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Chen S, Lin X, Wang M, Gu Z, Wang M, Ji Y, Yang M. Research on the status and influencing factors of maternal health literacy among postpartum women in urban villages. J Adv Nurs 2024. [PMID: 39235264 DOI: 10.1111/jan.16379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/03/2024] [Accepted: 07/27/2024] [Indexed: 09/06/2024]
Abstract
AIM To comprehensively identify the status and influencing factors on maternal health literacy among postpartum women in Guangzhou urban villages. DESIGN An explanatory sequential mixed-method research was conducted from November 2021 to July 2022. METHODS The quantitative survey was conducted among postpartum women in Guangzhou urban villages using the convenience sampling principle, and a questionnaire survey was used to reflect the status and influencing factors on maternal health literacy. The qualitative interview conducted purposive sampling based on the survey and semi-structured interviews with women to supplement the non-quantifiable influencing factors. RESULTS The quantitative survey showed that the maternal health literacy score of 501 women was 193.84 ± 22.23. The quantitative results suggested that ethnicity, education, income, household registration, delivery mode and social support were important influencing factors (p < .15). The qualitative interviews were conducted with 16 women and revealed three themes and eight sub-themes, including demographic factors (ethnicity, education, income, occupation and family history), pregnancy factors (delivery mode and pregnancy complications) and social factors (social support), which influenced maternal health literacy through three routes: women's motivation, access and ability in screening health information. CONCLUSION Maternal health literacy among postpartum women in urban villages needs to be improved, especially critical health literacy. Maternal and infant workers need to guide women to develop appropriate health information concepts and consider the realistic knowledge needs of women in different socio-cultural and economic backgrounds. They should also construct a comprehensive social support system for women to better improve maternal health literacy. IMPACT Highlights the positive benefits of maternal health literacy among postpartum women, as preparation for providing accurate and effective maternal and child health education services. PATIENT OR PUBLIC CONTRIBUTION The information on maternal health literacy in this study was based on an interview with postpartum women in Guangzhou urban villages during the study period.
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Affiliation(s)
- Shanxia Chen
- Health Management and Biotechnology School, Guangdong Food and Drug Vocational College, Guangzhou, China
| | - Xiaoli Lin
- Otolaryngology Head and Neck Surgery, Department of Foshan First People's Hospital, Foshan, China
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Minyi Wang
- Otolaryngology Head and Neck Surgery, Department of Foshan First People's Hospital, Foshan, China
| | - Zhimin Gu
- Otolaryngology Head and Neck Surgery, Department of Foshan First People's Hospital, Foshan, China
| | - Meiyu Wang
- Otolaryngology Head and Neck Surgery, Department of Foshan First People's Hospital, Foshan, China
| | - Yuting Ji
- Otolaryngology Head and Neck Surgery, Department of Foshan First People's Hospital, Foshan, China
| | - Ming Yang
- Otolaryngology Head and Neck Surgery, Department of Foshan First People's Hospital, Foshan, China
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Putri AP, Lu YY. Maternal Health Literacy in Pregnant Women: A Concept Analysis. Matern Child Health J 2024; 28:1272-1282. [PMID: 38864987 DOI: 10.1007/s10995-024-03945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES Maternal health literacy (MHL) plays a vital role in pregnancy outcomes, healthcare researchers should further analyze, refine, and develop this concept. This study aims to clarify the definition of MHL in pregnant women through a analysis of the concept. METHODS Walker and Avant's concept analysis approach was used to analyze the concept of MHL. A search of the literature was completed using the databases PubMed, CINAHL, Web of Science (WOS), and the Science and Technology Index (SINTA) for years 2001-2021; literature search included grey literature, publications from the government and academic institutions, and available both in English and Indonesia. A total of 12 articles were reviewed. RESULTS MHL is a multifaceted and comprehensive concept. This study presents a working definition of MHL during pregnancy as the skills enabling women to access, comprehend, evaluate, and apply health information related to pregnancy, which are necessary for making decisions for improving and maintaining both maternal and fetal health. Guided by Walker and Avant's method, the major attributes and outcomes are determined in this study. CONCLUSION Healthcare professionals can utilize this analysis to familiarize their institutions with the MHL concept, emphasize its importance, and apply it to practice. This contributes to enhancing the body of knowledge on MHL and potentially improving maternal health outcomes.
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Affiliation(s)
- Anggie Pradana Putri
- School of Nursing, Mamba'ul 'Ulum Health College of Surakarta, Global Lubna Jaya Co, Ring Road Utara KM 0.3 Mojosongo, Jebres, Founder, Sukoharjo, Surakarta, Indonesia
| | - Yu Ying Lu
- Department of Nursing, National Taipei University of Nursing and Health Sciences, No.365, Ming-De Road, Peitou District, Taipei City, 11219, Taiwan.
