Partner accompanying policy, distant allocation of health facility from people’s settlement and unfriendly services provided by health care providers. Conclusion: This study focused on assessing factors for late initiation of antenatal care in Kahama municipal council in Shinyanga, Tanzania. Different factors for late initiation of antenatal care were reported which included pregnant women and health care providers. Pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, and distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications. Health policy and managerial related factors were partner accompanying policy, unfriendly services, and allocation of health facility. 
 Recommendation: However different improvement made on maternal health services in Tanzania but still some of pregnant women are not utilizing it efficiently because of different obstacles like distance from people’s settlement to the health facility, Partner accompanying policy and unfriendly services provided by health care providers. Through such obstacles as a policy maker, I would like to advice Government through Ministry of Health to allocate health facility nearby people’s settlement, providing outreach program to educate the community about antenatal care rather than relying on partner accompanying policy and lastly is provision of refresher training related to client’s rights during health care services provision to all staff.

Exploring Factors and Strategies to Promote Chinese Elders’ Physical Activity

This study was designed to explore factors and strategies to promote Chinese elders’ physical activity and cultivate healthy lifestyles. We collected the CHARLS survey 2011 baseline data, and selected 2647 cases of the elderly population in China. Based on the social ecosystem theory, the univariate analysis and ordered logistic regression were used. The model was analyzed for multivariate analysis. In the present study, the appropriate IRB approval has been obtained from Peking University. The theory of social ecology believes that individual behavior is influenced individual factors, inter-individual factors, organizational factors, community factors and policy factors. This article used the gender, age, marriage, education, and self-assessment of health status in the survey results as independent variables of individual factors, used whether to provide care for grandchildren, the frequency of participation in social activities as independent variables of inter-individual factors, used whether there are organizations that assist the elderly, the weak, the disabled population and whether there are elderly associations as the independent variables of organizational factors, then uses whether there is geriatric health service center as an independent variable of community factor. In this paper, physical activity participation intensity was used as the dependent variable, and single factor correlation analysis was performed with each independent variable. The other nine chi-square test significant independent variables except for age were included in the multiple regression model. The results showed that compared with other marital status, the physical activity intensity of the elderly population with spouses living together is greater; the elderly population who has better self-rated health scores and has higher social frequency, has stronger physical activity intensity; the elderly population who has geriatric health care service centers in their residence has stronger physical activity intensity. The following suggestions to promote health of Chinese elderly population can be made: the elderly population should establish their own awareness of health care and exercise; the children of the elderly population should strengthen their care for the elderly population; the community pension service organizations should take the initiative to play an active role to care the elderly population; the elderly population residence should strengthen the supporting hardware facilities.

Large-scale participation in policy design: citizen proposals for rural development in Tunisia

• Individual vs. group policy design leads to differing outcomes. • In vulnerable areas, participatory policy design may flounder to produce innovation. • Proposals for collective action can emerge if using appropriate facilitation methods. • Grasping rationalities of participants’ proposals is key for policy design research. More and more literature and practice recommend involving the public at the early stages of the policy cycle, i.e. issue identification, definition of the policy objectives and policy design. Policy design involves, among others, identifying solutions, ideas or alternatives which may address the policy objectives. Three main arguments are often put forward to advocate for the involvement of stakeholders, or the public, in policy design: a “user-centered” argument (i.e. for the policy to better meet people's priorities), an innovation argument (i.e. to conceive new solutions) and a collective argument (i.e. to identify collective actions and better tackle environmental problems). However, in both research and practice these arguments have been challenged. Research has insufficiently generated evidence of the influence of large-scale participation in policy design on resulting proposed actions. The objective of this paper is to analyze whether a large-scale participatory process leads to action proposals that fit people's priorities and that are innovative and collective. It draws from a land management and rural development policy design experiment conducted in six vulnerable areas of Tunisia. 4,300 direct participants were involved and 11,583 action proposals were collected. Our results highlight the influence of the local circumstances on innovation and the interest towards collective actions. Our results also show that whether policy design is made individually or in group influences the outcomes. The results also suggest that appropriate facilitation can help fostering more collective and innovative actions. We conclude the paper by opening up the idea of hybridizing policy design methods with methods from political and agricultural sciences in order to better understand the drivers and rationalities behind participants’ action proposals.

