Information-seeking and its predictors in low-income pregnant women

Maternal Health Literacy, Health information-seeking Behavior and Pregnancy Outcomes Among Iranian Pregnant Women: A Cross-Sectional Study

Background: Maternal health literacy (MHL) and health information-seeking behavior (HISB) could impact maternal health and pregnancy outcomes.Purpose and Research Design: This cross-sectional study investigated MHL, HISBs, and pregnancy outcomes in Iranian pregnant women. This study was also aimed to determine the predictors of MHL and pregnancy outcomes.Study smple and Data Collection: In this study, 337 randomly selected postpartum women completed three questionnaires, including a demographics form, an obstetrics history checklist, and the Maternal Health Literacy and Pregnancy Outcome Questionnaire (MHLAPQ).Results: The mean MHL and pregnancy outcome scores were 60.80 ± 9.91 and 49.88 ± 5.69, respectively. Of the participants, 56% adopted both formal and informal HISB. Education and internet HISB was associated with the odds of being in the group with higher MHL. Participants with high MHL had more than twice higher odds for better pregnancy outcomes (OR = 2.25, p < 0.004).Conclusions: Continued efforts are required to make health information sources more accessible to pregnant women to improve their health literacy and pregnancy outcomes.

Exploring the Needs and Expectations of Expectant and New Parents for an mHealth Application to Support the First 1000 Days of Life: Steps toward a Co-Design Approach

To improve maternal and child health, it is essential to adhere to health-promoting and preventive measures. However, reliable information as well as effective tools are not easy to identify in this field. Our cross-sectional study investigated the needs and expectations of expectant and new mothers and fathers as potential primary users of a hypothetical application supporting the first 1000 days of life. Between May and August 2022, we recruited expectant and new parents by administering an 83-item 5-point Likert scale questionnaire related to the content, functionalities, and technical features of the hypothetical app. We stratified responses using sociodemographic characteristics and then performed ward hierarchical clustering. The 94 women and 69 men involved in our study generally agreed with the proposed content, but expressed low interest in certain app functionalities or features, including those related to the interaction mechanism and interactivity. Women were generally more demanding than men. Our findings, resulting from the engagement of end-users, may be useful for designers and technology providers to implement mHealth solutions that, in addition to conveying reliable information, are tailored to the needs and preferences of end-users in the first 1000 days of life.

Oral Health and Knowledge among Postpartum Women

Oral health behavior and risks during pregnancy and after birth affect the oral health of babies and toddlers. We examined the oral and gingival health and caries prevalence of 150 postpartum women shortly after giving birth and assessed their knowledge of oral hygiene using a questionnaire. We also compared the oral health knowledge of nulliparous and multiparous women. Although most participants (98.0%) understood the importance of maintaining oral hygiene in children, their overall knowledge of oral health was medium-low, regardless of the number of previous pregnancies. Only 4.6% of women received oral health advice from their obstetrician during their pregnancy. Most participants had a high gingival index score, which correlated with dental pain during pregnancy. In contrast, the number of decayed, missing and filled teeth was significantly lower in first-time mothers. There was a statistically significant positive correlation between women who regularly visit their dentist and those who regularly take their children to the dentist. Expecting mothers should be educated about their own oral health and that of their developing fetus and children. Raising awareness among obstetricians with regards to this topic may be an effective way to achieve this.

Medical, behavioural and social preconception and interconception risk factors among pregnancy planning and recently pregnant Canadian women

OBJECTIVES

The objective of this study is to describe the clustering of medical, behavioural and social preconception and interconception health risk factors and determine demographic factors associated with these risk clusters among Canadian women.

DESIGN

Cross-sectional data were collected via an online questionnaire assessing a range of preconception risk factors. Prevalence of each risk factor and the total number of risk factors present was calculated. Multivariable logistic regression models determined which demographic factors were associated with having greater than the mean number of risk factors. Exploratory factor analysis determined how risk factors clustered, and Spearman's r determined how demographic characteristics related to risk factors within each cluster.

SETTING

Canada.

PARTICIPANTS

Participants were recruited via advertisements on public health websites, social media, parenting webpages and referrals from ongoing studies or existing research datasets. Women were eligible to participate if they could read and understand English, were able to access a telephone or the internet, and were either planning a first pregnancy (preconception) or had ≥1 child in the past 5 years and were thus in the interconception period.

RESULTS

Most women (n=1080) were 34 or older, and were in the interconception period (98%). Most reported risks in only one of the 12 possible risk factor categories (55%), but women reported on average 4 risks each. Common risks were a history of caesarean section (33.1%), miscarriage (27.2%) and high birth weight (13.5%). Just over 40% had fair or poor eating habits, and nearly half were not getting enough physical activity. Three-quarters had a body mass index indicating overweight or obesity. Those without a postsecondary degree (OR 2.35; 95% CI 1.74 to 3.17) and single women (OR 2.22, 95% CI 1.25 to 3.96) had over twice the odds of having more risk factors. Those with two children or more had 60% lower odds of having more risk factors (OR 0.68, 95% CI 0.52 to 0.86). Low education and being born outside Canada were correlated with the greatest number of risk clusters.

CONCLUSIONS

Many of the common risk factors were behavioural and thus preventable. Understanding which groups of women are prone to certain risk behaviours provides opportunities for researchers and policy-makers to target interventions more efficiently and effectively.

The Health Literacy in Pregnancy (HeLP) Program Study Protocol: Development of an Antenatal Care Intervention Using the Ophelia Process

A pregnant woman needs adequate knowledge, motivation, and skills to access, understand, appraise, and apply health information to make decisions related to the health of herself and her unborn baby. These skills are defined as health literacy: an important factor in relation to the woman’s ability to engage and navigate antenatal care services. Evidence shows variation in levels of health literacy among pregnant women, but more knowledge is needed about how to respond to different health literacy profiles in antenatal care. This paper describes the development protocol for the HeLP program, which aims to investigate pregnant women’s health literacy and co-create health literacy interventions through a broad collaboration between pregnant women, partners, healthcare providers, professionals, and other stakeholders using the Ophelia (Optimising Health Literacy and Access) process. The HeLP program will be provided at two hospitals, which provide maternity care including antenatal care: a tertiary referral hospital (Aarhus University Hospital) and a secondary hospital (the Regional Hospital in Viborg). The Ophelia process includes three process phases with separate objectives, steps, and activities leading to the identification of local strengths, needs and issues, co-design of interventions, and implementation, evaluation, and ongoing improvement. No health literacy intervention using the Ophelia process has yet been developed for antenatal care.

Identifying design guidelines for online information resources: a study of expectant and new mothers

Purpose

The purpose of this article is to identify design guidelines for online resources based on the subjective assessment criteria used by individuals to assess and process information resources. This method of creating design guidelines targeted at precise user groups has the potential to aid designers and developers to create more user-centred information resources.