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Albayrak M, Arslan HF. Health Literacy Levels of Women Attending a Perinatology Outpatient Clinic for High-Risk Pregnancy Follow-Up. Cureus 2024; 16:e68267. [PMID: 39350824 PMCID: PMC11440338 DOI: 10.7759/cureus.68267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Health literacy, defined as the ability to obtain, understand, evaluate, and apply health information with knowledge, motivation, and skills, is crucial for maintaining and improving quality of life. Despite the availability of health information, limited health literacy is linked to health disparities, inadequate self-management of chronic diseases, and poorer health outcomes. OBJECTIVE The purpose of this study is to assess the health literacy of pregnant women who visit the Perinatology Outpatient Clinic for follow-up care. It seeks to identify gaps in knowledge and understanding that may impede effective healthcare delivery and inform targeted health education and public awareness programs to enhance health literacy. METHODS This prospective survey study included 210 pregnant women aged 18 to 40 years attending the Perinatology Outpatient Clinic at Giresun Obstetrics and Gynecology Training and Research Hospital, Turkey. Participants completed a questionnaire on health literacy, sociodemographics, and basic health status via Google Forms (Google Inc., Mountain View, CA, USA). Statistical analysis was performed using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA), employing tests such as Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, Student's t-test, ANOVA, Spearman, and Pearson correlation, and multivariate linear regression analysis. RESULTS The mean age of participants was 29.97±5.44 years, with a mean health literacy score of 29.89±7.05. Education level and living place significantly influenced health literacy scores, with higher scores among those with higher education and urban living (p = 0.014 and p = 0.038, respectively). Economic status also significantly impacted health literacy, with lower scores among those with poor economic status (p<0.001). Health literacy scores were higher among those receiving health information from healthcare professionals (p = 0.006) and lower among those finding medical information from doctors insufficient (p = 0.008). CONCLUSION Health literacy is significantly influenced by education level, living place, and economic status. The study emphasizes the necessity of focused health education initiatives, especially for individuals with lower educational attainment and those residing in rural regions. Improving health literacy via efficient communication from medical professionals can benefit expectant mothers and their unborn children by lowering medical expenses and improving health outcomes.
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Affiliation(s)
- Mehmet Albayrak
- Obstetrics and Gynecology, Giresun Training and Research Hospital, Giresun, TUR
| | - Hilmi Furkan Arslan
- Clinical Biochemistry, Giresun Obstetrics and Gynecology Education and Research Hospital, Giresun, TUR
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Lori JR, Kukula VA, Liu L, Apetorgbor VEA, Ghosh B, Awini E, Lockhart N, Amankwah G, Zielinski R, Moyer CA, Williams J. Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana. BMC Pregnancy Childbirth 2024; 24:37. [PMID: 38182969 PMCID: PMC10768124 DOI: 10.1186/s12884-023-06224-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/22/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Although the majority of Ghanaian women receive antenatal care (ANC), many exhibit low health literacy by misinterpreting and incorrectly operationalizing ANC messages, leading to poor maternal and newborn health outcomes. Prior research in low-resource settings has found group antenatal care (G-ANC) feasible for women and providers. This study aims to determine the effect of G-ANC on increasing maternal health literacy. We hypothesized that pregnant women randomized into G-ANC would exhibit a greater increase in maternal health literacy than women in routine, individual ANC. METHODS A 5-year cluster randomized controlled trial was conducted in 14 rural and peri-urban health facilities in the Eastern Region of Ghana. Facilities were paired based on patient volume and average gestational age at ANC enrollment and then randomized into intervention (G-ANC) vs. control (routine, individual ANC); 1761 pregnant women were recruited. Data collection occurred at baseline (T0) and post-birth (T2) using the Maternal Health Literacy scale, a 12-item composite scale to assess maternal health literacy. Logistic regression compared changes in health literacy from T0 to T2. RESULTS Overall, women in both the intervention and control groups improved their health literacy scores over time (p < 0.0001). Women in the intervention group scored significantly higher on 3 individual items and on overall composite scores (p < 0.0001) and were more likely to attend 8 or more ANC visits. CONCLUSION While health literacy scores improved for all women attending ANC, women randomized into G-ANC exhibited greater improvement in overall health literacy post-birth compared to those receiving routine individual care. Life-saving information provided during ANC must be presented in an understandable format to prevent women and newborns from dying of preventable causes. TRIAL REGISTRY Ethical approval for the study was obtained from the Institutional Review Boards of the University of Michigan (HUM#00161464) and the Ghana Health Service (GHS-ERC: 016/04/19).
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Affiliation(s)
- Jody R Lori
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America.