Inventory decision for products with deterioration and expiration dates for pollution-based supply chain model in fuzzy environments

The proposed study addresses a two-echelon sustainable supply chain (SC) model with a single-vendor and a single-buyer by considering the detrimental impacts of environmental pollution due to production. Moreover, an estimation function of pollution measure due to production is developed through a separate modelling. In the entire supply chain, we assume the deterioration rate increases with time and it also depends on the product’s expiration date. On the other hand, the demand for deteriorating items at the buyer’s end is assumed to be the dense fuzzy number because of learning effect. The model is developed by defining the exact profit functions for the vendor, the buyer and the entire supply chain and solved by classical method. These lead to the determination of individual optimal policies, as well as the optimal policy for the joint integrated supply chain. Fuzzifying the final objective function via dense fuzzy rule, we have employed extended ranking procedure for its defuzzification. A comparative study on numerical illustration of the proposed objective function under centralized and decentralized policies in both crisp and dense fuzzy environment has also been studied to validate the model. Finally graphical illustrations and sensitivity analysis have been made for its global justifications.

Beyond True and False: Fake News and the Digital Epistemic Divide

The massive fact-checking, flagging, and content removal campaigns run by major digital platforms during the 2020 elections and the Covid-19 pandemic did some good. However, they failed to prevent substantial portions of the population from believing that the election was stolen or that vaccinations are dangerous. In this Article, we argue that the reason for the ineffectiveness of truth-based solutions—such as fact-checking— is that they do not reach the heart of the problem. Both scholars and policymakers share the implicit or explicit belief that the rise of digital fake news is harmful mainly because it spreads false information, which lays a rotten groundwork for both individual decisions and collective policy making. While acknowledging the importance of accurate information, we argue that the main problem with fake news is not that it is false. Instead, what is distinctly threatening about digital misinformation is its ability to circumvent and undermine common knowledge-producing institutions including the sciences, courts, medical and other professions, and the media. The fundamental challenge is the fragmentation of our societies into separate epistemic communities. This shakes the factual common ground on which we stand. What does fact-checking matter if twenty percent of the population thinks that the fact-checkers are chronic liars? We call this new reality the Digital Epistemic Divide. Epistemic fragmentation of society is both more fundamental and more dangerous than the harms of false information as such. It is more fundamental because once a society is epistemically fragmented, the lack of trust in common epistemic authorities will inevitably proliferate disagreement over factual beliefs. It is more dangerous because it can exacerbate political polarization. It is one thing to believe that the other side of a political issue holds wrong values and preferences; it is quite another to believe that they are either constantly lying or deeply manipulated. To bridge the digital epistemic divide, we must go beyond truth-based solutions and implement policies to reconstitute societal trust in common epistemic authorities.

Where You Work Is Where You Stand: A Firm-Based Framework for Understanding Trade Opinion

AbstractWhat determines public support for trade liberalization? Scholars of international political economy have generally focused on the effects of openness on employment via individuals’ skill level, sector, or occupation. Recent developments in trade economics suggest that the characteristics of individual citizens’ employing firms may also shape their attitudes on trade policy. In this paper, using under-explored survey data combining trade opinion with measures of employer productivity (from the 2008 Japanese General Social Survey), we present evidence that employees of more productive, more globalized firms are much more supportive of trade openness than employees of less productive, domestically oriented firms, even when accounting for skill level and sectoral and occupational characteristics. Moreover, we find evidence that the effects of these characteristics described in the literature are conditioned by globalized firm employment. Last, we find that the effect of globalized firm employment is conditioned by employees’ relative position within their firms. Those who are more likely to benefit directly from firm success—such as permanent employees and managers—hold the most pro-trade preferences. These findings suggest that economic interests affect individual policy preferences in more nuanced ways than previously recognized.

Swiss Neutrality: From Policy to Doctrine

This article suggests that the modern discourse in Switzerland about neutrality signals a change in nature of the global understanding of neutrality from an apparently unchallengeable generic moral stance to a doctrine that requires individual policy consideration on a case-by-case basis.