Design/methodology/approach

The authors gathered data using a prospective longitudinal study investigating the information behaviour of expectant and new mothers. Women were asked to report on their information-seeking activities in a series of semi-structured interviews covering pregnancy and early motherhood.

Findings

This research identified 15 assessment criteria that were utilised by women to assess and process information resources. The most popular resource criteria amongst participants were credibility and convenience, while completeness and relevance were the most popular information content criteria. The authors found that assessment criteria were not considered in isolation, with criteria such as formatting and search engine ranking impacting on participants' perception of other criteria.

Practical implications

This research demonstrates the potential of linking a user groups subjective assessment criterion to design guidelines. The authors propose that these guidelines could be used to help design an online information resource. They could also be used to assess if an existing online resource met the needs of a user group. The methodology used in this study could be leveraged to create design guidelines for user groups.

Originality/value

This research uses subjective assessment criteria as a means of understanding how expectant new mothers process information resources. People use subjective judgements when processing information resources, and this should be incorporated into the design of information resources. Analysing longitudinal data allowed the authors to build a rich picture of how participants evaluated and compared different information resources.

Sources of information about gestational weight gain, diet and exercise among Brazilian immigrant women living in the USA: a cross-sectional study

OBJECTIVE

The objective of this study was to assess sources of information about gestational weight gain (GWG), diet and exercise among first-time pregnant Brazilian women in the USA.

DESIGN

Cross-sectional survey.

SETTING

Massachusetts, USA.

PARTICIPANTS

First-time pregnant Brazilian women.

RESULTS

Eighty-six women, the majority of whom were immigrants (96·5 %) classified as having low acculturation levels (68 %), participated in the study. Approximately two-thirds of respondents had sought information about GWG (72·1 %), diet (79·1 %) and exercise (74·4 %) via the internet. Women classified as having low acculturation levels were more likely to seek information about GWG via the internet (OR = 7·55; 95 % CI 1·41, 40·26) than those with high acculturation levels after adjusting for age and receiving information about GWG from healthcare provider (doctor or midwife). Moreover, many respondents reported seeking information about GWG (67 %), diet (71 %) and exercise (52 %) from family and friends. Women who self-identified as being overweight pre-pregnancy were less likely to seek information about diet (OR = 0·32; 95 % CI 0·11, 0·93) and exercise (OR = 0·33; 95 % CI 0·11, 0·96) from family and friends than those who self-identified being normal-weight pre-pregnancy.

CONCLUSIONS

This is the first study to assess sources of information about GWG, diet and exercise among pregnant Brazilian immigrants in the USA. Findings have implications for the design of interventions and suggest the potential of mHealth intervention as low-cost, easy access option for delivering culturally and linguistically tailored evidence-based information about GWG incorporating behavioural change practices to this growing immigrant group.

Explaining the concept of maternal health information verification and assessment during pregnancy: a qualitative study

Background

Pregnant women use information sources for their own health and health of their children. However, despite the importance of trusting the information sources, pregnant women may not have the ability to verify the maternal health information, which could have negative consequences for their health. The purpose of this study was to explain the concept of maternal health information verification and assessment in pregnant women according to their experiences and perception.

Methods

This is a qualitative study that was conducted in 2017 in Tehran, Iran. The participants in this study consisted of 19 pregnant women who were selected by purposeful sampling. To collect data, semi-structured, in-depth and face to face interviews were conducted with participants and continued until saturation of data. Conventional content analysis method was used to analyze the data and to identify concepts and synthesize them into general classes. MAXQDA software version 10 was used to manage the data.

Results

In the process of data analysis, the concept of verification and assessment of maternal health information in pregnancy was explained in two main categories, including “Validity of information resources” and “Reliance on information resources.” The category of Validity of information resources had two subcategories of valid and invalid sources, and the main category of Reliance on information resources had two subcategories of indicators of assurance, and confusion and trying to obtain assurance.

Conclusion

The results indicated that pregnant women used various sources and indicators, as well as different evaluation methods to obtain information and verify it, especially when they are confused. Thus, health authorities and healthcare professionals should provide appropriate programs to familiarize mothers with credible sources, train pregnant women on standards and practices for judging the accuracy of information, and create a safe margin of information.

Sources of get information and related factors during pregnancy among Afghan migrant women in Iran

AIM

The present study aims to investigate the sources of information and its related factors among pregnant Afghan migrant women who reside in southeast Tehran Province, Iran.

DESIGN

Cross-sectional study.

METHODS

A total of 280 pregnant Afghan women who received care at the prenatal clinics of selected healthcare centres in southeast Tehran Province (Iran) in 2018 enrolled in this study. Data were collected by continuous sampling by a questionnaire that asked about demographic, obstetric and sources of information used during pregnancy.

RESULTS

The most important sources of information accessed by pregnant Afghan women were healthcare providers (65.1%), family and friends (47.55%), the Internet (32.1%) and media (18.9%). There was statistically a significant relationship between sources of information and education level, number of children, length of residence in Iran, place of birth and insurance status.

Development of the Activity of Parents of Young Children on Social Networks

The paper analyzes the behavior and habits of expectant and new mothers on a specialized pregnancy/parenthood-oriented social network, especially whether and how the pregnancy, and later the age of infants, impact the online activity of mothers. The authors compared almost 5000 parents divided into 23 “term groups”—long-term discussion platforms of parents with the same due month. The age of the child (due date) was taken as the basis for the activity analysis—determining the phases in which the users were more or less active online. Results are shown as charts supported by verification of the following statistical hypotheses: (a) users in later-term groups are less active than those in earlier ones; (b) users’ activity peaks around their due dates; (c) users are still very active six months after the due date; (d) activity shortly rises again around the child’s first birthday. We concluded that expectant mothers were most active two months before their due dates and around their due dates. After that, the observed activity decreased, with a slight increase around the child’s first birthday. Our findings can be useful for sociological and psychological studies, as well as for marketing purposes.

Information-seeking in first visit pregnant women in Khayelitsha, South Africa

Background

The quality of the decisions made by women during pregnancy, especially their first visit, depends on their health needs, their health-seeking behaviour and the type of information available to them.

Aim

This study describes the health education needs, information barriers and health information-seeking behaviour of pregnant women on their first visit to antenatal clinics in a low-income setting in the Western Cape.

Setting

The setting was two antenatal facilities in Khayelitsha Health District facilities in South Africa.

Methods

A quantitative descriptive survey was conducted. A systematic random sample of 261 antenatal first visit attendees between May and July 2016 was selected. Data were collected using a researcher-administered questionnaire and was analysed using descriptive statistics, 95% confidence intervals and non-parametric tests.