| | - Vida Ami Kukula
- Dodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana
| | - Liya Liu
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America
| | | | - Bidisha Ghosh
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America
| | - Elizabeth Awini
- Dodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana
| | - Nancy Lockhart
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America
| | - Georgina Amankwah
- Dodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana
| | - Ruth Zielinski
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America
| | - Cheryl A Moyer
- Department of Learning Health Sciences, University of Michigan Medical School, University of Michigan, Ann Arbor, MI, United States of America
| | - John Williams
- Dodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana
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Austin RR, McLane TM, Pieczkiewicz DS, Adam T, Monsen KA. Advantages and disadvantages of using theory-based versus data-driven models with social and behavioral determinants of health data. J Am Med Inform Assoc 2023; 30:1818-1825. [PMID: 37494964 PMCID: PMC10586042 DOI: 10.1093/jamia/ocad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/17/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
OBJECTIVE Theory-based research of social and behavioral determinants of health (SBDH) found SBDH-related patterns in interventions and outcomes for pregnant/birthing people. The objectives of this study were to replicate the theory-based SBDH study with a new sample, and to compare these findings to a data-driven SBDH study. MATERIALS AND METHODS Using deidentified public health nurse-generated Omaha System data, 2 SBDH indices were computed separately to create groups based on SBDH (0-5+ signs/symptoms). The data-driven SBDH index used multiple linear regression with backward elimination to identify SBDH factors. Changes in Knowledge, Behavior, and Status (KBS) outcomes, numbers of interventions, and adjusted R-squared statistics were computed for both models. RESULTS There were 4109 clients ages 13-40 years. Outcome patterns aligned with the original research: KBS increased from admission to discharge with Knowledge improving the most; discharge KBS decreased as SBDH increased; and interventions increased as SBDH increased. Slopes of the data-driven model were steeper, showing clearer KBS trends for data-driven SBDH groups. The theory-based model adjusted R-squared was 0.54 (SE = 0.38) versus 0.61 (SE = 0.35) for the data-driven model with an entirely different set of SBDH factors. CONCLUSIONS The theory-based approach provided a framework to identity patterns and relationships and may be applied consistently across studies and populations. In contrast, the data-driven approach can provide insights based on novel patterns for a given dataset and reveal insights and relationships not predicted by existing theories. Data-driven methods may be an advantage if there is sufficiently comprehensive SBDH data upon which to create the data-driven models.
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Affiliation(s)
- Robin R Austin
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tara M McLane
- Dakota County Public Health, Apple Valley, Minnesota, USA
| | - David S Pieczkiewicz
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Terrence Adam
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
- College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Karen A Monsen
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
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Murugesu L, Damman OC, Timmermans DRM, de Wit S, Nieuwenhuijze M, Smets EMA, Fransen MP. Health literate-sensitive shared decision-making in maternity care: needs for support among maternity care professionals in the Netherlands. BMC Pregnancy Childbirth 2023; 23:594. [PMID: 37605153 PMCID: PMC10440871 DOI: 10.1186/s12884-023-05915-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) in maternity care is challenging when clients have insufficient health literacy (HL) skills. This study gained insight in how professionals apply HL-sensitive SDM in Dutch maternity care and their needs for support therein. METHODS Maternity care professionals (n = 30) completed a survey on SDM and the role of HL. Midwives (n = 13) were observed during simulated conversations discussing pain relief options and interviewed afterwards. The client-actors were instructed to portrait specific inadequate HL skills. Observation items focused on adapting communication to HL, and SDM (OPTION-5). RESULTS In the survey, professionals indicated experiencing most challenges when estimating clients' information comprehension. Observations showed that most midwives created choice awareness and informed clients about options, whereas exploring preferences and actual decision-making together with clients were observed less frequently. Their perceived HL-related obstacles and needs for support related to clients' information comprehension. In the interviews, midwives reported putting much effort into explaining available options in maternity care, but also that decisions about pain relief are often postponed until the moment of labour. CONCLUSION Professionals' self-reported needs focus on clients' information comprehension. However, observations indicate that it is not the stage of informing, but rather value clarification and actual decision-making that need improvement in HL-sensitive SDM.
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Affiliation(s)
- Laxsini Murugesu
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Olga C Damman
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands
| | - Danielle R M Timmermans
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands
| | - Sanne de Wit
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Universiteitssingel 60, Maastricht, 6229 ER, the Netherlands
- CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Ellen M A Smets
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
- Amsterdam UMC Location University of Amsterdam, Medical Psychology, Amsterdam, the Netherlands
| | - Mirjam P Fransen
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Jahnke HR, Rubin-Miller L, Henrich N, Moss C, Shah N, Peahl A. Association Between the Use of a Digital Health Platform During Pregnancy and Helping Users Avoid Emergency and In-Person Care: Retrospective Observational Study. J Med Internet Res 2023; 25:e43180. [PMID: 37184930 PMCID: PMC10227709 DOI: 10.2196/43180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/15/2023] [Accepted: 03/19/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Almost one-third of pregnant people visit the emergency room during pregnancy. Although some emergency care is necessary, gaps in patient education and inaccessibility of preventive services have been identified as key reasons for high-cost, low-value care in pregnancy. Digital platforms present a promising solution for providing resources to supplement routine prenatal care, thereby reducing the use of low-value in-person services. OBJECTIVE This study aimed to describe the relationship between the use of Maven and in-person care avoidance (emergency room or office visits) during pregnancy. Maven is a digital prenatal health platform that supplements routine prenatal care. Maven offers educational content (articles, videos, and classes), care coordination (through a care advocate), and provider services (web-based appointments and communication with providers) designed to complement prenatal care. Specifically, the aims of this study were to examine whether the use of Maven is associated with in-person care avoidance overall and whether improvements in pregnancy-related knowledge facilitate in-person care avoidance. To assess aim 2, we tested if the use of Maven is associated with improvements in self-reported understanding of warning signs and medically accurate information and if self-reported understanding of medically accurate information and warning signs is associated with in-person care avoidance in a population of Maven users. METHODS In this retrospective study, we used adjusted logistic regression to examine the relationship between digital platform use, avoidance of in-person care, and the platform's influence on pregnancy-related knowledge (learning medically accurate information and recognizing warning signs). Demographics, medical history, and in-person care avoidance were self-reported. RESULTS Of the 5263 users, 280 (5.32%) reported that Maven helped them avoid in-person care during pregnancy. More users who reported avoiding in-person care also reported that the digital platform helped them understand warning signs (231/280, 82.5%) and learned medically accurate information (185/280, 66.1%). In the adjusted models, all modes of digital service use (assessed as quartiles) were associated with avoiding in-person care in a dose-response manner (eg, web-based provider appointments: Q2 adjusted odds ratio [aOR] 1.57, 95% CI 1.00-2.41; Q3 aOR 2.53, 95% CI 1.72-3.72; Q4 aOR 5.26, 95% CI 3.76-7.42). Users were more likely to avoid in-person care if they reported that Maven helped them recognize warning signs (aOR 3.55, 95% CI 2.60-4.94) or learn medically accurate information (aOR 2.05, 95% CI 1.59-2.67). CONCLUSIONS These results suggest that digital platforms can be effective in helping patients to avoid in-person care. The educational pathway suggests that digital platforms can be particularly effective in helping patients recognize warning signs and learn medically accurate information, which may help them avoid in-person care by recognizing when in-person care is medically appropriate. Future work is needed to assess other pathways through which digital resources can support pregnant people and improve perinatal care use.
