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Lu Y, Fu X, Xu L, Lu J. Knowledge, attitudes, and perceptions of influenza vaccine among pregnant women in Minhang District, Shanghai. Hum Vaccin Immunother 2024; 20:2368944. [PMID: 38932738 PMCID: PMC11212563 DOI: 10.1080/21645515.2024.2368944] [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: 04/30/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey was conducted among pregnant women receiving prenatal care at various medical institutions in Minhang District, Shanghai, from March to June 2023. The survey included inquiries about demographic information, knowledge, and perception of influenza disease and influenza vaccine. Logistic regression models and chi-square tests were used to analyze the data. 6.9% (78/1125) of participants considered receiving the influenza vaccine during pregnancy. Participants with graduate education or above (OR = 4.632, 95%CI: 1.046-20.517), non-office workers (OR = 2.784, 95%CI: 1.560-4.970), and participants whose spouses were not office workers (OR = 0.518, 95% CI: 0.294-0.913) were significantly associated with high intent to vaccinate. Participants with superior knowledge (>30 points) exhibited greater willingness (p < .001). Participants who viewed post-influenza symptoms as mild had a significantly lower willingness to vaccinate during pregnancy (2.3%), compared to those who disagreed (p = .015). Conversely, those recognizing a heightened risk of hospitalization due to respiratory diseases in pregnant women post-influenza were significantly more inclined to vaccinate during pregnancy (8.8%) (p = .007). Participants recognizing benefits uniformly expressed willingness to receive the influenza vaccine during pregnancy (p < .001), while those perceiving barriers uniformly rejected vaccination (p < .001). Higher education, non-office worker status, and having an office worker spouse correlate with greater willingness to receive the influenza vaccine during pregnancy. Enhanced knowledge and accurate perceptions of influenza and its vaccine influenced willingness. Accumulating knowledge about influenza and its vaccine fosters accurate perceptions. Notably, overall willingness to vaccinate during pregnancy remains low, likely due to safety concerns, and lack of accurate perceptions. Targeted health education, improved communication between healthcare providers and pregnant women, and campaigns highlighting vaccine benefits for mothers and children are essential.
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Affiliation(s)
- Yan Lu
- Prevention and Health Department, Xinzhuang Community Health Service Center, Shanghai, China
| | - Xiaoya Fu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Ling Xu
- Obstetrics and Gynecology, Minhang District Central Hospital, Shanghai, China
| | - Jia Lu
- Comprehensive Prevention and Control Office, Minhang District Center for Disease Control and Prevention, Shanghai, China
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Sakai H, Kawata R, Adhikari R, Thapa YO, Bhandari TR. Effectiveness of art-based health education on anemia and health literacy among pregnant women in Western Nepal: A randomized controlled trial. PLoS One 2024; 19:e0281789. [PMID: 39348362 PMCID: PMC11441646 DOI: 10.1371/journal.pone.0281789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/12/2024] [Indexed: 10/02/2024] Open
Abstract
OBJECTIVE As Nepalese pregnant women vary widely in literacy levels and cultural backgrounds and are reluctant to make decisions about their health, general interventions are insufficient to improve maternal anemia. This study aimed to assess the effectiveness of "face-to-face health education using educational material created using pictures, photos, and nomograms" in reducing anemia and improving health literacy. METHODS A total of 156 Nepalese pregnant women with hemoglobin (Hb) levels below 11.0 g/dl were divided into three groups: the education group received three sessions of face-to-face health education using art-based material unaffected by literacy skills; the distribution group received material used in the education group; and the control group underwent general perinatal checkups. Hb levels and health literacy scores were assessed at baseline early pregnancy (8-12 weeks) and late pregnancy (36-40 weeks). A Nepalese version of the 14-item Health Literacy Scale (HLS-14) was developed to assess health literacy. RESULTS The post-intervention three-group comparison showed a statistically significant difference (P < 0.042) in mean Hb levels after the intervention. Dunnett's test showed a statistically significant difference (P < 0.044) between the education and control groups but no significant difference between the distribution and control groups (P = 0.972). No significant differences in health literacy (total scores and subscales) were observed among the three groups before the intervention in the Kruskal-Wallis test and after the intervention (although there was a trend towards improvement). Total health literacy scores before and after the intervention were statistically significantly different for the total group and all three groups (P<0.001). Only the education group showed statistically significant differences in functional (P<0.012), communication (P<0.004), and critical (P<0.014) literacy subscale scores. CONCLUSION Continuous face-to-face health education using literacy material significantly reduced anemia and improved health literacy among Nepalese pregnant women. TRIAL REGISTRATION UMIN Clinical Trials Registry (UMIN-CTR), URL: https://www.umin.ac.jp/ctr/ (Registration number: UMIN000049603).
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Affiliation(s)
- Hiroko Sakai
- Faculty of Nursing, Graduate School of Nursing, Kansai Medical University, Hirakata, Japan
| | - Rina Kawata
- Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Rajesh Adhikari
- Gynaecology Department of Pokhara Academy of Health Sciences, Pokhara, Nepal
| | - Yoko Oda Thapa
- Action Research for Community Health International, Damauli, Nepal
| | - Tulsi Ram Bhandari
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
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Tafti SP, Azarshab A, Mahmoudian RA, Khayami R, Abadi RNS, Ahmadi-Simab S, Shahidsales S, Vakilzadeh MM. Predictors of tobacco use among pregnant women: a large-scale, retrospective study. BMC Public Health 2024; 24:2544. [PMID: 39294628 PMCID: PMC11411856 DOI: 10.1186/s12889-024-20094-8] [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: 06/28/2024] [Accepted: 09/16/2024] [Indexed: 09/21/2024] Open
Abstract
OBJECTIVE To investigate the predictors of smoking among pregnant women in Iran, focusing on health literacy and associated socioeconomic factors. METHODS This retrospective cohort study included 103,042 pregnant women aged 18-45 years who attended healthcare centers affiliated with Mashhad University of Medical Sciences for routine prenatal and postnatal checkups between 2017 and 2020. Data were collected from the Sina Electronic Health Record System (SinaEHR®), which recorded sociodemographic characteristics, medical history, and lifestyle behaviors, including tobacco use. RESULTS Smoking prevalence was 0.9%. Women with undergraduate or higher education had significantly lower odds of smoking (OR = 0.36; 95% CI = 0.28-0.47) compared to those with primary education or less. Maternal age was marginally associated with increased smoking risk (OR = 1.01; 95% CI = 1.00-1.03). While unemployment showed an increased crude risk for smoking, this was not significant after adjustment (adjusted OR = 1.02; 95% CI = 0.86-1.21). Strong associations were found between tobacco use and alcohol consumption (OR = 46.3; 95% CI = 24.8-83.4) and opium addiction (OR = 23.4; 95% CI = 14.5-36.3). Chronic disease history also increased smoking odds (OR = 1.51; 95% CI = 1.17-1.92). CONCLUSION Lower education, substance use, and chronic disease are significant predictors of smoking among pregnant women in Iran. Targeted interventions to improve health literacy and address these factors are essential to reduce tobacco use during pregnancy.
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Affiliation(s)
| | - Adele Azarshab
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Reza Khayami
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Nejad Shahrokh Abadi
- Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Abdi KA, M. K. J, Adem M. The nexus between poverty and maternal healthcare utilization with a focus on antenatal care visits and choice of place of birth in Somaliland. Front Public Health 2024; 12:1417883. [PMID: 39377007 PMCID: PMC11457695 DOI: 10.3389/fpubh.2024.1417883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/19/2024] [Indexed: 10/09/2024] Open
Abstract
Introduction Poverty poses a significant barrier to accessing healthcare globally, particularly in relation to antenatal care (ANC) visits and the use of childbirth facilities, both of which are crucial for women's health and fetal well-being. In Somaliland, only 47% of pregnant women attend healthcare facilities for ANC, with a mere 33% receiving care from skilled birth attendants. Despite this, no previous studies have examined the relationship between poverty and maternal healthcare utilization in Somaliland. This study aims to investigate the effect of poverty on maternal healthcare utilization with focus on ANC visits and the choice of place of birth in Somaliland. Method Utilizing data from the 2020 Somaliland Demographic Health Survey, a cross-sectional study design was employed, analyzing a nationally representative sample. The sample size used in this study was 3,183 women of reproductive age. Descriptive analysis, negative binomial regression, and multinomial logistic regression were conducted using Stata version 18.0. Diagnostic tests, including Chi-square - 2log likelihood statistic, Akaike Information Criterion, and Bayesian Information Criterion, were employed to evaluate model fit. Results Poverty, as indicated by wealth quintile, was associated with reduced ANC visits (adjusted incidence rate ratio (aIRR) = 0.884, 95% CI: 0.791-0.987) among women in poorer households compared to those in richer households. Women in Togdheer, Sool, and Sanaag regions had lower ANC visit rates compared to Maroodi Jeex region (aIRR = 0.803, 95% CI: 0.687-0.939; aIRR = 0.710, 95% CI: 0.601-0.839; aIRR = 0.654, 95% CI: 0.558-0.768, respectively). Women from poorer households had lower probabilities of opting for public health facilities (adjusted relative risk ratio (aRRR) = 0.457, 95% CI: 0.352-0.593) and private health facilities (aRRR = 0.195, 95% CI: 0.111-0.341) over home births compared to women in richer households. Women in Togdheer, Sool, and Sanaag regions had lower probabilities of choosing public (aRRR range: 0.331-0.175) and private (aRRR range: 0.350-0.084) health facilities for delivery over home births compared to women in Maroodi Jeex region. Conclusion Poverty significantly impedes maternal healthcare utilization, contributing to lower ANC attendance and preference for home births over public or private health facility births. Addressing these disparities requires initiatives to eliminate financial barriers, such as user fees, and enhance equitable access through community-based health insurance and improved healthcare infrastructure.