Results

The response rate of the study was 92% (n = 240). Pregnant women attending an antenatal clinic for the first time reported high information needs with low health information-seeking behaviours and high information barriers. Doctors, nurses (2.2, ±1.0), family and friends (2.0, ±0.6) were the most frequently used sources of health information, while watching television or listening to the radio (1.5, ±0.9) were the least used sources of health information. Having a medical diagnosis (p < 0.001) and being of an advanced maternal age (p = 0.005) were predictive of higher health-seeking behaviour. The reliance on passively receiving information from health sources may indicate low levels of health literacy and its inverse relationship to health promoting behaviours which should be the subject of further investigation.

A mixed-methods investigation of women's experiences seeking pregnancy-related online nutrition information

BACKGROUND

The objective of this study was to describe women's processes for finding pregnancy-related nutrition information, their experiences seeking this information online and their ideas for improving internet sources of this information.

METHODS

In total, 97 pregnant women completed an online quantitative questionnaire and 10 primiparous pregnant women completed semi-structured telephone interviews. Questionnaires and interviews asked participants to describe sources of pregnancy-related nutrition information; time of seeking; processes of searching online; experiences searching online; ideas for improving information found online. Survey data were analyzed using descriptive statistics and Chi square tests; interview data were analyzed using thematic analysis.

RESULTS

Nearly all (96%) survey participants sought nutrition information online. Information was most commonly sought during the first trimester of pregnancy. Motivators for using the internet included convenience and lack of support from health care providers. Barriers to using online information included lack of trust, difficulty finding information and worry. Women adapted the information they found online to meet their needs and reported making positive changes to their diets.

CONCLUSIONS

The internet is a key source of prenatal nutrition information that women report using to make positive dietary changes. Women would benefit from improved access to trustworthy internet sources, increased availability of information on different diets and health conditions, and increased support from health care providers.

The complex information needs of disadvantaged young first-time mothers: insights into multiplicity of needs

Purpose

The purpose of this paper is to holistically explore the information needs of socioeconomically disadvantaged young first-time mothers and associated issues of complexity.

Design/methodology/approach

This paper used survey and semi-structured field interviews with 39 young mothers (aged 15–23) from UK areas of multiple deprivations.

Findings

Participants reported multiple and complex needs spanning interrelated topics of parenting, poverty and personal development. In the majority of instances, participants were either unsure of their ability to meet their needs or needed help with needs, and several described situations of considerable anxiety and stress. Multiplicity is identified and conceptualised as an important factor contributing to complexity, including three component elements: simultaneous occurrence of needs (concurrency), relationships between needs (interconnectivity) and evolving needs (fluidity). In various combinations, these elements influenced a mother's actions and/or ability to selectively attend to needs, with multiple needs often competing for attention, and compounding issues of cognitive load and affect.

Research limitations/implications

This study draws attention to multiplicity of needs as an understudied topic within human information behaviour and calls for further research into how people recognise and attend to complex needs and influencing factors.

Practical implications

This study raises important questions regarding how we approach complexity of information needs in our design and delivery of information systems and services.

Originality/value

Evidences disadvantaged young mothers to have more extensive and complex information needs than previously understood, and identifies and conceptualised multiplicity as an important factor contributing to the complexity of information needs during major life transitions such as motherhood.

Periodic Information-seeking Behaviors of First-time Mothers in China

First-time mothers have a unique and varied set of information needs, but at present, these needs are seldom adequately addressed by libraries in China. As a first step in making libraries more helpful to this group, this study reports the results of a series of interviews aimed at understanding new mothers’ current information seeking behaviors. Thirty-seven first-time mothers (children from first year of birth to six years of age) took part in semi-structured in-depth interviews, answering questions about their information demand, information source selection (and factors influencing this selection), and obstacles encountered in the process of information search. It was found that first-time mothers’ information-seeking behavior varies from stage to stage, e. g. between pregnancy and the immediate postpartum period. Internet search plays an important role because of its perceived convenience and accessibility, but trust is the key factor during the process of information selection, regardless of source. Overall, the mothers we interviewed seldom use the library. This paper puts forward some suggestions to remedy that situation: libraries might consider opening a first-time-mothers reading room, increasing cooperative promotions with other institutions, providing diversified service projects, and organizing reading-promotion activities for first-time mothers at different stages. If implemented, these suggestions promise to help mothers navigate the transitions of pregnancy, childbirth, and childcare.

Continuing Education Module-Information Needs and Information-Seeking Processes of Low-Income Pregnant Women in Relation to Digital Maternity Education Resources

Pregnant women need high-quality, timely information for self-management. The extent to which digital education resources meet their needs is unclear. This study elucidated how low-income pregnant women characterize their digital information needs and seeking processes and identified barriers/facilitators to meeting them. Focus groups bookending field-testing of a digital maternity education resource elicited barriers to and facilitators of Internet access, Internet use patterns, preferred methods to access information, and explored acceptability and desired features of online resources. Content analysis was used to analyze transcripts and six thematic categories were identified. Digital maternity education resources should be flexible, easily shared with loved ones, and responsive to users' experiences. Although helpful, digital resources are insufficient to meet pregnant women's need for social support.

Health information needs, sources of information, and barriers to accessing health information among pregnant women: a systematic review of research

INTRODUCTION

Awareness of health information needs, sources of health information, and barriers to accessing health information among pregnant women is critical for the development of health interventions and provides high-quality prenatal care for them. Hence, the aim of this review study was to summarize evidence from studies evaluating health information needs, sources of information and barriers to accessing health information of women during pregnancy.

METHODS

A systematic literature search was conducted using Web of Science, Scopus, PubMed, ScienceDirect, and Google Scholar for relevant studies published between 1 January 2000 and 24 May 2018. The methodological quality of cross-sectional studies was assessed using the STROBE checklist. The Critical Appraisal Skills Programme (CASP, 2018) was used to appraise the qualitative studies. Data were analyzed descriptively.

RESULTS

Thirty-one studies from 14 countries met criteria for inclusion in this review. The majority of articles focused on information needs and sources of information used by women during pregnancy. The most common information needs among women during pregnancy were information about unborn child, nutrition, and labor/delivery. The most frequent information source used by women during pregnancy was health professionals followed by informal source (family and friends), and Internet. The most prominent barriers to information access included the following: feeling ashamed or embarrassed to talk about pregnancy-related issues, long waiting times at clinic to see a health provider, and lack of adequate information resources.

CONCLUSIONS

Due to the limited number of studies examining barriers to health information seeking among pregnant women, further research is warranted. Further qualitative research is also recommended to explore pregnant women's perceptions of, and satisfaction with the use of health information sources.

Developing Culturally Sensitive mHealth Apps for Caribbean Immigrant Women to Use During Pregnancy: Focus Group Study

Background

A valuable addition to the mobile health (mHealth) space is an exploration of the context of minorities in developed countries. The transition period postmigration, culture, and socioeconomic uniqueness of migratory groups can shed light on the problems with existing prenatal mHealth apps.

Objective

The objectives of this study were to (1) use the theoretical concept of pregnancy ecology to understand the emotional, physical, information, and social challenges affecting low-income Caribbean immigrant women’s prenatal well-being practices and (2) develop a deep understanding of challenges worthy of consideration in mHealth design for these women.