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Affiliation(s)
| | | | | | | | - Neel Shah
- Maven Clinic, New York, NY, United States
- Harvard Medical School, Boston, MA, United States
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Alex Peahl
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
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Modde Epstein C, Houfek JF, Jones LP. Deep health: A qualitative, woman-centered perspective of health during pregnancy. Midwifery 2023; 120:103628. [PMID: 36870255 PMCID: PMC10111285 DOI: 10.1016/j.midw.2023.103628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/09/2022] [Accepted: 02/05/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE To explore and define a woman-centered perspective on health during pregnancy. DESIGN Qualitative study using abductive thematic analysis of semi-structured interview data. SETTING & PARTICIPANTS Twenty pregnant participants, primarily single and low-income, were recruited from an urban women's health clinic in the Midwestern United States and interviewed during mid-to-late pregnancy. FINDINGS Women experienced health as "deeper than physical health" to include emotional well-being, financial stability, and support. We defined the central theme of Deep Health to be an embodied sense of happiness, energy, stability, and purpose (Being) supported through positive health practices (Doing) and adequate financial and social resources (Having). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE While the Doing aspects of health are often a focal point for health promotion efforts in prenatal care, a restricted focus on lifestyle behaviors may contribute to a lack of shared understanding about health between women and their healthcare providers. Greater attention to the Being and Having aspects of health may work to bolster shared priorities for health between pregnant women and their providers.
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Affiliation(s)
- Crystal Modde Epstein
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, United States; School of Nursing, University of North Carolina Greensboro, 1007 Walker Avenue, Greensboro, NC 27412, United States.
| | - Julia F Houfek
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, United States
| | - Lawrency P Jones
- School of Nursing, University of North Carolina Greensboro, 1007 Walker Avenue, Greensboro, NC 27412, United States
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Chen S, Yue W, Han X, Luo J, Na L, Yang M. An integrative review on the maternal health literacy among maternal and child workers. J Nurs Manag 2022; 30:4533-4548. [PMID: 36190727 DOI: 10.1111/jonm.13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 12/30/2022]
Abstract
AIMS This study aim to capture the most comprehensive evidence-based dimensions of maternal health literacy, including summarizing the definitions, theoretical frameworks, measuring instruments, and the association between maternal health literacy and health behaviours. BACKGROUND Maternal health literacy has been recognized as an important approach to achieving high-quality maternal and child health; however, little is known about maternal health literacy comprehensively and scientifically. EVALUATION An integrative review retrieved articles from 11 databases, following the methodology of Whittemore and Knafl. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. KEY ISSUES A total of 5580 articles were retrieved and 23 articles were finally identified. Existing definitions and theoretical frameworks took less consideration of maternal applicability and failed to summarize maternal health literacy from a dynamic and systematic perspective. Measurement instruments were set up with many items that make it difficult to quickly screen for poor maternal health literacy. Most articles proved the association between maternal health literacy and health behaviours through correlation analysis or regression analysis but less explored the influence pathways between them. CONCLUSION The definition and theoretical framework need to focus on maternal applicability and explain the process of individual mothers acquiring and understanding health knowledge and skills from a dynamic and systematic perspective. A rapid instrument for maternal health literacy should be developed and high-quality empirical research was conducted to understand the associated mechanisms between maternal health literacy and health behaviours. IMPLICATIONS FOR NURSING MANAGEMENT It is necessary to strengthen maternal and child health education of primary health care nurses and enhance their ability to help perinatal women use maternal and child health information effectively.
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Affiliation(s)
- Shanxia Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Yue
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Xinrui Han
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianghe Luo
- Department of Gynecology and Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Liu Na
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming Yang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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10
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Muscat DM, McCaffery K. Advancing interventional health literacy research through more transparent reporting. PATIENT EDUCATION AND COUNSELING 2022; 105:2997-2998. [PMID: 35963744 DOI: 10.1016/j.pec.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Danielle M Muscat
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.