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Affiliation(s)
- Khalid Ahmed Abdi
- Department of Economics, College of Business and Economics, Bahir Dar University, Bahir Dar, Ethiopia
| | - Jayamohan M. K.
- College of Business and Economics, Jimma University, Jimma, Ethiopia
| | - Mohammed Adem
- Department of Economics, College of Business and Economics, Bahir Dar University, Bahir Dar, Ethiopia
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Pawellek M, Köninger A, Melter M, Kabesch M, Apfelbacher C, Brandstetter S. Effect of mothers' health literacy on early childhood allergy prevention behaviours: results from the KUNO-Kids health study. BMC Public Health 2024; 24:2420. [PMID: 39237956 PMCID: PMC11375835 DOI: 10.1186/s12889-024-19906-8] [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: 05/16/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Parents can engage in several behaviours with regard to early childhood allergy prevention (ECAP). These can be related to diet of mother/child and the modification of the home environment; not all of them are justified by current evidence. Previous studies showed that parental health literacy (HL) is related to favourable health behaviours directed at the child. This study aimed to investigate the causal effect of mothers' HL on ECAP behaviours and to test different moderators of this effect. METHODS One thousand six hundred sixty-two mothers participating in the KUNO-Kids health study in the area of Regensburg, Germany were surveyed on HL (assessed via the health care scale of the Health Literacy Survey-EU questionnaire, HLS-EU-Q47) and ECAP behaviours implemented during pregnancy and the child's first year of life. Patterns in ECAP behaviours were identified by latent class analysis. Multinomial regression modelling was performed with HL as exposure, ECAP as outcome variable, allergy risk, parental competence and bonding, anxiety and depression as moderators as well as potentially confounding variables. RESULTS We identified three classes of ECAP behaviours (class 1: "breastfeeding " N = 871; class 2: "allergen-avoidance " N = 490; class 3: "mixed behaviours " N = 301). In univariable as well as fully adjusted regression models, compared to class 1, class 2 was negatively, and class 3 was not associated with HL. None of the tested moderating variables altered the association between HL and ECAP significantly. CONCLUSIONS We found an effect of mothers' HL on ECAP behaviours: lower HL of mothers increased allergen-avoiding behaviour directed at their child, while decreasing the chance of exclusive breastfeeding. Improving HL could contribute to the implementation of recommended ECAP behaviours in families, especially to the reduction of allergen-avoiding behaviours.
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Affiliation(s)
- Maja Pawellek
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany.
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.
| | - Angela Köninger
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
- University Clinic of Gynecology and Obstetrics, Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Michael Melter
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Michael Kabesch
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Christian Apfelbacher
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
- Institute of Social Medicine and Health Systems Research, Otto Von Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
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Kim J, Heazell AEP, Whittaker M, Stacey T, Watson K. Impact of health literacy on pregnancy outcomes in socioeconomically disadvantaged and ethnic minority populations: A scoping review. Int J Gynaecol Obstet 2024. [PMID: 39175268 DOI: 10.1002/ijgo.15852] [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: 05/14/2024] [Revised: 07/23/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Health literacy, influenced by sociodemographic characteristics such as ethnicity, economic means and societal factors, affects the ways in which pregnant women maintain their health; this in turn may increase risk of adverse pregnancy outcomes. OBJECTIVE To explore what is known about the impact of personal health literacy on prevention of stillbirth and related adverse outcomes in pregnant women of low socioeconomic status or from ethnic minority backgrounds. SEARCH STRATEGY MEDLINE, CINAHL, PsychINFO, and CENTRAL were searched as well as reference lists of included studies and gray literature. SELECTION CRITERIA Included studies focused on personal health literacy and stillbirth prevention in women from low socioeconomic or ethnic minority backgrounds in the perinatal period. DATA COLLECTION AND ANALYSIS A meta-summary approach was adopted for qualitative, observational, descriptive, and audit studies. Findings of intervention studies were extracted, and meta-analyses were conducted where possible. The primary outcome was stillbirth; maternal mortality and neonatal mortality were secondary outcomes. MAIN RESULTS Forty-one studies were included from diverse geographical settings. The meta-summary synthesized five abstracted statements. These recognized lower personal health literacy and greater difficulty interacting with healthcare services in the studied populations, primarily as the result of limited health knowledge, lack of positive perception towards health services, language barriers, illiteracy, and relying on friends or family members for health information. Meta-analysis of intervention studies revealed no association between current interventions that aimed to increase personal health literacy and the risk of stillbirth (relative risk [RR] 1.04, 95% confidence interval [CI] 0.96-1.12), neonatal mortality (RR 0.88, 95% CI 0.75-1.03), and maternal mortality (RR 0.87, 95% CI 0.63-1.22). CONCLUSIONS Various factors suggest lower personal health literacy in women of low socioeconomic status or ethnic minority, which can increase the risk of stillbirth. However, this review identified no significant impact of current health education interventions on the risk of stillbirth, or neonatal or maternal mortality. Although not directly measured, the health education interventions were anticipated to increase personal health literacy. Further research on the topic of this scoping review is warranted, particularly in lower-resource settings and regarding the potential role of e-literacy and organizational health literacy to improve pregnancy outcomes. To address deficits in health literacy, efforts must be made to provide pregnant women with health information in novel, accessible ways.
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Affiliation(s)
- Jiwon Kim
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Alexander E P Heazell
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Maya Whittaker
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tomasina Stacey
- Faculty of Nursing Midwifery and Palliative Care, King's College London, London, UK
| | - Kylie Watson
- Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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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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Ningrum EW, Lusmilasari L, Huriyati E, Marthias T, Hasanbasri M. Improving maternal health literacy among low-income pregnant women: A systematic review. NARRA J 2024; 4:e886. [PMID: 39280277 PMCID: PMC11391996 DOI: 10.52225/narra.v4i2.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 08/06/2024] [Indexed: 09/18/2024]
Abstract
Previous studies on maternal health have highlighted the need to improve health literacy, particularly among women from lower socioeconomic backgrounds. Some crucial factors for improving maternal health literacy are midwife capacity and systems support that can help ensure women's ability and motivation to access timely health services. However, the extent of roles midwives need and the system that must be developed require further elaboration. The aim of this systematic review was to investigate approaches for enhancing maternal health literacy in low-income pregnant women. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic search was conducted on two databases: PubMed and ScienceDirect. All English articles published from 2011 to 2023 were searched using the keywords pregnant, antenatal, prenatal, perinatal, midwife, health literacy, midwife-led care, helpline, and photo novel. Of the 1,539 articles, 15 were included in the final assessment. The results suggested that improving maternal health literacy among low-income pregnant women was related to: (a) empowering low-income women; (b) empowering midwives as frontline care providers engaging with low-income pregnant women; and (c) empowering the health care system as a health literacy organization. In conclusion, improving the healthcare system and strengthening midwives' leadership as proximal caregivers is crucial for improving maternal health literacy among low-income pregnant mothers. These efforts could be realized with support from government roles, educational institutions, and professional associations.
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Affiliation(s)
- Ema W Ningrum
- Doctoral Program in Medical and Health Science, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Nursing Study Program, Faculty of Health, Universitas Harapan Bangsa, Purwokerto, Indonesia
| | - Lely Lusmilasari
- Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Emy Huriyati
- Department of Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tiara Marthias
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
| | - Mubasysyir Hasanbasri
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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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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Melwani S, Cleland V, Patterson K, Nash R. Health literacy and non-communicable disease knowledge of pregnant women and mothers in Tasmania: Qualitative exploration. Health Promot J Austr 2024. [PMID: 39020439 DOI: 10.1002/hpja.902] [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: 03/03/2023] [Revised: 06/11/2024] [Accepted: 06/29/2024] [Indexed: 07/19/2024] Open
Abstract
ISSUE ADDRESSED The World Health Organisation is prioritising health literacy development to address the growing burden of non-communicable diseases (NCDs). Empowering pregnant women and mothers through health literacy development may help to reduce the intergenerational impact of NCDs. However, significant gaps exist in understanding the health literacy needs of this priority population globally. METHODS This study aimed to qualitatively explore the health literacy strengths and challenges as well as NCDs knowledge and beliefs of pregnant women and mothers with young children (0-8 years) in Tasmania. Data were collected online using in-depth semi-structured interviews and analysed inductively using reflexive thematic analysis. RESULTS Twenty women (mean age 35.5 years, standard deviation 5.13) participated. Four parent themes were generated from the data: perceived knowledge and awareness of NCDs and their causative factors; social determinants of health and the surrounding environment; social networks and peer support as health navigator; and trust in health services and social connections. These themes highlighted diverse factors that influenced the participant's access and use of health information and services and their engagement in healthy lifestyle practices and active health management. CONCLUSION Participants demonstrated good knowledge and awareness about NCDs and associated risk factors but experienced numerous health literacy strengths and challenges which influenced their access to health care and engagement in healthy lifestyle practices. SO WHAT This study highlights the need to address the diverse health literacy needs of pregnant women and mothers through codesigning locally informed health literacy development strategies combined with the creation of enabling service environments to reduce the growing burden of NCDs.