Methods

This qualitative interpretive approach using analytical induction presents the findings of 3 focus group sessions with 12 Caribbean immigrant women living in South Florida in the United States. The study took place from April to September 2015.

Results

The participants revealed problematic tiers and support needs within the pregnancy ecology including emotional stressors caused by family separation, physical challenges, information gaps, and longing for social support.

Conclusions

mHealth interventions for low-income Caribbean immigrant women must be designed beyond the conventional way of focusing on the events surrounding the unborn child. It can be tailored to the needs of the expecting mother. Pregnancy information should be customized on the basis of the variability of lifestyle, cultural practices, socioeconomic status, and social ties while still being able to deliver appropriate guidelines and clear cultural misconceptions.

Translating prenatal oral health clinical standards into dental education: results and policy implications

OBJECTIVES

To evaluate characteristics of pregnant women served through the University of North Carolina's (UNC) prenatal oral health program (pOHP) dental clinic and community healthcare pathways to inform efforts in promoting prenatal oral health policies.

METHODS

The pOHP provides medical and dental students and practitioners with interprofessional experiences caring for pregnant women. A retrospective chart audit captured 314 pregnant women who made appointments over 33 months. Descriptive statistics and bivariate comparisons were computed to assess factors associated with dental appointment attendance and treatment completion.

RESULTS

There were 564 pregnant women, with mean age of 29 years and gestation of 25 weeks, referred to the pOHP dental clinic from UNC OB-GYN and 20 community sites. Only 56% (N = 314) scheduled an appointment. Of the 314 appointed women, 55% (N = 172) attended at least one appointment. The majority (87%) presented with acute and/or complex treatment needs. Medicaid status was positively associated with appointment attendance (P = 0.001). Less than half (42%) of the women completed treatment prior to delivery. Mean maternal age, gestational age, and weeks to estimated date of delivery (EDD) were not significantly associated with completed treatment.

CONCLUSIONS

This study provides descriptive evidence of an academic, interprofessional program's ability to provide safety-net dental care to pregnant women in the state of North Carolina. Results underscore the need for dental services among pregnant women, signaling for promotion of prenatal oral health clinical standards and informing policy on the state and national levels to maximize dental coverage.

Social Interaction Needs and Entertainment Approaches to Pregnancy Well-Being in mHealth Technology Design for Low-Income Transmigrant Women: Qualitative Codesign Study

Background

Low-income Caribbean transmigrant women face unique health challenges during pregnancy that set forth multidimensional implications for the design of mobile health (mHealth). Acknowledgment of the unique health needs of low-income Caribbean immigrant women in the United States and what that entails regarding technology design remains rarely examined in the literature of mHealth technologies.

Objective

The goal of this study was to reveal the needs and gaps in mHealth interventions for pregnant immigrant women not yet realized in this field. These understandings reveal design opportunities for mHealth.

Methods

The use of the qualitative participatory action research approach of codesign workshops in this study resulted in design solutions by the participants after reflecting on their earlier focus group discussions. The highlights are not the resulting designs per se but rather the inferences derived from the researcher reflecting on these designs.

Results

The designs exposed two themes relevant to this paper. First, the participants desired the inclusion and rebuilding of social and organizational relationships in mHealth. The resulting designs formulate an understanding of the women’s health-related social support needs and how technology can facilitate them. Second, the participants wanted entertainment with an element of social participation incorporated in mHealth pregnancy management interventions. This brings attention to the role entertainment can add to the impact mHealth can deliver for pregnancy well-being.

Conclusions

The study concluded with an examination of social and entertainment design implications that reveal pregnant immigrant women’s virtual health-related sharing habits, choice of sharing interaction scenarios during pregnancy (eg, local, long distance, one-way, two-way, and many-many), and choice of sharing media (eg, text, voice, and video). Additionally, the study revealed exclusions to social sharing capabilities in health technologies for these women.

Health Information Behavior of Expectant and Recent Fathers

Given the importance of paternal involvement in maternal and child health, the current investigation takes a closer look at expectant and recent (E/R) fathers' health information behavior during pregnancy, childbirth, and child care. A total of 186 E/R fathers (68 low-income) completed a survey gauging information needs, sources of information, and information-seeking behavior. Results are summarized in four statements that may help low-income E/R fathers get the information they need during a partner's pregnancy or after a child is born: (a) paternal information needs are diverse, (b) information needs change across stages of child development,

Health information needs of pregnant women: information sources, motives and barriers

BACKGROUND

Pregnant women should be provided with relevant and useful information to manage this specific period of their lives. Assessing information needs of this group is a prerequisite for providing this information.

OBJECTIVE

The aim of this study was to assess the information needs of pregnant women during their pregnancy and childbirth.

METHODS

This descriptive study was conducted on the pregnant women who attended antenatal clinics and obstetricians/gynaecologists' offices in Kerman, Iran, in 2015. Data were collected using a self-administered, valid and reliable questionnaire. A total of 400 women participated in the study.

FINDINGS

Most pregnant women needed information about care of the foetus (n = 344, 86%), physical and psychological complications after delivery (n = 333, 83%), development and growth of the foetus (n = 330, 82.5%), pregnancy nutrition (n = 327, 82%) and special tests during pregnancy (n = 326, 81.5%). They mostly (n = 195, 49%) looked for information when they were suffering from a disease or pregnancy complications.

CONCLUSIONS

As pregnant women need extensive information to be able to take care of themselves and their babies, their information needs should be identified and taken into consideration when planning educational programmes for this group of women.

Pregnant Women's Infant Oral Health Knowledge and Beliefs: Influence of Having Given Birth and of Having a Child in the Home

Introduction Prenatal oral health interventions can positively impact maternal and child oral health, yet limited information exists concerning how to best educate pregnant women about infant oral health. Our objective was to examine the influence of having given birth on pregnant women's infant oral health knowledge and beliefs. Methods We conducted a secondary analysis of data collected from a cross-sectional survey of pregnant women ≥18 years old attending UNC's Ultrasound Clinic. Four binomial items were categorized as infant knowledge (IK) and five rated on a Likert scale (1-5) as infant belief (IB). Overall IK and IB scores were calculated, averaging the items within each construct. Respondents were categorized into two groups: multiparous (N = 268), women having at least one previous live birth and a child between 2 and 6 years old, or nulliparous (N = 186), women with no previous live births or a child between 2 and 6 years old. Regression models for IK and IB were conducted using SAS 9.2 with maternal demographic characteristics, dental utilization, and birth history as explanatory variables (p ≤ 0.05). Results IK was affected by race (p = 0.04), mother's oral health self-rating (p = 0.0002), and birth history (p < 0.0001). On average, IK was 0.12 units higher in subjects with a history of giving birth, adjusting for explanatory variables. IB was influenced by maternal oral health beliefs (p = 0.002) and history of access to dental care (p = 0.0002). IB did not differ based on birth history (p = 0.17). Discussion The influence of birth history on pregnant women's infant oral health knowledge and beliefs can be considered in future intervention designs to maximize available resources.