Analysis on Scientific and Technological Innovation of Grain Production in Henan Province Based on SD‐GM Approach

A sustainable growth of grain outputs mainly relies on improving output per unit area through scientific and technological innovation. From the perspective of scientific and technological innovation, taking the grain production process as the research object, a systems model of scientific and technological innovation in grain production is constructed based on the relevant data of Henan Province from 2010 to 2019. Firstly, the internal mechanism of grain production scientific and technological innovation is explored, and the feedback loop of grain production scientific and technological innovation is then established. Secondly, system dynamics and grey system theory are combined to construct table functions and logistic functions to establish the grain production scientific and technological innovation system model. Through testing the model, the stability and feasibility of the model are demonstrated, and the simulation and prediction of the innovation system of grain production scientific and technological in Henan Province are carried out. Thirdly, in order to explore the impact of feasible policy schemes on grain production, seven policy plans are designed to simulate grain production policy scenarios from the perspective of scientific and technological innovation. The results show that: (1) The adjustment of individual policies, especially the adjustment of the protection policy of scientific and technological innovation in grain production or the subsidy policy of agricultural materials, has a weak influence on the improvement of grain output. The progress of agricultural technology is the main support for improving the comprehensive grain production capacity. (2) The future grain growth potential of Henan Province should focus on increasing the yield per unit area, and the protection of cultivated land resources should not be ignored. (3) The combination of policies has mutually reinforcing effect, which leads to an ideal system simulation effect. Finally, from the perspective of the composition of scientific and technological innovation system in Henan Province, this study puts forward countermeasures and suggestions for the implementation of the strategy of “storing grain in technology” in Henan Province.

Safety of SARS-CoV-2 vaccines in patients with chronic myeloid leukemia: a multicenter survey in China.

Safety of SARS-CoV-2 vaccines in patients with chronic myeloid leukemia: a multicenter survey in China.

Disability and Employment Policy in Canada: National Policy Variation for Working Age Individuals

AbstractThis article analyses and compares disability policies for working-age individuals in Canada with a focus on the mode of policy provision and type of measure to determine the degree to which direct funding is used in this country. To consider policy diversity in this federal system, policies are compared using a mixed-methods approach. Using quantitative methods, federal, provincial and territorial policies are first compared using hierarchical cluster analysis. This provides evidence of three distinct clusters in Canada according to policy provision and measure type. In a second, qualitative analysis, the disability strategies of four provinces’ (British Columbia, Ontario, Newfoundland and Labrador and Quebec) are compared, to determine over arching policy orientations. Findings indicate that policy provision in Canada largely favours money over services. Furthermore, most provinces emphasize either health or integration measures over substantive measures. Despite these commonalities, significant variation persists across Canada. This extends to poverty and disability reduction strategies with two of the four provinces having a broader orientation while the other two provinces focus specifically on employment as a means of social inclusion. The article concludes with a discussion on the state of employment policies for individuals with a disability in Canada.

UNIVERSITY STUDENTS’ PERCEPTION ON CITY’S AIR QUALITY: A TALE OF THREE CITIES IN BANGLADESH

The underlying endeavor of this paper is to understand the air pollution situation, particularly PM 2.5, in the major three cities of Bangladesh through the lenses of university students. In order to achieve this aim, a structured questionnaire was developed and scheduled interview was performed with the students from three universities of Bangladesh, namely Khulna University, Chittagong University, and Dhaka University. Data was collected on three categories: demographic, seasonal variation and consequences, and lastly some prevention perceptions. Accumulated data were analyzed by deploying descriptive statistics. Multinomial logistic regression, Pearson correlation along with PCA and cluster analysis were performed to understand the prevention perceptions. The result shows that air pollution has adverse effects on participants and air quality is most deteriorated during summer season. Statistically, pollution in Dhaka city is the most while least was found in Khulna city. Participants witness and bear the consequences of air pollution, but they think individual prevention measures are not at work. This study unveils the air quality problem in three major cities in Bangladesh and pollution problem is out of individual control. Further studies are encouraged to understand individual pollution control measures and policies.