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Affiliation(s)
- Satish Melwani
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kira Patterson
- School of Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Rosie Nash
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Krämer M, Wohlhüter L, Hermeling L, Koetsenruijter J, Kamradt M, Wensing M, Bombana M. A counselling intervention for individual strategies to prevent complications and strengthen resources during pregnancy in gynaecological care (AOK-Family +): study protocol for a cluster-randomised controlled trial. Trials 2024; 25:393. [PMID: 38890726 PMCID: PMC11186123 DOI: 10.1186/s13063-024-08215-5] [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: 06/30/2023] [Accepted: 05/31/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Lifestyle-related risk factors can increase complications during pregnancy and negatively impact the health of a mother and her child. Knowledge about these compliances among many pregnant women and women of childbearing age is lacking. In the study AOK-Family + , we propose the evaluation of a newly developed counselling intervention. The intervention aims to raise awareness and to provide relevant information about the impact of lifestyle-related risk factors during pregnancy. The aim of the proposed study is to evaluate the effect of this counselling intervention on women's knowledge of lifestyle-related risk factors during pregnancy and the concomitant healthy behaviours. METHODS A cluster-randomised trial with three arms in Baden-Wuerttemberg, Germany, is proposed. Pregnant women and women of childbearing age will be allocated to one of three groups: online intervention, on-site intervention, or a waiting-list control. Trained counsellors from AOK Baden-Wuerttemberg, a German statutory health insurer, will conduct the counselling sessions. Data collection is conducted throughout validated questionnaires administered at three intervals: before counselling (t0), directly after counselling (t1), and at a 6-week follow-up (t2). The primary outcomes will be health knowledge and healthy behaviours relating to LRFFs during pregnancy. A process evaluation will examine the processes, used resources, and future implementations through additional quantitative questions and qualitative interviews and focus groups. DISCUSSION Based on this study, an implementation strategy for future conduction of lifestyle consultation during pregnancy could be developed with the aim of reducing pre- and post-mortem mobility and mortality. TRIAL REGISTRATION The German Clinical Trials Register DRKS00027804. Registered on 2022/01/12.
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Affiliation(s)
- Mareike Krämer
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany
| | - Laura Wohlhüter
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany
| | - Lina Hermeling
- Department of Health Promotion, AOK Baden-Wuerttemberg, Presselstrasse 19, Stuttgart, 70191, Germany
| | - Jan Koetsenruijter
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany
| | - Martina Kamradt
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany
| | - Michel Wensing
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany
| | - Manuela Bombana
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany.
- Department of Health Promotion, AOK Baden-Wuerttemberg, Presselstrasse 19, Stuttgart, 70191, Germany.
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12
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Mohammed H, Abebe D, Yetwale F, Mekuannint W, Mesfin S. Knowledge and utilization of iodized salt among expectant mothers in Harar City's public health facilities: a multicenter study in Eastern Ethiopia. Int Health 2024:ihae045. [PMID: 38881408 DOI: 10.1093/inthealth/ihae045] [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: 01/04/2024] [Revised: 04/30/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Insufficient iodine intake during pregnancy can result in abortion, stillbirths, neonatal mortality, cretinism and permanent cognitive impairment. Even although iodized salt is widely accessible in Ethiopia, pregnant women still experience persistent problems related to iodine deficiency disorders. METHODS A facility-based cross-sectional study was conducted among randomly selected 573 pregnant women who were attending antenatal care services at public health facilities. Bivariate and multivariable logistic regression models were used, and independent predictors were determined based on adjusted ORs with 95% CIs and p<0.05. RESULTS Knowledge and practice of pregnant women on iodized utilization were 35.6% (95% CI 31.8 to 39.6%) and 37.7% (95% CI 32.1 to 42.9%), respectively. Living in urban areas (adjusted OR [AOR]=1.976, 95% CI 1.136 to 3.435) and having a higher level of education (AOR=2.018, 95% CI 1.037 to 3.930) were associated with having adequate knowledge. Having a diploma or higher education (AOR=2.684, 95% CI 1.137 to 6.340) and adequate knowledge about iodized salt utilization (AOR=2.095, 95% CI 1.273 to 3.447) were significantly associated with good practice. CONCLUSIONS The current study highlights the level of knowledge and practices of pregnant women on iodized salt. It emphasizes the necessity for targeted programs about the benefits of iodized salt and how to use it correctly, particularly for those with low literacy levels and those living in rural areas.
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Affiliation(s)
- Hanan Mohammed
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Abebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fisseha Yetwale
- School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Worku Mekuannint
- School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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13
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Rodrigues R, Freitas C, Gonçalves B, Freitas J, Abreu J. Childbirth Experience and Pain Control: Expectation, Satisfaction, and Analgesia Myths. Cureus 2024; 16:e63082. [PMID: 39055406 PMCID: PMC11270153 DOI: 10.7759/cureus.63082] [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: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND In our days, increasing importance has been given to maternal satisfaction as a quality indicator in healthcare services. A positive childbirth experience should meet a woman's personal and sociocultural beliefs and expectations in every setting. This study aimed to evaluate childbirth experience regarding expectations, satisfaction, and myths around epidural analgesia. METHODOLOGY A cross-sectional survey designed was carried out in the Obstetric Department of a public hospital in Madeira-Portugal. A well-structured questionnaire was applied to 101 post-partum women covering aspects such as sociodemographic details, childbirth expectations, overall satisfaction, and prevailing myths. IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY) was used for data analysis. RESULTS From the total of 101 participants, 32 (31%) women belonged to the 31-35 age group. Among the respondents, 58 (57%) had attained a high school diploma. The results showed that there was a positive experience with childbirth; out of the total women, 79 (78%) considered it exceeded their expectations. The majority of pregnant women (93, 92%) received neuraxial analgesia for labor, reporting the experience as good or excellent. The overall satisfaction related to the birth experience was good or excellent for 88 (87%) women. Regarding the myths, education level was significantly associated with the myth Epidurals often cause permanent back pain (P < 0.05), since women with higher education don't believe them. CONCLUSIONS The result of this study proves that, despite the high level of satisfaction with the labor and delivery experience found in our maternity unit, satisfaction remains a complex and dynamic phenomenon.
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Affiliation(s)
| | | | | | - Joana Freitas
- Anesthesiology, Funchal Central Hospital, Funchal, PRT
| | - Jhonny Abreu
- Nursing, Hospital Central do Funchal, Funchal, PRT
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14
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Kilpatrick ML, Venn AJ, Barnden KR, Newett K, Harrison CL, Skouteris H, Hills AP, Hill B, Lim SS, Jose KA. Health System and Individual Barriers to Supporting Healthy Gestational Weight Gain and Nutrition: A Qualitative Study of the Experiences of Midwives and Obstetricians in Publicly Funded Antenatal Care in Tasmania, Australia. Nutrients 2024; 16:1251. [PMID: 38732498 PMCID: PMC11085055 DOI: 10.3390/nu16091251] [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: 03/15/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Individual and health system barriers can impede clinicians from supporting weight-related behaviour change for pregnant women, particularly in publicly funded antenatal care accessed by women from diverse socioeconomic backgrounds. The aim was to understand clinicians' experiences of supporting healthy gestational weight gain for pregnant women in a publicly funded antenatal setting. The work was undertaken to guide the implementation of systems changes, resource development, and workforce capacity building related to nutrition, physical activity, and gestational weight gain in the service. The qualitative descriptive study used purposive sampling and semi-structured interviews conducted between October 2019 and February 2020. Nine midwives and five obstetricians from a publicly funded hospital antenatal service in Tasmania, Australia participated. Interview transcripts were analysed using inductive thematic analysis. The three dominant themes were prioritising immediate needs, continuity of care support weight-related conversations, and limited service capacity for weight- and nutrition-related support. The subthemes were different practices for women according to weight and the need for appropriately tailored resources. Improving access to continuity of care and clinician training, and providing resources that appropriately consider women's socioeconomic circumstances and health literacy would enhance the ability and opportunities for clinicians to better support all women.
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Affiliation(s)
- Michelle L. Kilpatrick
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
- Centre for Mental Health Service Innovation, Advocate House, Hobart, TAS 7000, Australia
| | - Alison J. Venn
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
| | | | - Kristy Newett
- Royal Hobart Hospital, Hobart, TAS 7000, Australia; (K.R.B.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3168, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (H.S.); (B.H.)
- Warwick Business School, University of Warwick, Coventry CV4 7AL, UK
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia;
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (H.S.); (B.H.)
| | - Siew S. Lim
- Eastern Health Clinical School, Monash University, Melbourne, VIC 3128, Australia;
| | - Kim A. Jose
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
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Chavin M, Latour G, Guyard-Boileau B, Durand MA. Evaluation of the Tuto’Tour pregnancy intervention among pregnant smokers in vulnerable situations. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2024; 36:45-72. [PMID: 38580466 DOI: 10.3917/spub.241.0045] [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: 04/07/2024]
Abstract
INTRODUCTION In France, pregnant women generally receive written information about their pregnancy. The efficacy of these materials is limited for socially disadvantaged women, who are more likely to have lower levels of health literacy. As an alternative tool, awareness-raising videos have become popular, and the “Tuto’Tour de la grossesse” health promotion intervention has been created, which includes videos about smoking. The study objective was to evaluate the acceptability, usability, and accessibility of two videos about smoking among pregnant smokers in vulnerable situations. METHODS We conducted semi-structured interviews with these women, using a participatory approach. We then carried out a hybrid qualitative analysis, combining an analysis based on a conceptual framework and an inductive analysis. RESULTS Out of twenty participants, nine were separated from their child’s father and nine were unemployed. Twelve participants had less than a baccalaureate level of education and seven had a mother tongue other than French. Participants found the videos acceptable, usable, and accessible. We received positive feedback about the efficacy of the videos in terms of participants’ ability, opportunity, and motivation to change their behavior. Suggestions for improving the videos were made. CONCLUSIONS Other studies have looked at health promotion with similar interventions, but acceptability, usability, and accessibility have not been tested with socially disadvantaged women. These videos, which are acceptable, usable, and accessible to socially disadvantaged people, seem to have an influence on two out of three factors leading to behavior change. They could now be tested on a larger scale in a randomized controlled study.