Listening to Communities: Mixed-Method Study of the Engagement of Disadvantaged Mothers and Pregnant Women With Digital Health Technologies

Background

US health care providers are increasingly demanding patient engagement with digital health technologies to enroll in care, access personal health information, communicate with providers, and monitor their own health. Such engagement may be difficult for disadvantaged populations who may have limited health literacy, time constraints, or competing priorities.

Objective

We aimed to understand the extent of adoption and use of digital health tools and to identify key perceived psychological motivators of technology use among disadvantaged first-time pregnant women and mothers of young children.

Methods

We recruited women from health organizations serving low-income communities in the Midwest and on the East and West coasts. A total of 92 women participated in 14 focus groups. During each session, we administered worksheets that measured 3 utilization outcomes: the number of recent Web-based health-seeking activities, current use of digital health-management practices (eg, accessing personal health information, communicating with providers, and scheduling appointments), and potential adoption of digital health-management tools among low users or nonusers. Responses to the worksheets and to a pre-focus group survey on demographics, technology access, and motivators of use were examined to create user profiles. Separate regression models identified the motivators (eHealth literacy, internal health orientation, and trust in digital information) associated with these outcomes. Qualitative data were incorporated to illustrate the worksheet responses.

Results

Whereas 97% of the participants reported that they had searched for health information on the Internet in the past year, 42% did not engage in digital health-management practices. Among the low users and nonusers, 49% expressed interest in future adoption of digital health tools. Web-based health information-seeking activities were associated with digital health-management practices (P<.001). When controlling for covariates, eHealth literacy was positively correlated with the number of Web-based health-seeking activities (beta=.03, 95% CI 0.00-0.07). However, an internal health orientation was a much stronger correlate of digital health-management practices (beta=.13, 95% CI 0.02-0.24), whereas trust in digital information increased the odds of potential adoption (vs no adoption) in adjusted models (OR 5.21, 95% CI 0.84-32.53). Demographic characteristics were not important drivers of digital health use and few differences distinguished use among mothers and pregnant women.

Conclusions

Seeking health information on the Internet may be an important gateway toward engaging in digital health-management practices. Notably, different consumer motivators influence digital health tool use. The relative contributions of each must be explored to design tools and interventions that enhance competencies for the management of self and child health among disadvantaged mothers and pregnant women. Unless we address disparities in digital health tool use, benefits from their use will accrue predominantly to individuals with the resources and skills to use technology effectively.

Women's experiences of personalised support for asthma care during pregnancy: A systematic review of the literature

BACKGROUND

Asthma and pregnancy are both sources of anxiety for women. Although there has been a focus on physiological management of asthma and pregnancy, there has been little research on the impact that personalised support can have on asthma care during pregnancy. This systematic review and narrative synthesis of the literature set out to answer the question 'What are women's experiences of asthma care, its management and education, during pregnancy?'

METHODS

This systematic review was carried out using accepted methodology from the York Centre for Reviews and Dissemination. Electronic database searches were conducted using PsycInfo, CINAHL, MedLine, Google Scholar and the Cochrane Library, using the combination search terms: 'Asthma' AND 'Pregnancy' AND 'Care' AND ('Education OR Information OR Experience'). Hand searching of journals and searches for grey literature were also undertaken. Independent quality appraisal by the three authors took place using the criteria detailed by Kmet et al. (Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields, 2004).

RESULTS

All papers scoring in excess of 60% were deemed to be of adequate quality for inclusion, of which there were five: two qualitative designs and three quantitative designs. The designs were too methodologically heterogeneous to permit statistical meta-analysis so narrative review and synthesis was undertaken. Despite an embryonic evidence bases, it is reasonable to conclude that personalised care has beneficial outcomes for pregnant asthmatic women.

CONCLUSIONS

Larger randomised controlled trials investigating personalised care are required to build an evidence base which can establish the efficacy of such interventions.

Mind the Gap: Assessing the Disconnect Between Postpartum Health Information Desired and Health Information Received

INTRODUCTION

Seeking and receiving health information are critical aspects of prenatal and postpartum care; however, many informational sources lack postpartum content. This study explores the gaps between information desired and information received postpartum and identifies the sources women use for health information seeking, with an emphasis on emergent online and mobile phone-based resources.

METHODS

Participants were recruited from our community partners' client base for a cross-sectional study. Mothers (n = 77) of a child 48 months or younger completed a survey on health information seeking, health information needs, and technology use. Postpartum health information gaps were defined as topics about which a participant indicated that she wanted information, but did not receive information. Bivariate analyses assessed the association between demographic characteristics, sources of health information used during pregnancy, and postpartum information gaps.

RESULTS

Health care providers, Internet-based resources, and mobile applications were common sources of health information during pregnancy. Mental and sexual health were the most common types of postpartum health information gaps. In bivariate analyses, higher income and education were associated with postpartum information gaps in mental health and sexual health, respectively (p < .05).

CONCLUSIONS

Postpartum health information gaps were common in this sample, particularly for topics in mental and sexual health. Unexpected associations between higher levels of education and income and postpartum health information gaps were observed in bivariate analyses. Health educators have the opportunity to capitalize on high rates of Internet information seeking by providing health information online. Health care providers must incorporate mental and sexual health into routine postpartum care.

Compliance of Parenting Magazines Advertisements with American Academy of Pediatrics Recommendations

This study examined 3218 advertisements from the two parenting magazines with highest circulation in the United States. The authors compared each advertisement for a product for use by children, against all the published recommendations of the American Academy of Pediatrics (AAP) on topics such as toy safety, helmet use, age-defined choking hazards, infant sleep safety, and others. Any advertisement with images or products which went against a published AAP recommendation was deemed as non-adherence and was categorized according to the statement it contradicted. Nearly one in six (15.7%) of the advertisements contained example(s) of non-adherence to AAP recommendations, with twelve categories of offense represented. Categories ranked by overall share from most to least include: non-Food and Drug Administration (FDA) approved medical treatments, age-defined choking hazards, vitamins, cold medicine, formula, oral care, screen time, toy/playground safety, infant sleep, nutrition, water safety, and fall risk. Given that repeated exposure to messages in advertisements has been associated with changes in health decision-making, and parents often turn to parenting magazines for advice and ideas regarding their children, the publishers might consider screening the content in order to prevent confusing and potentially dangerous messages from being disseminated in the media.