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Gourounti K, Sarantaki A, Dafnou ME, Hadjigeorgiou E, Lykeridou A, Middleton N. A qualitative study of assessing learning needs and digital health literacy in pregnancy: Baby Buddy Forward Greek findings. Eur J Midwifery 2022; 6:55. [PMID: 36119404 PMCID: PMC9434499 DOI: 10.18332/ejm/150770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 06/04/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The purpose of this study was to explore the learning needs and the digital health literacy of pregnant women in Greece regarding perinatal health and care issues. METHODS This was a qualitative study involving thirteen Greek pregnant women, in two focus groups of primiparous and multiparous. The interview topic guide was developed by consensus during a training workshop of the European Baby Buddy Forward research program. The interviews were recorded, transcribed and inductively content analyzed. RESULTS Pregnant women described a range of learning needs and identify antenatal classes, health professionals, Internet, books, friends and relatives, as their main sources of information. Women expressed satisfaction in terms of their communication with midwives, but they expressed ambiguity regarding communication with doctors. With regard to the Internet, women highlighted their concern about the validity of information and point out the difficulties they face in order to access reliable scientific resources. Moreover, the process of seeking information online occurs in parallel and independently from healthcare providers, who discourage it, thus, many women were reluctant to discuss any information they retrieved from the Internet with health professionals. CONCLUSIONS The content of antenatal classes should be tailored to address pregnant women learning needs more holistically. However, taking into consideration that a major source of information for pregnant women is the Internet, it is vital for health professionals to acknowledge this reality and provide pregnant women with trusted websites. It is also particularly important for health professionals to practice their communication skills and update their digital knowledge.
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Affiliation(s)
- Kleanthi Gourounti
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Antigoni Sarantaki
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Maria-Eleni Dafnou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Eleni Hadjigeorgiou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Aikaterini Lykeridou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Nicos Middleton
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Evaluation of the effectiveness of a health literacy education program during the pandemic. MARMARA MEDICAL JOURNAL 2022. [DOI: 10.5472/marumj.1121841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nawabi F, Krebs F, Lorenz L, Shukri A, Alayli A, Stock S. Health Literacy among Pregnant Women in a Lifestyle Intervention Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5808. [PMID: 35627343 PMCID: PMC9141630 DOI: 10.3390/ijerph19105808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Health literacy plays a crucial role during pregnancy, influencing the mother's health behavior which in turn affects the unborn child's health. To date, there are only few studies that report on health literacy among pregnant women or even interventions to promote health literacy. GeMuKi (acronym for "Gemeinsam Gesund: Vorsorge plus für Mutter und Kind"-Strengthening health promotion: enhanced check-up visits for mother and child) is a cluster-randomized controlled trial, aimed at improving health literacy in pregnant women by means of a lifestyle intervention in the form of brief counseling. The women in the intervention group receive counseling on lifestyle topics, such as nutrition and physical activity, during their regular prenatal check-ups. The counseling is tailored to the needs of pregnant women. Demographic data is collected at baseline using a paper-based questionnaire. Data on health literacy is collected using the Health Literacy Survey Europe with 16 items (HLS-EU-16) at baseline and the Brief Health Literacy Screener (BHLS) questionnaire at two points during the pregnancy by means of an app, which was developed specifically for the purpose of the project. The results of the study indicate that around 61.9% of the women participating in the GeMuKi study have an adequate level of health literacy at baseline. The regression analyses (general estimating equations) showed no significant effect of the GeMuKi intervention on general health literacy as measured by the BHLS (ß = 0.086, 95% CI [-0.016-0.187]). However, the intervention was significantly positively associated with pregnancy specific knowledge on lifestyle (ß = 0.089, 95% CI [0.024-0.154]). The results of this study indicate that GeMuKi was effective in improving specific pregnancy related knowledge, but did not improve general health literacy.
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Affiliation(s)
- Farah Nawabi
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Cologne, Germany; (F.K.); (L.L.); (A.S.); (A.A.); (S.S.)
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Tavananezhad N, Bolbanabad AM, Ghelichkhani F, Effati-Daryani F, Mirghafourvand M. The relationship between health literacy and empowerment in pregnant women: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:351. [PMID: 35459098 PMCID: PMC9447403 DOI: 10.1186/s12884-022-04686-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/18/2022] [Indexed: 11/15/2022] Open
Abstract
Background Maternal health literacy is defined as the acquisition of required cognitive and social skills to enable women to access, understand, appraise, and use the information needed to maintain and enhance their health conditions. The World Health Organization (WHO) proposes health literacy and women empowerment as two pivotal components of maternal health improvement programs. In this regard, providing women with education and training in various fields is a key factor for their empowerment, prosperity, and well-being. Therefore, the present study aimed to determine the relationship between health literacy and empowerment during pregnancy. Methods This descriptive-analytical cross-sectional study examined 355 pregnant women, presented to different health centers in Sanandaj, Iran, in 2021. The cluster technique was used for sampling. For data collection, the socio-demographic and obstetrics characteristics, health literacy, and pregnant women's empowerment questionnaires were completed by interviewing research subjects. Data analysis was done using t-test, one-way ANOVA, Pearson correlation coefficient, and multivariate linear regression in STATA13. Results The mean and standard deviation of health literacy and empowerment were 80.03 ± 12.79 (0–100) and 80.30 ± 8.14 (27–108), respectively. In terms of empowerment, the highest (19.50) and the lowest (12.92) scores were, respectively, observed in subdomains of “self-efficacy” and “the joy of an addition to the family.” With respect to health literacy, the highest (88.52) and lowest (73.78) mean scores were, respectively, observed in the subdomains of “understanding” and “access.” Pearson correlation test suggested that there was a significant direct correlation between the overall health literacy (r = 0.26; p < 0.001) and access (r = 0.18; p = 0.001), understanding (r = 0.11; p = 0.038), evaluation (r = 0.18; p = 0.001), and decision-making (r = 0.33; p < 0.001) with empowerment during pregnancy. Based on the multivariate linear regression model, empowerment during pregnancy improved with increasing health literacy (B = 0.16, 95% CI = 0.09 to 0.23; p < 0.001). Conclusion The results show a direct relationship between health literacy and its dimensions with empowerment during pregnancy. Therefore, it is recommended to improve the health literacy of all women of reproductive age.