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Affiliation(s)
- Maëva Chavin
- UMR 1295 CERPOP, Inserm, université Toulouse-III-Paul-Sabatier, EQUITY, Toulouse, France
- CHU de Toulouse, Toulouse, France
| | - Gillien Latour
- UMR 5502 IMFT, Institut de mécanique des fluides de Toulouse, Toulouse, France
| | | | - Marie-Anne Durand
- UMR 5502 IMFT, Institut de mécanique des fluides de Toulouse, Toulouse, France
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, NH, États-Unis
- Unisanté, centre universitaire de médecine générale et santé publique, Lausanne, Suisse
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LaManna S, Hatfield B, McCann E. Considering the Influence of Social Determinants of Health on Parent Feeding Practices: A Case Example. Adv Neonatal Care 2024; 24:110-118. [PMID: 38241685 DOI: 10.1097/anc.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding. EVIDENCE ACQUISITION A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain. RESULTS This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice. IMPLICATIONS FOR PRACTICE AND RESEARCH By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.
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Affiliation(s)
- Stefanie LaManna
- Author Affiliation: American Speech-Language-Hearing Association, Rockville, Maryland (Mss LaManna and Hatfield); and Independent Researcher, Voorhees, New Jersey (Ms McCann)
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Fakes K. Patient experiences and anxiety related to medical imaging: challenges and potential solutions. J Med Radiat Sci 2024; 71:3-6. [PMID: 38154787 PMCID: PMC10920950 DOI: 10.1002/jmrs.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023] Open
Abstract
Patients' experiences of medical imaging are varied. In referencing the work of Plunkett et al. https://doi.org/10.1002/jmrs.725, relating to fetal MRI, this editorial explores potential methods for increased education and support to alleviate anxiety in patients undergoing medical imaging procedures.
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Affiliation(s)
- Kristy Fakes
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
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Şenol DK, Aydin Özkan S, Ağralı C. The effect of the training provided to primiparous pregnant women based on the model on pregnancy risk perception and health literacy. Women Health 2024; 64:283-293. [PMID: 38389185 DOI: 10.1080/03630242.2024.2322130] [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: 03/14/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024]
Abstract
The purpose of this study was to assess the impact of health education based on the health belief model (HBM) on the perception of risk in pregnancy and health literacy in primiparous pregnant women to maintain and improve their health. The study was carried out with 82 pregnant women who were in the second trimester. The number of samples was calculated using the G-Power program version 3.1.7. The number of samples was found 44 for the education group and 44 for the control group with a confidence interval of 95 percent, a margin of error of 5 percent, a large Cohen d effect size value (0.5), and a power of 80 percent. Randomization was performed using the envelope method to determine the interventional and control groups. The training prepared in line with the SIM was presented to the participants in the education group. 2 sessions per week, a total of 4 times. "Personal Information Form," Health Literacy Scale (HLS), and Perception of Pregnancy Risk Questionnaire (PPRQ) were used as data collection tools. The mean of the risk perception of the pregnant toward the baby posttest score was 9.95 ± 13.30 in the education group, and 23.35 ± 21.41 in the control group (p = .001). The mean health literacy scale posttest score was 103.52 ± 19.77 in the education group and 93.5 ± 19.02 in the control group, and it was found to be statistically significantly higher in the health literacy education group than in the control group (p = .027). This study found that educating pregnant women using the health belief model reduces their risk perception and boosts their degree of health literacy.
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Affiliation(s)
- Derya Kaya Şenol
- Faculty of Health Sciences, Department of Midwifery, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Semiha Aydin Özkan
- Faculty of Health Sciences, Department of Midwifery, Adıyaman University, Adıyaman, Turkey
| | - Cansu Ağralı
- Faculty of Health Sciences, Department of Midwifery, Osmaniye Korkut Ata University, Osmaniye, Turkey
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Melwani S, Cleland V, Patterson K, Nash R. Health literacy profiles of pregnant women and mothers in Tasmania: A cluster analysis. Health Promot J Austr 2024. [PMID: 38402877 DOI: 10.1002/hpja.854] [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: 04/19/2023] [Revised: 02/17/2024] [Accepted: 02/18/2024] [Indexed: 02/27/2024] Open
Abstract
ISSUE ADDRESSED Health literacy development can help to reduce the growing noncommunicable disease burden globally. However, less is known about the health literacy needs of pregnant women and mothers necessary to guide health literacy development in this priority population group. To enhance the understanding of the health literacy needs of pregnant women and mothers, this study aimed to develop data-informed health literacy profiles of pregnant women and mothers with children (0-8 years) in Tasmania, as well as data-informed vignettes describing the health literacy needs of women in the different health literacy profiles. METHODS An online cross-sectional survey was undertaken. The survey included demographic questions and the health literacy questionnaire (HLQ). The data were analysed using a cluster analysis to identify subgroups with varying health literacy needs. The clusters, in conjunction with demographic characteristics, were used to generate data-informed vignettes representing various health literacy profiles. RESULTS The cluster analysis generated seven health literacy profiles and five vignettes representing diverse health literacy needs of pregnant women and mothers in Tasmania. Each vignette tells a data-informed story of women in Tasmania experiencing diverse health literacy strengths and challenges influencing their access and use of health information and health services. This allowed deeper exploration of the health literacy needs of the subgroups within the target population. CONCLUSION A better understanding of the health literacy needs of pregnant women and mothers can provide policymakers and health care providers with the key insights needed to guide the planning and development of fit-for-purpose solutions. This understanding can also guide the tailoring of existing health and community services, to create a health literacy-responsive environment that is more likely to meet the diverse health needs of pregnant women and mothers. SO WHAT We must shift away from a 'one size fits all' approach and promote the development of a health literacy-responsive environment to improve health and equity outcomes for pregnant women and mothers in Tasmania.
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Affiliation(s)
- Satish Melwani
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kira Patterson
- School of Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Rosie Nash
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Lanyo TN, Adjei CA, Ani-Amponsah M. Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana. SAGE Open Nurs 2024; 10:23779608241255183. [PMID: 38828400 PMCID: PMC11141223 DOI: 10.1177/23779608241255183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/24/2024] [Accepted: 04/28/2024] [Indexed: 06/05/2024] Open
Abstract
Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviors for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.
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Affiliation(s)
- Theresa Norpeli Lanyo
- Department of Women and Children, University of Ghana Medical Centre, Accra, Greater Accra, Ghana
| | - Charles Ampong Adjei
- Department of Public Health Nursing, University of Ghana, School of Nursing and Midwifery, Legon, Greater Accra, Ghana
| | - Mary Ani-Amponsah
- Department of Maternal and Child Health, University of Ghana, School of Nursing and Midwifery, Legon, Greater Accra, Ghana
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Elbarazi I, Alam Z, Ali N, Loney T, Al-Rifai RH, Al-Maskari F, Ahmed LA. Health literacy among pregnant women in the United Arab Emirates: The Mutaba'ah study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057231224179. [PMID: 38279806 PMCID: PMC10822065 DOI: 10.1177/17455057231224179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 10/09/2023] [Accepted: 12/12/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Health literacy is the degree to which individuals can obtain, process, understand, and communicate health-related information. Health literacy among pregnant women, in particular, may have a significant impact on maternal and child health. In the United Arab Emirates, no previous studies have been carried out to investigate the health literacy levels of pregnant women. OBJECTIVE This study aimed to investigate antenatal health literacy levels and identify associated factors among pregnant Emirati women in the United Arab Emirates. DESIGN This analysis was based on the baseline cross-sectional data for pregnant women participating in the prospective cohort Mutaba'ah Study, recruited between May 2017 and August 2022. METHODS Participants completed a self-administered questionnaire during their antenatal visits that collected sociodemographic and pregnancy-related information. Adequacy of health literacy was assessed using the BRIEF health literacy screening tool with adequate health literacy defined as a score ⩾ 17. Regression modeling investigated the association between the pregnant women characteristics with having adequate health literacy level (ability to read and comprehend most patient education materials). RESULTS A total of 2694 responses to the BRIEF health literacy screening tool were analyzed. Approximately, three-quarters (71.6%) of respondents showed adequate health literacy, followed by marginal (22.8%), and limited (5.6%) health literacy levels, respectively. Higher education levels (adjusted odds ratio (aOR) = 1.74, 95% confidence interval = 1.46-2.08), employment (adjusted odds ratio = 1.35, 95% confidence interval = 1.10-1.65), and adequate social support (adjusted odds ratio = 1.69, 95% confidence interval = 1.26-2.28) were associated with adequate health literacy levels. Participants who expressed worry about birth were less likely to have adequate literacy levels (adjusted odds ratio = 0.70, 95% confidence interval = 0.58-0.85). CONCLUSION Nearly three-quarters of pregnant women have adequate health literacy. Nevertheless, measures including policies to sustain and enhance health literacy levels among all expectant mothers are required, with a specific focus on those having limited health literacy.
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Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Zufishan Alam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University, Dubai, United Arab Emirates
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Bin Sultan Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Le QT, Huynh NKT, Hoang TDT. Awareness of Nutrition and Supplements Among Pregnant and Preconception Women: A Real-World Study in Vietnam. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:506-516. [PMID: 37908636 PMCID: PMC10615086 DOI: 10.1089/whr.2023.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 11/02/2023]
Abstract
Background Few studies have addressed relationships between health literacy (HL) and nutritional awareness in preconception/pregnancy populations, especially within Asia. We explored the rationale for nutrition-related education and/or HL interventions to improve nutritional intake among preconception/pregnant women. Methods A cross-sectional questionnaire-based real-world study was conducted among 100 preconception and 200 pregnant women in Vietnam in January/February 2022. The questionnaire included a validated screening tool for HL (Newest Vital Sign [NVS]), and questions on preconception/pregnancy-related nutritional knowledge and behavior, prenatal supplementation, sources of nutritional advice. Results Most respondents (62%) had limited HL and only 5% had adequate HL. Respondents with limited HL (NVS 0-1) showed less awareness of benefits of healthy eating before/during pregnancy, such as reduction in risk of birth defects. Most (94%) considered prenatal supplements beneficial, yet 64% were not convinced of supplement safety. The limited HL group reported the lowest use of supplements, including multivitamins, iron, and folic acid/folate. Conclusion The prevalence of limited HL and the low awareness of preconception/pregnancy-related nutrition suggest an urgent need to invest in nutrition-specific education and improving HL in maternal populations. This will help support adequate maternal nutrition and appropriate micronutrient supplementation before conception and throughout the "first 1000 days" of life.
