What About Mom? Health Literacy and Maternal Mortality

Using the teach-back method to improve postpartum maternal-infant health among women with limited maternal health literacy: a randomized controlled study

AIM

This study aimed to evaluate the effects of using the teach-back method among women with limited maternal health literacy (LMHL) on maternal health literacy(MHL), postpartum health behaviours and maternal-infant health outcomes.

METHODS

A randomized controlled study was conducted in the obstetrics department of Anhui Provincial Hospital, China. A total of 258 pregnant women with LMHL were recruited at the point of admission to the hospital for birth and randomly assigned to the control group (n = 130), where women received routine education sessions, and the teach-back group (n = 128), where women received routine education sessions plus a teach-back intervention. The two groups were assessed in terms of MHL before and after the intervention, breastfeeding execution, uptake of 42-day postpartum check-ups, complete uptake of one-time recommended vaccines, and physical health outcomes. Statistical tests were employed for data analysis.

RESULTS

There was no significant difference between the two groups in terms of MHL and other social, demographic, and medical status at baseline. After the intervention, the teach-back group had a higher level of MHL (p < 0.001), better postpartum health behaviours in terms of exclusive breastfeeding within 24 hours postpartum (x² = 22.853, p<0.001), exclusive breastfeeding within 42 days postpartum (x² = 47.735, p<0.001), uptake of 42-day postpartum check-ups (x² = 9.050, p = 0.003) and vaccination (x² = 5.586, p = 0.018) and better maternal-infant health outcomes in terms of the incidence of subinvolution of the uterus (x² = 6.499, p = 0.011), acute mastitis (x² = 4.884, p = 0.027), postpartum constipation (x² = 5.986, p = 0.014), overweight (x² = 4.531, p = 0.033) and diaper dermatitis (x² = 10.896, p = 0.001).

CONCLUSIONS

This study shows that the teach-back method is effective for enhancing MHL, leading to positive postpartum health behaviours, and improving postpartum maternal-infant health outcomes among women with LMHL. The teach-back method may play an important role in improving postpartum maternal-infant health and could be considered in maternal health education.

TRIAL REGISTRATION NUMBER

Our trial has been prospectively registered at ClinicalTrials.gov (Ref. No.: NCT04858945) and the enrollment date was 26/04/2021.

Maternal Warning Signs Education During Home Visiting: Results from a Formative Evaluation in Maryland

Background:

Maternal mortality rate reviews have identified the need for improved patient education regarding the warning signs of maternal complications to reduce preventable deaths. Maternal and child home visiting programs have the potential to deliver this education in communities.

Aims:

This study sought to evaluate the baseline provision of warning signs education among home visiting programs in Maryland and to assess the acceptability of and preferences for warning signs education materials among program staff.

Materials and Methods:

This sequential exploratory, mixed-methods study included qualitative interviews and focus group discussions followed by a web-based survey of all home visiting programs providing early postpartum visits in Maryland.

Results:

Twenty-five home visiting program staff took part in qualitative data collection, and survey responses were submitted by a manager from 40 of 58 eligible home visiting programs (69% response rate). All survey respondents agreed that home visiting programs should provide warning signs education and more than 80% of programs provided some warning signs education during pregnancy and the postpartum period. Printed pamphlets were provided by 68% of programs for pregnancy complications and 43% for postpartum complications. Only 33% of respondents were satisfied with their existing warnings signs education materials; 98% were interested in new illustrated pamphlets and 88% were interested in education videos. Qualitative participants considered pamphlets with simple designs, limited text, and visuals, as the most accessible for home visiting clients.

Conclusions:

There are opportunities to strengthen and expand warning signs education in Maryland through home visiting programs using new printed and video education materials.

Accessibility of web-based health information for women in midlife from culturally and linguistically diverse backgrounds or with low health literacy

OBJECTIVE

To measure the accessibility of Australian web-based health information for midlife women including those from culturally and linguistically diverse (CALD) backgrounds or with low health literacy.

METHODS

Search terms relating to midlife health were entered into Google Australia to identify health information websites. The content of the first two results pages was assessed using the European Commission's quality criteria for health websites. Readability was assessed using the Flesch Readability Ease Score with Grade 8 accepted as the average Australian reading level.

RESULTS

Sixteen websites were evaluated. Accessibility scores ranged between 0 and 8. The Victorian Government's health website Better Health Channel and the Jean Hailes for Women's Health website contained the most accessible information, each scoring 8, but were both 'difficult to read' on the readability test. Four websites included written resources in languages other than English and two had information in audio-visual format in languages other than English.

CONCLUSIONS

There is a gap in accessible online health information for Australian women from CALD backgrounds or those with low health literacy. Implications for public health: Healthy behaviour changes in midlife may lead to better health in older age. More accessible health information resources are needed for women in midlife from CALD backgrounds and those with low health literacy.

Change in maternal intention and perception about postpartum care after provision a leaflet media in Bau Bau City

OBJECTIVE

Postpartum is the riskiest period of the pregnancy process. Treatment at this stage must be carried out until the puerperium is complete. Provision of health education about childbirth care is needed to improve maternal behavior, including through the provision of leaflets. This study aims to assess changes in maternal intentions and perceptions in postpartum care after giving leaflets. This research uses a quasi-experiment with One Group Time Series design. The study population was all pregnant women who examined their pregnancies from September to February 2019, totaling 131 pregnant women. The sample was determined using a purposive sampling method with 26 mothers selected. Data analysis using the Wilcoxon test and paired t-test.

RESULTS

Intention and perception of maternal were change after giving leaflets. An increase can see the value of measurements (p=0.019) of intentions and attitudes in pretest 2 to post-test 1. The repeated analysis of the first pretest for the third post-test also shows an increase in the measurement value (p=0.000) toward the intention and perception after giving the leaflet.

CONCLUSIONS

There was a change in intention and positive perception and lasts a long time in pregnant women before and after the provision of leaflets about postpartum care. Changes in plans and positive opinions are significant in pregnant women with age groups 20-35 years and advanced education level. It is recommended that providers at the health center use leaflets as a companion to the Maternal and Child Health Book to educate pregnant women about postpartum care to improve maternal intentions and perceptions.