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Affiliation(s)
- Nikta Tavananezhad
- Department of Obstetrics, Islamic Azad University, Sanandaj Branch, Sanandaj, Iran
| | - Amjad Mohamadi Bolbanabad
- Healthcare Services Management, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fatemeh Ghelichkhani
- Department of Midwifery, Imam Sajjad Hospital, Shahriar, Iran University of Medical Sciences, Shahriar, Tehran, Islamic Republic of Iran
| | - Fatemeh Effati-Daryani
- Midwifery Department, Faculty of Nursing and Midwifery, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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The Health Literacy in Pregnancy (HeLP) Program Study Protocol: Development of an Antenatal Care Intervention Using the Ophelia Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084449. [PMID: 35457317 PMCID: PMC9030865 DOI: 10.3390/ijerph19084449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/27/2022] [Accepted: 04/01/2022] [Indexed: 01/21/2023]
Abstract
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.
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Chen S, Yue W, Liu N, Han X, Yang M. The progression on the measurement instruments of maternal health literacy: a scoping review. Midwifery 2022; 109:103308. [DOI: 10.1016/j.midw.2022.103308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 02/10/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
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Yazıcı Topçu T, Aktaş S. An Investigation of the Relationship between Health Literacy Levels of Pregnant Women and Their Perceptions of Traumatic Childbirth. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:195-207. [PMID: 34658298 DOI: 10.1080/19371918.2021.1986450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The researchers aimed to investigate the relationship between the health literacy levels of pregnant women and their perceptions of traumatic childbirth. The sample consisted of 384 pregnant women. The data were collected using the 'Pregnancy Information Form", the "Health Literacy-32 Scale," and the "Traumatic Birth Perception Scale." Health literacy levels of pregnant women were found to be inadequate (44%) and limited (43.5%). 56.8% of pregnant women had moderate, and 27.1% had a high perception of traumatic birth. A negative correlation was determined between the total score and sub-dimensions of the Health Literacy Scale of pregnant women (i.e. access to health information, understanding health information, protection from diseases, and health promotion) and their perceptions of traumatic birth (p < .001).
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Affiliation(s)
- Tuğba Yazıcı Topçu
- Midwife, RM, Newborn Intensive Care Unit, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey
| | - Songül Aktaş
- Midwife, RM, Department of Gynecology and Obstetrics Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
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Aslantekin Özçoban F, Ergün S, Erkal Aksoy Y. Effects of health literacy education on adaptation to pregnancy, self-efficacy, fear of childbirth and health literacy in Turkish pregnant women: A randomized, controlled trial. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e537-e549. [PMID: 34957621 DOI: 10.1111/hsc.13690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/25/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
This research aims to evaluate the effects of health literacy (HL) education on Turkish pregnant women's adaptations to pregnancy, self-efficacy, fear of childbirth and HL levels. This was a randomised, controlled trial. The research was carried out in the Marmara region of Turkey between July 2018 and April 2019. This research was conducted with three groups including one control (n = 73) and two intervention (n = 109) groups. One of the intervention groups was given antenatal education (AE) for improving HL (HL-AE) (n = 53), and the other was provided AE (n = 56) only. A Pregnancy Information Form, Prenatal Self-Evaluation Questionnaire, Fear of Childbirth and The Postpartum Period Scale, General Self-Efficacy Scale and Turkey Health Literacy Scale-32 were used for data collection. Results show that adaptation to pregnancy, general self-efficacy and HL levels significantly improved while fear of childbirth decreased in the group that was provided HL-AE intervention group. Additional when the pre-education and post-education scale scores were compared in the AE group, it was found that there was a significant difference in other scale scores, but not for fear of childbirth.