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Affiliation(s)
- Quang Thanh Le
- Obstetrics Division, Tu Du Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Khanh Trang Huynh
- Department of Obstetrics and Gynaecology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Thi Diem Tuyet Hoang
- Obstetrics and Genetics Department, Hung Vuong Hospital, Ho Chi Minh City, Vietnam
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Abay H, Alagöz F, Tekin ÖM. The Turkish validity and reliability of the maternal health literacy inventory in pregnancy. Midwifery 2023; 125:103774. [PMID: 37490808 DOI: 10.1016/j.midw.2023.103774] [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: 12/23/2022] [Revised: 05/22/2023] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND There is no Turkish scale measuring maternal health literacy during pregnancy. This study adapted the Maternal Health Literacy Inventory in Pregnancy (MHELIP) to Turkish. METHODS A methodological study's sample consisted of 500 pregnant women admitted to the antenatal clinics of a Maternity Hospital in Ankara, Türkiye. Data were collected using a personal information form, the MHELIP and the Turkish Health Literacy Index (HLI). Language, content, and construct validity were determined. Cronbach's alpha coefficient and item analysis were used to assess reliability. Equivalent-form reliability was evaluated using the HLI. RESULTS The scale has a four-factor structure that fits well with 48 items (factor loadings: 0.57-0.92; fit index: 4.15 x2/df, 0.08 RMSEA, 0.07 SRMR). The total scale has a Cronbach's alpha of 0.96. The subscales "maternal health knowledge," "search for maternal health information," "assessment of maternal health information," and "maternal health decision making and behavior" have Cronbach's alpha of 0.96, 0.91, 0.86, and 0.94, respectively. There is a correlation between MHELIP and HLI scores (r = 0.570, p<0.001). CONCLUSION The MHELIP is a valid and reliable tool for measuring and screening the maternal health literacy of Turkish pregnant women.
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Affiliation(s)
- Halime Abay
- Ankara Yıldırım Beyazıt University Faculty of Health Sciences, Nursing Department, Ankara, Türkiye.
| | - Feride Alagöz
- Health Ministry of Turkey Republic, Ankara Bilkent City Hospital-Maternity Hospital, Ankara, Türkiye
| | - Özlem Moraloğlu Tekin
- Health Ministry of Turkey Republic, Ankara Bilkent City Hospital-Maternity Hospital, Ankara, Türkiye
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Lee VV, Vijayakumar S, Ng WY, Lau NY, Leong QY, Ooi DSQ, Su LL, Lee YS, Chan SY, Blasiak A, Ho D. Personalization and localization as key expectations of digital health intervention in women pre- to post-pregnancy. NPJ Digit Med 2023; 6:183. [PMID: 37775533 PMCID: PMC10541409 DOI: 10.1038/s41746-023-00924-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
Health behaviors before, during and after pregnancy can have lasting effects on maternal and infant health outcomes. Although digital health interventions (DHIs) have potential as a pertinent avenue to deliver mechanisms for a healthy behavior change, its success is reliant on addressing the user needs. Accordingly, the current study aimed to understand DHI needs and expectations of women before, during and after pregnancy to inform and optimize future DHI developments. Forty-four women (13 pre-, 16 during and 15 postpregnancy; age range = 21-40 years) completed a 60-minute, semistructured, qualitative interview exploring participant's experience in their current phase, experience with digital health tools, and their needs and expectations of DHIs. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. From the interviews, two core concepts emerged-personalization and localization of DHI. Between both concepts, five themes and nine subthemes were identified. Themes and subthemes within personalization cover ideas of two-way interactivity, journey organization based on phases and circumstances, and privacy trade-off. Themes and subthemes within localization cover ideas of access to local health-related resources and information, and connecting to local communities through anecdotal stories. Here we report, through understanding user needs and expectations, the key elements for the development and optimization of a successful DHI for women before, during and after pregnancy. To potentially empower downstream DHI implementation and adoption, these insights can serve as a foundation in the initial innovation process for DHI developers and be further built upon through a continued co-design process.
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Affiliation(s)
- V Vien Lee
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
| | - Smrithi Vijayakumar
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Wei Ying Ng
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Ni Yin Lau
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Qiao Ying Leong
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Delicia Shu Qin Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Lin Lin Su
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.
| | - Shiao-Yng Chan
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
| | - Agata Blasiak
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Dean Ho
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Church S, Ejder Apay S, Gurol A, Slaveva Y, Mills R. Student midwives' perspectives of women's sexual and reproductive health literacy in Turkey. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 37:100864. [PMID: 37331301 DOI: 10.1016/j.srhc.2023.100864] [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: 04/28/2022] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE This study focused on the issues surrounding health literacy in the context of women's sexual and reproductive health (SRH), the significance and availability of information for midwives and women; and the socio-cultural influences and barriers related to women's level of health literacy. METHODS A cross sectional on-line survey was distributed to 280 student midwives in their 2nd 3rd and 4th year of a midwifery programme. This paper focuses on the responses from 138 students which were analysed using descriptive and non-parametric tests. RESULTS Student midwives indicated their level of agreement regarding women's ability to access, understand, and appraise information they received verbally and in written form about the six main SRH topics (namely contraception, STIs, abortion, Pap tests and cervical cancer, and fertility and pregnancy), from their midwife but agreement was much lower regarding women's access to SRH information from peers and their families. False beliefs were ranked as the most common barrier to accessing information and services. Students ranked being a refugee, being from a rural area, being educated to a primary school level or not formally educated, as having the greatest negative impact on women's health literacy. CONCLUSIONS Findings from this study indicate the role that the sociocultural background of Islamic culture plays in the disparities in sexual and reproductive health literacy (SRHL) for women from the perspective of student midwives. Our findings indicate the need for future research to focus on women as participants to gain their first-hand experiences of SRHL.
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Affiliation(s)
- Sarah Church
- School of Nursing & Midwifery, Institute of Health & Social Care, London South Bank University, London, United Kingdom.
| | - Serap Ejder Apay
- Faculty of Health Sciences, Atatürk University & Atateknokent Company, Erzurum, Turkey
| | - Ayse Gurol
- Faculty of Health Sciences, Erzurum Technical University, Turkey
| | - Yoanna Slaveva
- School of Nursing & Midwifery, Institute of Health & Social Care, London South Bank University, London, United Kingdom
| | - Rhianna Mills
- School of Nursing & Midwifery, Institute of Health & Social Care, London South Bank University, London, United Kingdom
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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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George N, Reynolds S, de Long R, Kacica M, Ahmed R, Manganello J. Social Media and Black Maternal Health: The Role of Health Literacy and eHealth Literacy. Health Lit Res Pract 2023; 7:e119-e129. [PMID: 37463292 PMCID: PMC10351964 DOI: 10.3928/24748307-20230614-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Black women experience greater maternal mortality and morbidity than White women. Although there are many causes of this disparity, providing more and better maternal health information to this population may be beneficial. Social media offers a way to easily and quickly disseminate information to empower and educate Black women about health during pregnancy. OBJECTIVE This study sought to identify social media use patterns to determine what sources Black women used to obtain information about pregnancy and to explore whether health literacy/eHealth literacy influence those patterns. METHODS This cross-sectional, nationally representative survey panel included 404 Black women. Health literacy was measured by the Single Item Literacy Screener, and eHEALS was used to measure eHealth literacy. We examined participants' social media activity, social media use, social media use for support, and sharing of pregnancy-related health information. Relationships between health literacy, eHealth literacy, and social media use were assessed. KEY RESULTS Overall, 67.5% of participants had high health literacy, and the average eHealth literacy score was high (34.5). Most women (71.6%) reported using more than three social media accounts as a source for pregnancy information. Women with low health literacy searched social media for general and specific pregnancy health information, reported more social media use during pregnancy in general (p < .001), and more use of social media for giving and getting support (p = .003). Women with higher eHealth literacy were more likely to report more social media use (r = 0.107, p = .039) and often used social media to give and get support (r = 0.197, p = .0001). Women with high health literacy more often reported sharing the pregnancy information they found on social media with their nurse (χ2 = 7.068, p = .029), doula (χ2 = 6.878, p = .032), and childbirth educator (χ2 = 10.289, p = .006). Women who reported higher eHealth literacy also reported more often sharing the pregnancy information they found on social media with their doctor (r = 0.115, p = .030), nurse (r = 0.139, p = .001), coworkers (r = 0.160, p = .004), and family or friends (r = 0.201, p = .0001). CONCLUSION Substantial numbers of Black women use social media to find pregnancy health information. Future studies should elicit more detailed information on why and how Black women use social media to obtain pregnancy information and support as well as what role health literacy and eHealth literacy may have on birth outcomes. [HLRP: Health Literacy Research and Practice. 2023;7(3):e119-e129.].