Associations Between Patient Characteristics and the Amount of Arthritis Medication Information Patients Receive

Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid arthritis (RA; n = 328) completed an online cross-sectional survey. Patients reported demographic and clinical/patient characteristics and the amount of arthritis medication information received from 15 information sources. Bivariate and multivariate linear regression analyses were used to investigate whether those characteristics were associated with the amount of medication information patients received. Arthritis patients received the most information from health professionals, followed by printed materials, media sources, and interpersonal sources. Greater receipt of information was associated with greater medication adherence, taking more medications, greater medication-taking concerns, more satisfaction with doctor medication-related support, and Black compared to White race. RA patients reported receiving more information compared to OA patients, and differences were found between RA patients and OA patients in characteristics associated with more information receipt. In conclusion, arthritis patients received the most medication information from professional sources, and both positive (e.g., greater satisfaction with doctor support) and negative (e.g., more medication-taking concerns) characteristics were associated with receiving more medication information.

Pregnant women: What do they need to know during pregnancy? A descriptive study

BACKGROUND

Antenatal education programs provide women with essential knowledge and skills in various aspects of maternal and fetal health. Antenatal education is based on improving women's health, reducing the risks of complications and enhancing couples' positive experience during childbirth. There is a lack of formal antenatal educational programs based on women's needs in Jordan.

AIM

This study sought to identify and prioritize the learning needs for women during pregnancy.

METHODS

A descriptive cross-sectional design was employed. The study sample was recruited from three maternal and child health centers. Data were collected from a convenient sample of 150 pregnant women during their antenatal visits. One hundred and twenty three participants (response rate=82%) completed the self-reported antenatal learning needs questionnaire.

FINDINGS

Women identified their most important learning needs were related to managing major complications of pregnancy (mean=3.49, SD=0.78), investigations and physician follow-up visit during pregnancy (mean=3.42, SD=0.71), appropriate diet (mean=3.36, SD=0.84) and information about medication and supplements (mean=3.22, SD=0.97). Spearman correlation showed negative association between participants' age and physical (r=-0.536, p=0.015) and emotional concerns (r=-0.490, p=0.001). Women who had a diploma or higher degree reported greater concern regarding physical (median=4.00, IQR=3.00-4.00, p=0.047) and emotional changes (median=3.33, IQR=3.00-4.00, p=0.004). Finally, migrant participants showed greater significant concern regarding emotional changes and coping with minor complications.

CONCLUSION

A large proportion of pregnant women in this study reported a high degree of importance of specific learning topics that were closely relevant to their current period of pregnancy. The lack of focusing on issues related to maternal emotional status and possible complications suggests a need for a national strategy to provide antenatal education based on women's perceptions of their needs.

"Will my work affect my pregnancy?" Resources for anticipating and answering patients' questions

BACKGROUND

Authoritative information on occupational reproductive hazards is scarce and complex because exposure levels vary, multiple exposures may be present, and the reproductive toxicity of many agents remains unknown. For these reasons, women's health providers may find it challenging to effectively address workplace reproductive health issues with their patients who are pregnant, breast-feeding, or considering pregnancy. Reproductive epidemiologists at the Centers for Disease Control and Prevention National Institute for Occupational Safety and Health answered >200 public requests for occupational reproductive health information during 2009 through 2013. The most frequent occupations represented were health care (41%) and laboratory work (18%). The most common requests for exposure information concerned solvents (14%), anesthetic gases (10%), formaldehyde (7%), infectious agents in laboratories (7%) or health care settings (7%), and physical agents (14%), including ionizing radiation (6%). Information for developing workplace policies or guidelines was sought by 12% of the requestors. Occupational exposure effects on breast-feeding were an increasing concern among working women. Based on information developed in response to these requestors, information is provided for discussing workplace exposures with patients, assessing potential workplace reproductive hazards, and helping patients determine the best options for safe work in pregnancy. Appendices provide resources to address specific occupational exposures, employee groups, personal protective equipment, breast-feeding, and workplace regulations regarding work and pregnancy. These tools can help identify those most at risk of occupational reproductive hazards and improve workers' reproductive health. The information can also be used to inform research priorities and assist the development of workplace reproductive health policies.

The everyday life information seeking behaviours of first-time mothers

Purpose

– The purpose of this paper is to investigate the everyday life information seeking behaviours of first-time mothers, as they encounter new, significant and pressing information needs which arise alongside their new responsibilities.

Design/methodology/approach

– A qualitative approach combined narrative interviews with participatory methods to facilitate engagement and remain sensitive to the social context.

Findings

– Mothers particularly valued the experiential nature of information received from peers or family members. However, fear of judgement influenced their use of interpersonal sources, both on- and off-line. Their accounts of information seeking contained instances of confusion, tension, conflict and information overload. Feeling under pressure to be “good mothers”, they withheld information needs from others, including healthcare professionals.

Research limitations/implications

– There was a notable absence of younger ( < 20 year old) and/or less educated mothers in the study. This corresponds to previous findings which report that very young mothers are reluctant to participate in support groups with older mothers. They remain an understudied and potentially marginalised group.

Practical implications

– The findings show how social support groups can mitigate for societal pressures which impact upon mothers’ information behaviour, allowing them to connect and share information within a trusted environment. The study highlights the importance of healthcare and information services professionals remaining sensitive to such pressures. Relatedly, the finding that public libraries are used very little has implications for audience engagement and service provision.

Originality/value

– Focused upon first-time mothers’ information behaviours during the early stages of parenthood, the study provides insight into how relationships and experiences with others influence information seeking behaviours. It provides evidence that fear of judgement can influence information seeking behaviour, helping us to understand why some information sources, although considered important and useful, can be used very little.

Promoting weight loss methods in parenting magazines: Implications for women

Weight gain before and after pregnancy is important for women's health. The purpose of this study was to assess articles and advertisements related to weight loss in three widely read parenting magazines, "Parenting School Years," "Parenting Early Years," and "Parenting," which have an estimated combined readership of approximately 24 million (mainly women readers). Almost a quarter (23.7%, n = 32) of the 135 magazine issues over a four year period included at least one feature article on weight loss. A variety of topics were covered in the featured articles, with the most frequent topics being on losing weight to please yourself (25.2%), healthy ways to lose weight (21.1%), and how to keep the weight off (14.7%). Less than half (45.9%) of the articles displayed author credentials, such as their degree, qualifications, or expertise. A fifth (20.0%, n = 27) of the magazines included at least one prominent advertisement for weight loss products. Almost half (46.9%) of the weight loss advertisements were for weight loss programs followed by weight loss food products (25.0%), weight loss aids (21.9%), and only 6.2% of the advertisements for weight loss were on fitness. Parenting magazines should advocate for healthy weight loss, including lifestyle changes for sustained health.

Nutrition Information-seeking Behaviour of Low-income Pregnant Maghrebian Women

Purpose

Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed.

Methods

Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women’s nutrition decision-making.

Results

Environmental factors likely to influence informationseeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members.

Conclusions

Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women’s specific information needs.