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Affiliation(s)
| | - Sibel Ergün
- Department of Nursing, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey
| | - Yasemin Erkal Aksoy
- Department of Midwifery, Faculty of Health Sciences, Selcuk University, Konya, Turkey
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Yee LM, Silver R, Haas DM, Parry S, Mercer BM, Wing DA, Reddy U, Saade GR, Simhan H, Grobman WA. Association of Health Literacy Among Nulliparous Individuals and Maternal and Neonatal Outcomes. JAMA Netw Open 2021; 4:e2122576. [PMID: 34468757 PMCID: PMC8411280 DOI: 10.1001/jamanetworkopen.2021.22576] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Health literacy is considered an important social determinant of health that may underlie many health disparities, but it is unclear whether inadequate health literacy among pregnant individuals is associated with adverse maternal and neonatal outcomes. OBJECTIVE To assess the association between maternal health literacy and maternal and neonatal outcomes among nulliparous individuals. DESIGN, SETTING, AND PARTICIPANTS This was a secondary analysis of a large, multicenter cohort study of 10 038 nulliparous individuals in the US (2010-2013). Participants underwent 3 antenatal study visits and had detailed maternal and neonatal data abstracted. Data analysis was performed from July to December 2019. EXPOSURES Between 16 and 21 weeks of gestation, health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine-Short Form, a validated 7-item word recognition test. In accordance with standard scoring, results were dichotomized as inadequate vs adequate health literacy. MAIN OUTCOMES AND MEASURES On the basis of theoretical causal pathways between health literacy and health outcomes, a priori maternal and neonatal outcomes (determined via medical records) were selected for this analysis. Multivariable Poisson regression models were constructed to estimate the associations between health literacy and outcomes. Sensitivity analyses in which education was removed from models and that excluded individuals who spoke English as a second language were performed. RESULTS Of 9341 participants who completed the Rapid Estimate of Adult Literacy in Medicine-Short Form, the mean (SD) age was 27.0 (5.6) years, and 2540 (27.4%) had publicly funded prenatal care. Overall, 1638 participants (17.5%) had scores indicative of inadequate health literacy. Participants with inadequate health literacy were more likely to be younger (mean [SD] age, 22.9 [5.0] vs 27.9 [5.3] years), have less educational attainment (some college education or greater, 1149 participants [73.9%] vs 5279 participants [94.5%]), have publicly funded insurance (1008 participants [62.2%] vs 1532 participants [20.0%]), and report they were a member of an underrepresented racial or ethnic group (non-Hispanic Black, 506 participants [30.9%] vs 780 participants [10.1%]; Hispanic, 516 participants [31.5%] vs 948 participants [12.3%]) compared with those with adequate health literacy. Participants who had inadequate health literacy had greater risk of cesarean delivery (adjusted risk ratio [aRR], 1.11; 95% CI, 1.01-1.23) and major perineal laceration (aRR, 1.44; 95% CI, 1.03-2.01). The adjusted risks of small-for-gestational-age status (aRR, 1.34; 95% CI, 1.14-1.58), low birth weight (aRR, 1.33; 95% CI, 1.07-1.65), and 5-minute Apgar score less than 4 (aRR, 2.78; 95% CI, 1.16-6.65) were greater for neonates born to participants with inadequate health literacy. Sensitivity analyses confirmed these findings. CONCLUSIONS AND RELEVANCE These findings suggest that inadequate maternal health literacy is associated with a variety of adverse maternal and neonatal outcomes.
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Affiliation(s)
- Lynn M. Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Robert Silver
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Utah, Salt Lake City
| | - David M. Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis
| | - Samuel Parry
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Brian M. Mercer
- Department of Obstetrics and Gynecology, The MetroHealth System, Case Western Reserve University, Cleveland, Ohio
| | - Deborah A. Wing
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine
| | - Uma Reddy
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Yale University, New Haven, Connecticut
| | - George R. Saade
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston
| | - Hyagriv Simhan
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - William A. Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Nawabi F, Alayli A, Krebs F, Lorenz L, Shukri A, Bau AM, Stock S. Health literacy among pregnant women in a lifestyle intervention trial: protocol for an explorative study on the role of health literacy in the perinatal health service setting. BMJ Open 2021; 11:e047377. [PMID: 34210730 PMCID: PMC8252873 DOI: 10.1136/bmjopen-2020-047377] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Pregnancy is a vulnerable period that affects long-term health of pregnant women and their unborn infants. Health literacy plays a crucial role in promoting healthy behaviour and thereby maintaining good health. This study explores the role of health literacy in the GeMuKi (acronym for 'Gemeinsam Gesund: Vorsorge plus für Mutter und Kind'-Strengthening health promotion: enhanced check-up visits for mother and child) Project. It will assess the ability of the GeMuKi lifestyle intervention to positively affect health literacy levels through active participation in preventive counselling. The study also explores associations between health literacy, health outcomes, health service use and effectiveness of the intervention. METHODS AND ANALYSIS The GeMuKi trial has a hybrid effectiveness-implementation design and is carried out in routine prenatal health service settings in Germany. Women (n=1860) are recruited by their gynaecologist during routine check-up visits before 12 weeks of gestation. Trained healthcare providers carry out counselling using motivational interviewing techniques to positively affect health literacy and lifestyle-related risk factors. Healthcare providers (gynaecologists and midwives) and women jointly agree on Specific, Measurable, Achievable Reasonable, Time-Bound goals. Women will be invited to fill in questionnaires at two time points (at recruitment and 37th-40th week of gestation) using an app. Health literacy is measured using the German version of the Health Literacy Survey-16 and the Brief Health Literacy Screener. Lifestyle is measured with questions on physical activity, nutrition, alcohol and drug use. Health outcomes of both mother and child, including gestational weight gain (GWG) will be documented at each routine visit. Health service use will be assessed using social health insurance claims data. Data analyses will be conducted using IBM SPSS Statistics, version 26.0. These include descriptive statistics, tests and regression models. A mediation model will be conducted to answer the question whether health behaviour mediates the association between health literacy and GWG. ETHICS AND DISSEMINATION The study was approved by the University Hospital of Cologne Research Ethics Committee (ID: 18-163) and the State Chamber of Physicians in Baden-Wuerttemberg (ID: B-F-2018-100). Study results will be disseminated through (poster) presentations at conferences, publications in peer-reviewed journals and press releases. TRAIL REGISTRATION German Clinical Trials Register (DRKS00013173). Registered pre-results, 3rd of January 2019, https://www.drks.de.