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Ferguson M, Shapiro GD, McDonald SD. Understanding and preferences regarding risk communication during pregnancy: a survey to facilitate provider communication with patients. Am J Obstet Gynecol MFM 2023; 5:100929. [PMID: 36931434 DOI: 10.1016/j.ajogmf.2023.100929] [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: 12/13/2022] [Revised: 02/02/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Clear communication of medical risk helps to ensure proper patient understanding of healthcare options and supports informed decision-making. Communication involving visual and written risk typically conveys risk more effectively than conversations alone between a patient and a clinician. However, perception of risk is context-dependent, and the efficacy of and preferences for commonly-used risk communication formats are not well-understood during pregnancy, which is a time of complex decision-making. We sought to address this knowledge gap. OBJECTIVE This study aimed to assess pregnant and recently pregnant people's understanding and preferences for different risk communication formats. STUDY DESIGN We conducted an open online REDCap survey of pregnant and recently pregnant people over a 1-month period in 2022. Study participants were aged 16 to 49 years, pregnant or recently pregnant, and able to provide informed consent in English. Data collected included demographics, measurements of accuracy of understanding including both gist accuracy (general understanding) and verbatim accuracy (numeric quantification), and preferences for risk communication formats including icon arrays, pie charts, bar graphs, and text. Descriptive analyses of the proportion of correctly answered questions were calculated. RESULTS A total of 247 participants completed ≥1 item on accuracy and risk communication preferences, and 230 provided complete responses. Gist (general) understanding was accurate between 74% and 89% of the time for most graphical formats. Verbatim understanding (exact numeric quantification) was approximately 90% accurate for most formats. Respondents preferred that figures be used over circles to display risk in icon arrays, both for themselves and for infants, although figures generated more worry. However, participants substantially preferred pie charts over bar graphs (59%-70% vs 19%-25%). Respondents preferred risk to be expressed with a lower denominator of 200 rather than a higher denominator of 1000 (79% vs 13%, although the lower denominator generated more worry), and in terms of chance of survival rather than chance of death (50% vs 33%). CONCLUSION In a survey of pregnant and recently pregnant people, most respondents preferred pie charts over other graph formats, and lower rather than higher denominators in text. Presentations of survival rather than death estimates were also preferred. Approximately 75% to 90% of respondents accurately understood risk presented with visual and written communication. For the remaining participants, for whom accurate understanding was challenging, new strategies need to be developed.
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Affiliation(s)
- Margot Ferguson
- Faculty of Science, McMaster University, Hamilton, Canada (Ms Ferguson)
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada (Dr Shapiro)
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Radiology, and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada (Dr McDonald).
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Eslami V, Sany SBT, Tehrani H, Ghavami V, Peyman N. Examining health literacy and self-efficacy levels and their association with preventive behaviors of urinary tract infection in Iranian pregnant women: across sectional study. BMC Womens Health 2023; 23:258. [PMID: 37173682 PMCID: PMC10180610 DOI: 10.1186/s12905-023-02359-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE Urinary tract infection (UTI) is assumed to be associated with the risk of fetal and maternal mortality and morbidity during pregnancy. The potential effect of health literacy and self-efficacy on UTI preventive behaviors among pregnant women has not yet been fully studied. Our objectives were to determine the level of health literacy, self-efficacy, and UTI prevention behaviors in pregnant women, and whether health literacy and self-efficacy are associated with UTI prevention behaviors in pregnant women. DESIGN A cross-sectional study was conducted, from November 2020 to December 2020, through a multi-stage sampling design on 235 pregnant women aged between 18 and 42 years in Mashhad, Iran. Data were collected through valid and reliable questionnaires including the Test of Functional Health Literacy in Adults (TOFHLA), General Self-Efficacy Questionnaire (GSE), and research made-preventive behaviors recommendations for UTI disease. RESULTS The level of UTI prevention behaviors scores is moderate (71.39 ± 8.58) among women during their pregnancy. Insufficient health literacy and self-efficacy were observed in 53.6% and 59.3% of participants, respectively. The regression model highlighted that 21.20% of the total variance of UTI preventive behaviors was predicted by sociodemographic characteristics, while 40.81% of the variance of UTI preventive behaviors was predicted by health literacy and self-efficacy. CONCLUSION It has been observed that health literacy and self-efficacy are main determinants to improve UTI preventive behaviors. Focusing on an intervention based on health literacy skills may be a practical strategy to promote a healthy lifestyle in this population.
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Affiliation(s)
- Vajieh Eslami
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Belin Tavakoly Sany
- Department of Health, Safety and Environment, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Ghavami
- Department of Epidemiology and Biostatistics, Faculty of Health sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Rasmussen TD, Nybo Andersen AM, Ekstrøm CT, Jervelund SS, Villadsen SF. Improving health literacy responsiveness to reduce ethnic and social disparity in stillbirth and infant health: A cluster randomized controlled effectiveness trial of the MAMAACT intervention. Int J Nurs Stud 2023; 144:104505. [PMID: 37267853 DOI: 10.1016/j.ijnurstu.2023.104505] [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: 06/23/2022] [Revised: 01/26/2023] [Accepted: 04/12/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The MAMAACT intervention aims to reduce ethnic and social disparities in stillbirth and infant death by improving communication between pregnant women and midwives regarding warning signs of pregnancy complications. This study evaluates the effect of the intervention on pregnant women's health literacy (two domains from the Health Literacy Questionnaire) and complication management - interpreted as improved health literacy responsiveness among midwives. DESIGN Cluster randomized controlled trial, 2018-2019. SETTING 19 of 20 Danish maternity wards. PARTICIPANTS Cross-sectional survey data were collected using telephone interviews (n = 4150 pregnant women including 670 women with a non-Western immigrant background). INTERVENTION A six-hour training session for midwives in intercultural communication and cultural competence, two follow-up dialog meetings, and health education materials for pregnant women on warning signs of pregnancy complications - in six languages. MAIN OUTCOME MEASURES Differences in mean scores at post-implementation of the domains Active engagement with healthcare providers (Active engagement) and Navigating the healthcare system from the Health Literacy Questionnaire, and differences in the certainty of how to respond to pregnancy complication signs between women in the intervention and control group. RESULTS No difference was observed in women's level of Active engagement or Navigating the healthcare system. Women from the intervention group were more certain of how to respond to complication signs: Redness, swelling, and heat in one leg: 69.4 % vs 59.1 %; aOR 1.57 (95 % CI 1.32-1.88), Severe headache: 75.6 % vs 67.3 %; aOR 1.50 (95 % CI 1.24-1.82), and Vaginal bleeding: 97.3 % vs 95.1 %; aOR 1.67 (95 % CI 1.04-2.66). CONCLUSION The intervention improved women's certainty of how to respond to complication signs, but was unable to improve pregnant women's health literacy levels of Active engagement and Navigating the healthcare system, likely due to barriers related to the organization of antenatal care. A reorganization of antenatal care and a care model sensitive to diversity within the entire healthcare system might help reduce disparities in perinatal health. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03751774.
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Affiliation(s)
- Trine Damsted Rasmussen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1353 Copenhagen K, Denmark.
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1353 Copenhagen K, Denmark.
| | - Claus Thorn Ekstrøm
- Section for Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1353 Copenhagen K, Denmark.
| | - Signe Smith Jervelund
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1353 Copenhagen K, Denmark.
| | - Sarah Fredsted Villadsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1353 Copenhagen K, Denmark.
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Lindblad V, Kragholm KH, Eidhammer A, Melgaard D. Discharge time after birth is associated with parity - A retrospective cohort study. Heliyon 2023; 9:e14004. [PMID: 36915540 PMCID: PMC10006520 DOI: 10.1016/j.heliyon.2023.e14004] [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: 08/26/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/01/2023] Open
Abstract
Background All healthy mothers with uncomplicated births are recommended to be discharged directly from the labour ward a few hours after birth as a change in practice in three hospitals in Denmark. However, despite this practice, there is limited knowledge about when mothers leave the hospital after birth in clinical practice. Objective The aim of this study is to examine 1) when mothers are discharged from hospital after birth, 2) if discharge time from the hospital after birth is associated with parity, and 3) which factors are associated with discharge time. Methods This retrospective study is based on data from the North Denmark Regional Hospital and included mothers giving vaginal birth from March 25, 2019 to April 10, 2021. Results A total of 1990 mothers were included. Nearly 50% of the new mothers stayed at the hospital less than 6 h after birth (26% of primiparous women vs 64% of multiparous women). Primiparous women had an adjusted RR 0.44 (95% CI 0.39-0.49) for discharge ≤6 h, RR 1.71 (95% CI 1.15-2.54) for discharge >6-12 h, and RR 3.76 (95% CI 3.03-4.67) for discharge >48 h after birth compared to multiparous women. Multiparous women's adjusted RR for discharge >6-12 h was 0.15 (95% CI 0.12-0.20) and for discharge >48 h 0.16 (95% CI 0.14-0.20) compared to discharge less than 6 h after birth. Furthermore, smoking, low education level, and younger age were associated with early discharge. Conclusion There is a significant association with parity and discharge time after birth and factors related to discharge time which healthcare professionals should be aware of when planning inpatient and outpatient care. In addition, healthcare professionals should be aware of mothers discharged early who are smoking, of younger age, lower education level or multiparity.
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Affiliation(s)
- Victoria Lindblad
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark
| | - Kristian Hay Kragholm
- Unit of Clinical Biostatistics and Epidemiology, Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Anya Eidhammer
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark
| | - Dorte Melgaard
- Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark.,Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000, Aalborg, Denmark
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Şahin E, Çatıker A, Özdil K, Bulucu Büyüksoy GD. Predictors of eHealth literacy in pregnant women: A structural equation model analysis. Int J Gynaecol Obstet 2023; 160:783-789. [PMID: 36018076 DOI: 10.1002/ijgo.14416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop and evaluate a theoretical model to explain the relationships between eHealth literacy and perception of health, and perception of pregnancy risk in pregnant women. METHOD This cross-sectional study was carried out with 238 pregnant women in one of the hospitals in Turkey between March 15, 2021 and May 15, 2021. Data were collected using an Information Form, eHealth Literacy Scale, Perception of Health Scale, and Perception of Pregnancy Risk Questionnaire. RESULTS The mean scores of the pregnant women participating in the study on eHealth literacy and perception of health were 30.45 ± 6.56 and 51.42 ± 6.91, respectively and their mean score on perception of pregnancy risk was 42.6 ± 29.38. The direct effect of the eHealth Literacy Scale on the "Risk for Baby" subscale of the Perception of Pregnancy Risk Questionnaire was insignificant whereas the scale's effect became significant with the Perception of Health Scale (β = -0.006; 0.057). CONCLUSION To reduce the perception of risk in pregnant women, it is important to improve not only their eHealth literacy but also their knowledge and attitudes about being healthy.