Associations between health literacy and beliefs about medicines in an Irish obstetric population

The authors wanted to determine the prevalence of limited health literacy, and the relation between health literacy and beliefs about medicines, in an obstetric population. A survey was administered in Cork University Maternity Hospital, Cork, Ireland. The Rapid Estimate of Adult Literacy in Medicine and the general section of the Beliefs About Medicines Questionnaire were used. Of 404 women, 15.3% (n=62) displayed limited health literacy. Age and health literacy were significantly associated with one another, as were health literacy and level at which participants completed formal education. In the general harm domain, level of education and health literacy were associated with stronger beliefs: M=11.85, SD=2.81 vs. M=9.75, SD=2.11; F(3)=13.69, p<.001. In the general overuse domain, those with limited literacy scored higher compared with those with adequate health literacy: M=12.48, SD=2.73 versus M=11.51, SD=2.63 (p=.01). These associations remained despite controlling for age (and education) in multivariable analyses. More than 1 in 7 had limited health literacy; these women may benefit from educational initiatives. Limited health literacy is associated with a more negative perception of medicines in this cohort.

Influence of health information levels on postpartum depression

While extensive research has been conducted on postpartum depression (PPD), the majority has been focused on psychological risk factors and treatments. There is limited research on the explicit relationship between the degree to which individuals are informed about relevant prenatal and postnatal health topics and whether this level of knowledge influences psychological outcome. This study assesses health information levels of new mothers and their influence on PPD as measured by Edinburgh Postnatal Depression Scale (EPDS) scores. Data from the 2006 Maternity Experiences Survey developed by the Canadian Perinatal Surveillance System (N = 6,421) were used. The study population included mothers ≥15 years of age at the time of the birth, who had a singleton live birth in Canada during a 3-month period preceding the 2006 Census and who lived with their infants at the time of the survey. Pre- and postnatal health information components were measured using latent variables constructed by structural equation modeling. EPDS score was added to the model, adjusting for known covariates to assess the effects of information levels on EPDS score. Pre- and postnatal health information levels are associated with decreased EPDS scores. More specifically, information on topics such as postnatal concerns and negative feelings was associated with the largest decrease in score for primiparous and multiparous women, respectively (p < 0.0001 for both). The pre-established predictors of PPD were confirmed for both samples, with life stress associated with the largest change in EPDS score for both samples (p < 0.0001 for both). This study demonstrates a distinct role for pre- and postnatal health information in influencing EPDS scores, supplementing previous literature. Primiparous and multiparous women benefited from different information content, with information on postnatal concerns had the largest effect on the primiparous group while information on negative feelings had the largest effect on the multiparous group. Therefore, information provision should be tailored to these two groups.

Oral health literacy and knowledge among patients who are pregnant for the first time

BACKGROUND

The authors conducted an observational cohort study to determine the levels of and examine the associations of oral health literacy (OHL) and oral health knowledge in low-income patients who were pregnant for the first time.

METHODS

An analytic sample of 119 low-income patients who were pregnant for the first time completed a structured 30-minute, in-person interview conducted by two trained interviewers in seven counties in North Carolina. The authors measured OHL by means of a dental word recognition test and assessed oral health knowledge by administering a six-item knowledge survey.

RESULTS

The authors found that OHL scores were distributed normally (mean [standard deviation], 16.4 [5.0]). The percentage of correct responses for each oral health knowledge item ranged from 45 to 98 percent. The results of bivariate analyses showed that there was a positive correlation between OHL and oral health knowledge (P < .01). Higher OHL levels were associated with correct responses to two of the knowledge items (P < .01).

CONCLUSIONS

OHL was low in the study sample. There was a significant association between OHL and oral health knowledge.

CLINICAL IMPLICATIONS

Low OHL levels and, thereby, low levels of oral health knowledge, might affect health outcomes for both the mother and child. Tailoring messages to appropriate OHL levels might improve knowledge.

Prevalence of infant formula advertisements in parenting magazines over a 5-year span

Marketing of infant formula contributes to a decreased likelihood to breastfeed. This study established the prevalence of infant formula advertisements in two popular US parenting magazines and explored trends in infant formula advertisement prevalence from 2007 to 2012.

METHODS

Advertisements were analyzed using a comprehensive coding schematic.

RESULTS

We established a high proportion of 0.43 advertisements per page of content in both magazines and observed a significant increase in infant formula advertisement prevalence beginning in 2009.

CONCLUSIONS

Infant formula companies use aggressive marketing in parenting magazines. Nurses who are well-trained in breastfeeding best practices can offer new mothers evidence-based information on the benefits of breastfeeding.

Can fish consumption advisories do better? Providing benefit and risk information to increase knowledge

Humans exposed to methylmercury (MeHg) can suffer from adverse health impacts, e.g., serious neurological damage; however, fish is also a good source of omega-3 fish oils which promotes infants' neurological development. Because eating fish is the primary mechanism of MeHg exposure, federal and state agencies issue fish consumption advisories to inform the public about the risks of eating contaminated fish. An advisory's purpose is to provide information to consumers to increase their knowledge of specific product attributes; however, the difficulty in communicating both the risks and benefits of eating fish leads readers of fish advisories to over-restrict their fish consumption. Because the effectiveness of fish consumption advisories are not often evaluated by states, we help fill this gap by evaluating the effectiveness of Maine's fish consumption advisory in terms of improving knowledge. The results suggest the advisory successfully increased women's knowledge of both the benefits and risks of consuming fish while pregnant. The advisory also increased their ability to differentiate fish by their MeHg content, knowledge of both low and high-MeHg fish and knowledge of detailed attributes of seemingly substitutable goods, such as white tuna, light tuna and pre-packaged salmon. People who did not read the advisory lack the knowledge of how to identify fish that provide: health benefits like Omega-3 fatty acids, or health risks like MeHg; reading the advisory reduces this lack of knowledge. Readers increased ability to make specific substitutions to minimize risk while maintaining the benefits of fish eating suggests the advisory has the potential of reducing MeHg-related health risks while avoiding the drop in fish consumption show in other studies.

Medication information seeking behavior of patients who use multiple medicines: how does it affect adherence?

OBJECTIVE

This article explores medication information seeking behavior (MISB). We aimed to develop a scale for measuring MISB and use it to explore the relationships between MISB, adherence and factors, which drive information seeking.

METHODS

Patients (N=910) using multiple medicines completed questionnaires. Exploratory and confirmatory factor analyses were performed. Correlations and multivariate analyses were used to investigate the relationships between variables.

RESULTS

Respondents sought medication information mainly from health professionals and written medicines information. The medication information seeking behavior scale (MISB) had acceptable reliability and validity. Information seeking was most intense among respondents who had recent changes in their medicine regimen and worries about their medicines. Those who sought medication information from autonomous sources were more likely to be non-adherent than those who never did (OR=2.00 [1.48, 2.70]). Seeking information from health professionals had no influence on adherence.

CONCLUSION

Health practitioners should carefully attend to patients' questions about medicines information. When patients mention that they are worried about their medicines and have sought medication information from television, magazines, brochures or family and friends, this could be a sign that they tend towards non-adherent behavior.