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Affiliation(s)
- Farah Nawabi
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Adrienne Alayli
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Federal Centre for Health Education, Cologne, Germany
| | - Franziska Krebs
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Laura Lorenz
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Arim Shukri
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Bovbjerg ML. Current Resources for Evidence-Based Practice, July 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:485-495. [PMID: 34147485 DOI: 10.1016/j.jogn.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of how fetal monitoring may lead to overuse of birth-related interventions, commentaries on reviews focused on bedsharing, and women's lifetime estrogen exposure and risk of cardiovascular mortality.
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Asadi L, Amiri F, Safinejad H. Investigating the effect of health literacy level on improving the quality of care during pregnancy in pregnant women covered by health centers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:286. [PMID: 33282991 PMCID: PMC7709769 DOI: 10.4103/jehp.jehp_204_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health literacy is the capacity to acquire, process, and understand basic information and services necessary for appropriate health decisions. Given the importance of health literacy in women, the aim of the present study was to determine the effect of health literacy level on improving the quality of care during pregnancy in pregnant women. MATERIALS AND METHODS The present study was a cross-sectional analytical study. In this study, 130 women referred to Yazd health centers were examined. Health literacy questionnaires and a researcher-made checklist of the quality of pregnancy care were used to gather information. The researcher-made checklist of the quality of pregnancy care was in accordance with the standard protocol of the Ministry of Health and Medical Education, entitled Integrated Health Care for Pregnant Mothers, which was validated and reliable. SPSS statistical software version 19 and t-test and ANOVA statistical tests were used to analyze the data. RESULTS According to the findings, the average score of health literacy in pregnant women was 74.09, which showed that the level of health literacy was in the marginal or border range. People with higher health literacy received significantly more prenatal counseling than other women and had a planned pregnancy (P = 0.04). CONCLUSION The level of health literacy in pregnant women is unfavorable. Given that the high level of health literacy in women in society can lead to an increase in the quality of pregnancy care, so to increase health literacy in women, it is recommended that regular training in society by health-care providers be given more attention.
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Affiliation(s)
- Leila Asadi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Midwifery, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Hadise Safinejad
- Midwifery Faculty, Kerman Branch, Islamic Azad University, Kerman, Iran
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Guo S, Yu X, Okan O. Moving Health Literacy Research and Practice towards a Vision of Equity, Precision and Transparency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7650. [PMID: 33092206 PMCID: PMC7589069 DOI: 10.3390/ijerph17207650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
Over the past two decades, health literacy research has gained increasing attention in global health initiatives to reduce health disparities. While it is well-documented that health literacy is associated with health outcomes, most findings are generated from cross-sectional data. Along with the increasing importance of health literacy in policy, there is a lack of specificity and transparency about how to improve health literacy in practice. In this study, we are calling for a shift of current research paradigms from judging health literacy levels towards observing how health literacy skills are developed over the life course and practised in the real world. This includes using a life-course approach, integrating the rationale of precision public health, applying open science practice, and promoting actionable knowledge translation strategies. We show how a greater appreciation for these paradigms promises to advance health literacy research and practice towards an equitable, precise, transparent, and actionable vision.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Xiaoming Yu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China;
| | - Orkan Okan
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany;
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Interventions to Improve Health among Reproductive-Age Women of Low Health Literacy: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207405. [PMID: 33053693 PMCID: PMC7601855 DOI: 10.3390/ijerph17207405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 11/17/2022]
Abstract
Background: Limited or low health literacy (HL) has been associated with poor health outcomes, including inadequate self-caring and preventive behaviors. A few studies have systematically summarized the effect of interventions to improve reproductive health and care in women with insufficient HL. The main objective of the study was to investigate health care promotion interventions and examine their effectiveness on women with inadequate HL through a systematic review of randomized controlled trials (RCT). Methods: RCTs and quasi-experimental studies that assessed HL interventions to improve reproductive health of women with low HL were included. The study protocol was registered with PROSPERO (CRD42020137059). Results: Of the 292 records initially identified, a total of 6 articles were included for review. Five different HL screening tools were used. Four different interventions were included: educational intervention, communication skills, a multimedia interactive tool, and text adaptation to enhance reading comprehension. Not enough research practice has been conducted on the influence of interventions on HL, and thus, it is difficult to implement evidence-based interventions. Conclusions: Interventions aiming to benefit and improve HL should consider the complex web of intersectional determinants that end up shaping the opportunities of women to make optimal decisions regarding their health and care, and which may require attention to much more than clinical or service delivery factors.
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