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Affiliation(s)
- Ebru Şahin
- Department of Nursing, Ordu University Faculty of Health Sciences, Ordu, Turkey
| | - Aslıhan Çatıker
- Department of Nursing, Ordu University Faculty of Health Sciences, Ordu, Turkey
| | - Kamuran Özdil
- Aged Care Program, Nevsehir Haci Bektaş Veli University, Health Services Vocational School, Nevsehir, Turkey
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Melwani S, Cleland V, Patterson K, Nash R. Health literacy status of pregnant women and women with young children in Tasmania. Health Promot J Austr 2023; 34:138-148. [PMID: 36285492 PMCID: PMC10100018 DOI: 10.1002/hpja.675] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 01/27/2023] Open
Abstract
ISSUE ADDRESSED The literature provides evidence that maternal health is strongly linked with noncommunicable diseases (NCDs) and their associated risk factors. Enabling women with the asset of health literacy may help to reduce the intergenerational impact of NCDs. However, little is known about the health literacy of pregnant women and women with young children in Tasmania and globally. This study aimed to identify the health literacy status of pregnant women and women with young children (0-8 years) living in Tasmania and describe their health literacy status according to their demographic characteristics. METHODS An online cross-sectional survey was undertaken. The survey included demographic questions and a health literacy questionnaire (HLQ). The description of demographic differences across the HLQ scales focused on effect sizes (ES) for standardised differences in mean health literacy scores. The differences found to be statistically significant at P < 0.05 were also included. RESULTS 194 participants completed the survey with a mean age of 35.3 years. 73.2% were married, 16.5% were pregnant, 93% had one or more children and 81.5% were university educated. For the first five HLQ scales (score range 1-4), the lowest overall score was seen for the scale "Actively managing my health" (mean = 2.96; SD = 0.54). For the last four scales (score range 1-5), the lowest overall score was seen for the scale "Navigating the health care system" (mean = 3.75, SD = 0.67). Nonpregnant women, women with children, women with chronic health conditions and nonmarried women experienced more health literacy challenges. CONCLUSION Women in our study showed various strengths and challenges with mean scores varying across the nine HLQ scales. Understanding the health literacy needs of women will enable health services to co-design solutions and interventions capable of responding to the evolving health needs of pregnant women and women with young children. This approach will ensure that codesigned solutions can engage the end-user in healthy lifestyle practices and the solutions are sustainable. SO WHAT?: We must shift away from a "one size fits all" approach to tailor services to respond to the differing health literacy needs of pregnant women and women with young children to support healthy lifestyle practices and reduce the NCD burden.
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Affiliation(s)
- Satish Melwani
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kira Patterson
- School of Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Rosie Nash
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Pawellek M, Köninger A, Melter M, Kabesch M, Apfelbacher C, Brandstetter S. Development of Mothers' Health Literacy: Findings From the KUNO-Kids Study. Health Lit Res Pract 2023; 7:e39-e51. [PMID: 36779929 PMCID: PMC9918306 DOI: 10.3928/24748307-20230131-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to analyze the longitudinal development of health literacy (HL) in a large cohort of new mothers in Germany and to investigate which determinants are associated with the initial HL level and with change over time. METHODS Longitudinal data from 1,363 mothers participating with their child in the KUNO-Kids Health Study was used; data were collected at birth of the child (baseline), after 6 and 12 months, using interviews and self-report questionnaires. The HL of mothers was assessed with the health care scale of the European Health Literacy Survey Questionnaire, which has 16 items on accessing, understanding, appraising, and applying health information in the health care setting. Latent growth curve models were used to analyze average trajectories and predictors of HL in the total sample and in the subgroup of first-time mothers. KEY RESULTS HL values increased from baseline (M = 35.46, standard deviation [SD] = 7.34) over 6 months (M = 37.31, SD = 7.31) to 12 months (M = 38.01, SD = 7.41). The increase was statistically significant in the total sample (1.188, standard error [SE] = 0.087, p < .001) and in the subgroup of first-time mothers (1.357, SE = 0.113, p <. 001), with a steeper trajectory for mothers with lower HL at baseline. Several personal and situational variables were associated with HL at baseline (e.g., education, child health) and with its development (e.g., number of children). CONCLUSION Overall, new mothers became slightly more health literate during their child's first year of life. However, some groups of mothers could benefit from support in developing HL skills even before childbirth. [HLRP: Health Literacy Research and Practice. 2023;7(1):e39-e51.] Plain Language Summary: We investigated how health literacy (that is the ability to find, understand, and apply health information) develops in new mothers in Germany. Mothers told us that this ability slightly improved during the child's first year of life. Some mothers still have difficulties in dealing with health information; these mothers should be supported even before childbirth.
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Affiliation(s)
- Maja Pawellek
- Address correspondence to Maja Pawellek, MSc, University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, Steinmetzstr. 1–3, 93049 Regensburg, Germany;
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Geissler KH, Evans V, Cooper MI, Shaw SJ, Yarrington C, Attanasio LB. Content Analysis of Patient-Facing Information Related to Preeclampsia. Womens Health Issues 2023; 33:77-86. [PMID: 36328927 PMCID: PMC9772133 DOI: 10.1016/j.whi.2022.09.003] [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: 11/09/2021] [Revised: 08/30/2022] [Accepted: 09/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Previous research has shown pregnant people are not knowledgeable about preeclampsia, a significant cause of maternal morbidity and mortality. This lack of knowledge may impact their ability to report symptoms, comply with recommendations, and receive appropriate follow-up care. Pregnant people commonly seek information from sources outside their treating clinician, including pregnancy-specific books and online sources. We examined commonly used preeclampsia information sources to evaluate whether pregnant people are receiving up-to-date, guideline-based information. METHODS We conducted a content analysis of preeclampsia-related information in top-ranking websites and bestselling pregnancy books. We used American College of Obstetricians and Gynecologists preeclampsia guidelines to construct a codebook, which we used to examine source content completeness and accuracy. For each source, we analyzed information about preeclampsia diagnosis, patient-reported symptoms, risk factors, prevention, treatment, and complications. RESULTS Across 19 included sources (13 websites and 6 books), we found substantial variation in completeness and accuracy of preeclampsia information. We found high rates of mentions for preeclampsia symptoms. Risk factors were more commonly included in online sources than book sources. Most sources mentioned treatment options, including blood pressure medication and giving birth; however, one-third of online sources positively mentioned the nonrecommended treatment of bed rest. Prevention methods, including prenatal aspirin for high-risk pregnancies, and long-term complications of preeclampsia were infrequently mentioned. CONCLUSIONS Varying rates of accuracy in patient-facing preeclampsia information mean there is substantial room for improvement in these sources. Ensuring pregnant people receive current guideline-based information is critical for improving outcomes and implementing shared decision-making.
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Affiliation(s)
- Kimberley H Geissler
- Department of Health Promotion and Policy, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts.
| | - Valerie Evans
- Department of Health Promotion and Policy, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts
| | - Michael I Cooper
- Department of Health Promotion and Policy, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts
| | - Susan J Shaw
- Department of Health Promotion and Policy, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts
| | - Christina Yarrington
- Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - Laura B Attanasio
- Department of Health Promotion and Policy, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts
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Killeen SL, Donnellan N, O'Reilly SL, Hanson MA, Rosser ML, Medina VP, Jacob CM, Divakar H, Hod M, Poon LC, Bergman L, O'Brien P, Kapur A, Jacobsson B, Maxwell CV, McIntyre HD, Regan L, Algurjia E, Ma RC, Adam S, McAuliffe FM. Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals. Int J Gynaecol Obstet 2023; 160 Suppl 1:10-21. [PMID: 36635083 PMCID: PMC10108324 DOI: 10.1002/ijgo.14539] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The period before and during pregnancy is increasingly recognized as an important stage for addressing malnutrition. This can help to reduce the risk of noncommunicable diseases in mothers and passage of risk to their infants. The FIGO Nutrition Checklist is a tool designed to address these issues. The checklist contains questions on specific dietary requirements, body mass index, diet quality, and micronutrients. Through answering these questions, awareness is generated, potential risks are identified, and information is collected that can inform health-promoting conversations between women and their healthcare professionals. The tool can be used across a range of health settings, regions, and life stages. The aim of this review is to summarize nutritional recommendations related to the FIGO Nutrition Checklist to support healthcare providers using it in practice. Included is a selection of global dietary recommendations for each of the components of the checklist and practical insights from countries that have used it. Implementation of the FIGO Nutrition Checklist will help identify potential nutritional deficiencies in women so that they can be addressed by healthcare providers. This has potential longstanding benefits for mothers and their children, across generations.