PRACTICE IMPLICATIONS

The MISB scale could be used to learn more about patients' use of medication information.

Medicines information needs during pregnancy: a multinational comparison

OBJECTIVES

The aim was to assess the perceived needs of medicines information and information sources for pregnant women in various countries.

DESIGN

Cross-sectional internet-based study.

SETTING

Multinational.

PARTICIPANTS

Pregnant women and women with children less than 25 weeks.

PRIMARY AND SECONDARY OUTCOME MEASURES

The need for information about medicines was assessed by a question: 'Did you need information about medicines during the course of your pregnancy?' A list of commonly used sources of information was given to explore those that are used.

RESULTS

Altogether, 7092 eligible women responded to the survey (5090 pregnant women and 2002 women with a child less than 25 weeks). Of the respondents, 57% (n=4054, range between different countries 46-77%) indicated a need for information about medicines during their pregnancy. On average, respondents used three different information sources. The most commonly used information sources were healthcare professionals-physicians (73%), pharmacy personnel (46%) and midwifes or nurses (33%)-and the internet (60%). There were distinct differences in the information needs and information sources used in different countries.

CONCLUSIONS

A large proportion of pregnant women have perceived information needs about medicines during pregnancy, and they rely on healthcare professionals. The internet is also a widely used information source. Further studies are needed to evaluate the use of the internet as a medicines information source by pregnant women.

Comparisons in perceived importance of and needs for maternal gestational weight information between african american and caucasian pregnant women

This study compared the perceived importance of and needs for maternal gestational weight information between African American and Caucasian pregnant women. A secondary analysis of data from 113 pregnant women (82 African Americans and 31 Caucasians) attending an inner-city prenatal clinic was conducted for this study. Perceived importance of and needs for information were measured in five areas: (1) nutrition, (2) prenatal vitamins, (3) rest/activity balance, (4) exercise, and (5) appropriate weight gain. African American women demonstrated significantly higher perceived importance of and needs for information on rest/activity balance and appropriate weight gain than Caucasian women. Exercise information was rated lower in importance but was most needed by both African American and Caucasian women. Education programs about maternal gestational weight need to be cognizant of ethnic women's needs.

Examining the pathways of pre- and postnatal health information

OBJECTIVES

The objectives of our study were to 1) assess Canadian women's health information levels regarding pre- and postnatal topics in both primiparous and multiparous samples, and 2) identify factors associated with levels of health information in both groups and the pathways of such associations.

METHODS

Data from the 2006 Maternity Experiences Survey developed by the Canadian Perinatal Surveillance System (N=6,421) were used. The study population included mothers ≥15 years of age at the time of the birth, who had a singleton live birth in Canada during a three-month period preceding the 2006 Census and who lived with their infants at the time of the survey. Structural equation modeling was used to identify and examine pre- and postnatal acquired health information components in both samples and to assess factors that may influence this level of information.

RESULTS

Primiparous and multiparous women perceived insufficient levels of information on similar topics: pain medication/anesthesia, warning signs/complications, formula feeding and changes in sexual responses. This common finding underscored that these informational needs had a large impact on the entire population of pregnant women, rather than being parity-specific. Level of perceived social support was positively associated with information acquisition on all health topics studied in both samples (p&lt;0.0001 for both). Income was also positively associated with information levels to a similar extent on a range of topics in both samples (p&lt;0.0001 - p&lt;0.05).

CONCLUSIONS

Canadian primiparous and multiparous women perceived an inadequate level of information on the same topics, identifying knowledge gaps that should be addressed. Perceived level of social support and income significantly influenced information levels on pre- and postnatal health topics. Therefore women with low income and those with perceived lack of social support may be identified by health care providers as requiring additional health information.

Patient-Held Maternal and/or Child Health Records: Meeting the Information Needs of Patients and Healthcare Providers in Developing Countries?

Though improvements in infant and maternal mortality rates have occurred over time, women and children still die every hour from preventable causes. Various regional, social and economic factors are involved in the ability of women and children to receive adequate care and prevention services. Patient-held maternal and/or child health records have been used for a number of years in many countries to help track health risks, vaccinations and other preventative health measures performed. Though these records are primarily designed to record patient histories and healthcare information and guide healthcare workers providing care, because the records are patient-held, they also allow families a greater ability to track their own health and prevention strategies. A LITERATURE SEARCH WAS PERFORMED TO ANSWER THESE QUESTIONS: (1) What are maternal information needs regarding pregnancy, post-natal and infant healthcare, especially in developing countries? (2) What is known about maternal information seeking behavior in developing countries? (3) What is the history and current state of maternal and/or child patient-held healthcare records, do they provide for the information needs of the healthcare provider and what are the effects and outcomes of patient-held records in general and for maternal and/or child health in particular? Specific information needs of pregnant women and mothers are rarely studied. The small numbers of maternal information behavior results available indicate that mothers, in general, prefer to receive health information directly from their healthcare provider as opposed to from other sources (written, etc.) Overall, in developing countries, patient-held maternal and/or child healthcare records have a mostly positive effect for both patient and care provider. Mothers and children with records tend to have better outcomes in healthcare and preventative measures. Further research into the information behaviors of pregnant women and mothers to determine the extent of reliance on interpersonal information seeking is recommended before expending significant resources on enhanced patient-held maternal and/or child healthcare records including storage on mobile devices. In particular, research is needed to explore the utility of providing targeted health messages to mothers regarding their own health and that of their children; this might best be accomplished through mobile technologies.

The use of complementary and alternative medicine by pregnant women: a literature review

BACKGROUND

The use of complementary and alternative medicine (CAM) has become increasingly prevalent in industrialised countries, with women being the most prolific users. Some women continue to consume these therapies when they become pregnant.

AIM

To review the literature exploring prevalence and motivation for use of complementary and alternative medicine by pregnant women.

METHOD

A search for relevant literature published from 2001 was undertaken using a range of databases and by examining relevant bibliographies.

RESULTS

Although the estimates vary widely from 1% to 87%, the general trend indicates that a significant number of pregnant women use complementary and alternative medicine. Common modalities used include massage, vitamin and mineral supplements, herbal medicine, relaxation therapies and aromatherapy. Reasons for use are varied and include the belief that these therapies offer safe alternatives to pharmaceuticals, they allow greater choice and control over the childbearing experiences, and they are congruent with their holistic health beliefs. The influence of traditional cultural practices on the use of these therapies is unclear. Most expectant women rely on advice from family and friends, and many do not disclose their use to their pregnancy care providers.

CONCLUSIONS

Many women use complementary and alternative medicine when they are pregnant. Further research is needed to gain a greater understanding of the true prevalence and expectant women's motivation for the use of complementary and alternative medicine. Health-care professionals are encouraged to ask women about their use of these treatments and seek out relevant information.