Determinants of overweight and obesity among adolescents in Zimbabwe: A scoping review

Background: Childhood obesity is a growing public health concern worldwide. Unfortunately, the health interventions remain biased towards addressing undernutrition. Aims: The study aimed to summarize the evidence on the determinants of obesity among adolescents in Zimbabwe. Methods: The Bronfenbrenner socio-ecological model (SEM) was used to classify these determinants: individual, social, environmental, and economic or government policies. The five-stage Arksey and O’Malley review methodology was used to formulate research questions, systematically search, and screen for relevant studies done between 2010 and 2020, data extraction, and summarizing the evidence. Google, PubMed, Google scholar, and United Nations websites were searched to identify relevant studies. The search yielded 22 results. Anthropometric indicators and the determinants assessed in each study were extracted. Results: Only 10 studies explored the determinants of obesity among adolescents in Zimbabwe. The risk of obesity was higher among older adolescents (16-19 years), particularly girls who reside in urban settings. Interestingly, girls had higher nutrition knowledge compared to boys. At the environmental level, fast food consumption, unhealthy snacking, low dietary diversity, carrying a packed lunchbox to school, and using non-active forms of transport to school was associated with obesity. In addition, having formally employed parents, and a small family size increased the odds of obesity. At the societal level, high family income and Christianity increased the rate of obesity. Economic instability appears to drive the availability and consumption of cheap unhealthy foods, particularly within the school environments. Conclusions: Adolescence is a critical stage where obesity starts to increase especially in girls as they graduate into adulthood. Sedentary lifestyles and the adoption of unhealthy dietary decisions appear to be exuberating this obesity problem in urban areas. School-based, family-oriented obesity prevention interventions which address gender discrepancies in eating habits and physical activity are recommended in these and related settings. Keywords: Adolescents, obesity, socio-ecological model, malnutrition, Zimbabwe.

Beleidsdiskriminasie, verandering en entrepreneurskap: Beperkte politieke regte vir "Kleurlinge" in Suid-Afrika tot 1979

Hierdie artikel kontekstualiseer, verduidelik en beoordeel die ontwikkeling van politieke regte vir "Kleurlinge" in Suid-Afrika, tot 1979. Dit word gedoen vanuit die teoretiese perspektief van beleidsentrepreneurs wat verskillende persoonlike, professionele en ander sosiale netwerke tot hulle beskikking gebruik om direkte beleidsbeïnvloeding te doen. Die artikel skets eers kortliks die teoretiese uitgangspunte en kenmerke van beleidsentrepreneurskap en -netwerkbeïnvloeding en som dan die ontwikkeling van politieke regte vir die "Kleurlingge-meenskap" in die land op, tot PW Botha die leierskap van die Nasionale Party oorgeneem het. Die artikel kontekstualiseer en fokus veral op die aanloop tot en die afloop van die Erika Theron-kommissie, wat 'n direkte rol gespeel het by die uiteindelike instelling van 'n fun-damentele nuwe staatsbestel in die land. Die ondersoek illustreer die toepassing en impak wat doelgerigte individuele beleidsentrepreneurskap en -netwerkbeïnvloeding deur strategies geposisioneerde individue, groepe en netwerke op fundamentele samelewingsverandering kan hê. Dit illustreer en staaf verder die belangrike kumulatiewe effek wat beide interne en eksterne politieke druk op beleidsverandering kan hê. Dit het belangrike implikasies vir huidige en toekomstige beleidsaanpassings in Suid-Afrika en in ander demokratiese beleidsveran-deringsprosesse.

A US State Index of Successful Aging: Differences Between States and Over Time.

Although it is recognized that aspects of US state environments impact the likelihood that older adults age successfully, there is currently no reliable and comprehensive measure of contexts that best support successful aging at a state level. The current project adapts a multidimensional index previously used to assess adaptation to successful aging in developed countries and applies it to the 50 US states and the District of Columbia. We obtained data from multiple sources for all 50 US states and the District of Columbia from 2003 to 2017 in order to measure five distinct domains that define successful population aging: (1) productivity and engagement, (2) security, (3) equity, (4) cohesion, and (5) well-being. We created a ranking of states for the year 2017 based on these domains, and also examined how individual US state rankings changed over time from 2003 to 2017. The level of adaptation to successful aging varied substantially between states and over time. The highest-ranked states in 2017 were Vermont, Hawaii, Iowa, Colorado, and New Hampshire, and the lowest-ranked states were Louisiana, Arkansas, Kentucky, West Virginia, and Mississippi. Mississippi, South Carolina, Iowa, Arizona, and Delaware had the greatest improvement in their ranking over the period of 2003 to 2017. Our findings were generally robust to the weighting scheme used and were not overly influenced by any particular domain. The US State Index of Successful Aging can be used to monitor US state progress in promoting the well-being and health of aging populations. Factors driving the changes in the index remain to be elucidated.

Income support for parents of children with chronic conditions and disability: where do we draw the line? A policy review

ObjectiveThe aim of this review was to identify and describe whether parents who have had to stop paid employment to care for a child with a chronic condition or disability...

Long-term analysis of antibodies elicited by SPUTNIK V: A prospective cohort study in Tucumán, Argentina

BackgroundGam-COVID-Vac (SPUTNIK V) has been granted emergency use authorization in 70 nations and has been administered to millions worldwide. However, there are very few peer-reviewed studies describing its effects. Independent reports regarding safety and effectiveness could accelerate the final approval by the WHO. We aimed to study the long-term humoral immune response in naïve and previously infected volunteers who received SPUTNIK V.MethodsHumoral immune responses, assayed by anti-SARS-CoV-2-spike-RBD IgG ELISA and neutralization assays, were measured in 602 healthcare workers at 0, 14, 28, 60 and 180 days after receiving SPUTNIK V between December 2020 and July 2021 in Tucumán, Argentina.FindingsSeroconversion was detected in 97% of individuals after 28 days post-vaccination (dpv) (N = 405). Anti-RBD titers began to decrease after 60 dpv (N = 328), but remained detectable in 94% at 90 dpv (N = 224). At 180 dpv, anti-RDB titers persisted in 31% (N = 146). Previous infection triggered an increased immune response to the first dose and increased neutralization activity against variants of concern (VOC). Second doses in previously infected individuals further increased titers, even 90 dpv (N = 75). Basal antibody titers had more influence on post-vaccination anti-RBD responses than the time elapsed between diagnosis and vaccination (N = 274).InterpretationData presented herein provides essential knowledge regarding the kinetics of antibodies induced by SPUTNIK V up to six months after immunization, and suggests that when considering one-dose vaccination policies for individuals with previous SARS-CoV-2 infection, serological studies to determine basal titers may be important, independent of when diagnosis occurred.FundingTucumán Public Health System (SIPROSA), Argentinean National Research Council (CONICET), National University of Tucumán (UNT).

Exploring the direct and indirect effects of elite influence on public opinion.

Political elites both respond to public opinion and influence it. Elite policy messages can shape individual policy attitudes, but the extent to which they do is difficult to measure in a dynamic information environment. Furthermore, policy messages are not absorbed in isolation, but spread through the social networks in which individuals are embedded, and their effects must be evaluated in light of how they spread across social environments. Using a sample of 358 participants across thirty student organizations at a large Midwestern research university, we experimentally investigate how real social groups consume and share elite information when evaluating a relatively unfamiliar policy area. We find a significant, direct effect of elite policy messages on individuals’ policy attitudes. However, we find no evidence that policy attitudes are impacted indirectly by elite messages filtered through individuals’ social networks. Results illustrate the power of elite influence over public opinion.

Virtual Visits in Prenatal Care: An Integrative Review.

Addressing gaps in access to prenatal care is an important step to reversing rising rates of maternal and neonatal morbidity and mortality and invites the exploration of innovative care models. This integrative review of published literature explores the patient, health care provider, and organizational experience of integrating virtual visits in prenatal care. A literature search to identify original studies and quality improvement projects published between 2010 and 2020 was conducted in PubMed, Scopus, CINAHL, and Google Scholar using keywords associated with both telemedicine and prenatal care. Inclusion criteria specified articles pertaining to synchronous virtual visits between pregnant patients and health care providers, and articles were excluded if visits were not pregnancy-centric or pertaining to telemonitoring or mobile applications. Reference lists of identified reviews were screened, and a hand search of 4 applicable journals was also conducted. Findings were organized according to the factors of the social ecological model: individual, interpersonal, organizational, community, and public policy. The search identified 2666 articles after duplicates were removed, of which 13 met all criteria. Findings across these 13 articles indicated strong patient and health care provider satisfaction with virtual care related to cost savings and convenience, with clinic wait times and cancellation rates also improving. Health care provider input and thoughtful organizational planning were key to a smooth telemedicine implementation process. There were notably no significant differences in clinical outcomes for those who used virtual care. Although data are limited, offering an integrated model that uses both virtual visits and in-person visits has been well-received by patients and health care providers and could improve access to care well into the future. Virtual visits in prenatal care have been well-received by patients and health care providers, showing promise as an emerging model for improving access to care.