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Affiliation(s)
- Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Niamh Donnellan
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Chandni Maria Jacob
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | | | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - Cynthia V Maxwell
- Maternal Fetal Medicine, Sinai Health and Women's College Hospital, University of Toronto, Toronto, Canada
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Sakurai S, Mwilike B, Horiuchi S. Women's experiences with hypertensive disorders of pregnancy from a national referral hospital in Tanzania: A qualitative study. Jpn J Nurs Sci 2023; 20:e12513. [PMID: 36116438 DOI: 10.1111/jjns.12513] [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: 04/25/2022] [Revised: 07/22/2022] [Accepted: 08/22/2022] [Indexed: 01/05/2023]
Abstract
AIM This study aimed to explore the experiences among postpartum women with hypertensive disorders of pregnancy, from pregnancy to admission at a referral hospital in Tanzania. METHODS This was a descriptive cross-sectional design with purposive sampling. Data were collected from semi-structured in-depth interviews with postpartum women diagnosed with hypertensive disorders and who were admitted to the maternity ward of Muhimbili National Hospital. Data were analyzed using NVivo software for qualitative content analysis. RESULTS Fourteen women participated in interviews. Half were primipara and two-thirds had over four antenatal visits. Data analysis yielded four categories and 27 sub-categories. The four categories were: "I'm shocked; I thought I was normal," "The treatment journey," "What health care providers did and did not teach me," "I have a risky future; I hope health care providers can help me." CONCLUSION Women regarded themselves going from being normal to having a risk through the process of experiencing their treatments. They did not expect to be admitted or referred to a major hospital and while they demanded more information and education, they also expressed appreciation for their health care providers. Education during pregnancy addressing their needs and level of understanding is recommended for improvement of early detection and access to the health service.
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Affiliation(s)
| | - Beatrice Mwilike
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Meldgaard M, Gamborg M, Terkildsen Maindal H. Health literacy in the prenatal phase: a systematic review. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 34:100796. [DOI: 10.1016/j.srhc.2022.100796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/15/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
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Butts SJ, Huber LRB. Pre-pregnancy Diabetes, Pre-pregnancy Hypertension and Prenatal Care Timing among Women in the United States, 2018. Matern Child Health J 2022; 26:2300-2307. [PMID: 36149535 DOI: 10.1007/s10995-022-03531-1] [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: 09/09/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Women with pre-pregnancy diabetes or pre-pregnancy hypertension have increased risks of complications during pregnancy. Women who obtain prenatal care in the first trimester receive necessary routine testing and disease management tools that aid in controlling such conditions. However, research on the association between pre-pregnancy hypertension and pre-pregnancy diabetes and prenatal care timing among US women is limited. METHODS This study used data from the 2018 National Vital Statistic System (n = 3,618,853). Trained personnel collected information on prenatal care timing, maternal conditions, and demographics. Multivariate logistic regression models evaluated the association between pre-pregnancy hypertension, pre-pregnancy diabetes and prenatal care timing. A stratified analysis was conducted to determine if race/ethnicity modified the associations. RESULTS After adjustment, women with pre-pregnancy hypertension or pre-pregnancy diabetes had statistically significant increased odds of receiving early prenatal care compared to women without these conditions (OR 1.23; 95% CI: 1.21-1.26 and OR 1.27; 95% CI: 1.24-1.31, respectively). Among non-Hispanic White, non-Hispanic Black, and Hispanic women, those with pre-pregnancy hypertension or pre-pregnancy diabetes had statistically significantly increased odds of receiving early prenatal care compared to women without those pre-existing conditions (P < .001). DISCUSSION Further research is needed on the transition from preconception care to obstetric care for women with pre-existing diabetes or hypertension. However, these findings suggest that women who have conditions that could cause pregnancy complications are pursuing early prenatal care services to mitigate the development of adverse maternal and infant health conditions.
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Affiliation(s)
- Shanika Jerger Butts
- Department of Public Health Sciences, The University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA.
| | - Larissa R Brunner Huber
- Department of Public Health Sciences, The University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
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Perrotta K, Messer A, Alvarado S, Gaudette M, Tran C, Bandoli G. COVID-19 vaccine hesitancy and acceptance among pregnant people contacting a teratogen information service. J Genet Couns 2022; 31:1341-1348. [PMID: 35763777 PMCID: PMC9349653 DOI: 10.1002/jgc4.1608] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/11/2022] [Accepted: 06/03/2022] [Indexed: 12/14/2022]
Abstract
Pregnant people are at increased risk of severe illness from SARS-CoV-2 infection and are more likely to be admitted to an intensive care unit, be put on a mechanical ventilator, and die, if infected. Having COVID-19 during pregnancy also increases the risk of preterm delivery. Vaccination is a critical tool for controlling the COVID-19 pandemic; however, to date, just over 30% of pregnant people in the United States have been vaccinated. It is important to identify any barriers to acceptance of the COVID-19 vaccine among the pregnant population so that specific hesitancy concerns can be addressed. Our objective was to identify the proportion of pregnant people who are unsure or not planning to be vaccinated against COVID-19 and collect information about their reasons for hesitancy. A questionnaire examining views on COVID-19 vaccine interest was administered to 299 pregnant people who contacted MotherToBaby 3/1/21-7/23/21. Questions obtained information about the perception of COVID-19 risk in pregnancy, interest in receiving a COVID-19 vaccine while pregnant, and reasons for acceptance or hesitancy. Within the sample, 21% had already been vaccinated against COVID-19, 43% were planning to get vaccinated, 9% were not planning to receive the vaccine, and 27% were undecided. Women who were not planning to get vaccinated and those that were undecided both said their concern was 'not enough safety information for pregnancy'. Individuals aged 18-25, those who made less than $50,000/year, and those who lived in the Northeast were more likely to be hesitant. Based on these data, continued efforts to collect and communicate high-quality and understandable information to pregnant people about vaccine safety should be a key priority in efforts to increase vaccine acceptance among this group.
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Affiliation(s)
- Kirstie Perrotta
- MotherToBaby CaliforniaSan DiegoCaliforniaUSA,Department of PediatricsUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Angela Messer
- MotherToBaby CaliforniaSan DiegoCaliforniaUSA,Department of PediatricsUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Sonia Alvarado
- MotherToBaby CaliforniaSan DiegoCaliforniaUSA,Department of PediatricsUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Mara Gaudette
- MotherToBaby CaliforniaSan DiegoCaliforniaUSA,Department of PediatricsUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Cindy Tran
- Department of PediatricsUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Gretchen Bandoli
- Department of PediatricsUniversity of California, San DiegoLa JollaCaliforniaUSA
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Bello C, Esan D, Akerele S, Fadare R. Maternal health literacy, utilisation of maternal healthcare services and pregnancy outcomes among newly delivered mothers: A cross-sectional study in Nigeria. PUBLIC HEALTH IN PRACTICE 2022; 3:100266. [PMID: 36101756 PMCID: PMC9461586 DOI: 10.1016/j.puhip.2022.100266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 04/05/2022] [Accepted: 04/28/2022] [Indexed: 11/03/2022] Open
Abstract
Objectives Study design Methods Results Conclusions
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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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von Sommoggy J, Grepmeier EM, Curbach J. Health Literacy-Sensitive Counselling on Early Childhood Allergy Prevention: Results of a Qualitative Study on German Midwives' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074182. [PMID: 35409865 PMCID: PMC8998819 DOI: 10.3390/ijerph19074182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 02/06/2023]
Abstract
In Germany, midwives are involved in extensive antenatal and postnatal care. As health professionals, they can play a key role in strengthening health literacy (HL) of parents on how to prevent chronic allergic diseases in their children. The objective of this study is to explore midwives' perspectives regarding HL-sensitive counselling in early childhood allergy prevention (ECAP). Twenty-four qualitative semi-structured interviews were conducted with midwives, and data were analyzed using qualitative content analysis. Only a small number of study participants were aware of HL as a concept. However, most of these use screening and counselling strategies which consider individual information needs and which support parental HL. HL sensitivity in counselling is largely based on the midwives' "gut feelings" and counselling experience, rather than on formal education. The midwives were largely aware of evidence-based ECAP recommendations; however, allergy prevention was not seen as a stand-alone topic but as part of their general counselling on infant feeding and hygiene. They found parents to be more open to receiving complex prevention information during antenatal counselling. In order to strengthen midwives' roles in HL-sensitive ECAP counselling, their formal education should provide them with explicit HL knowledge and counselling skills. ECAP should be an inherent part of antenatal care.
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Affiliation(s)
- Julia von Sommoggy
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, 93051 Regensburg, Germany
- Correspondence:
| | - Eva-Maria Grepmeier
- Medical Faculty, Institute of Social Medicine & Health Systems Research, Otto von Guericke University Magdeburg, 39120 Magdeburg, Germany;
| | - Janina Curbach
- Department of Business Studies, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany;
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Abstract
The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the 'patient voice'. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.
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Aba Y, Basak T, Sevimli S. The relationship between health literacy and patterns of drug use in pregnancy. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2022. [DOI: 10.4103/jnms.jnms_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Luong TC, Pham TTM, Nguyen MH, Do AQ, Pham LV, Nguyen HC, Nguyen HC, Ha TH, Dao HK, Trinh MV, Do TV, Nguyen HQ, Nguyen TTP, Tran CQ, Tran KV, Duong TT, Pham HX, Do TT, Nguyen PB, Tra AL, Phan DT, Do BN, Duong TV. Fear, anxiety and depression among pregnant women during COVID-19 pandemic: impacts of healthy eating behaviour and health literacy. Ann Med 2021; 53:2120-2131. [PMID: 34761972 PMCID: PMC8592601 DOI: 10.1080/07853890.2021.2001044] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/27/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has been influencing people's psychological health, especially in pregnant women. We aimed to examine associated factors of fear of COVID-19, anxiety and depression among pregnant women during the pandemic where the impacts of healthy eating behaviour (HES) and health literacy (HL) were emphasized. METHODS A cross-sectional study was conducted between 14 February 2020 and 31 May 2020 in 18 health centres and hospitals across Vietnam. Data of 518 pregnant women were analysed, including socio-demographics, pregnant-related factors, HES, HL, health-related behaviours, fear of COVID-19 scale (FCoV-19S), anxiety (using the generalized anxiety disorder (GAD-7)) and depression (using the patient health questionnaire with 9 items (PHQ-9)). Regression analysis was utilized to explore the associations. RESULTS Pregnant women with higher scores of HES and HL had lower likelihood of anxiety (odds ratio, OR, 0.79; 95% confidence interval (95%CI), 0.73, 0.87; p < .001; and OR, 0.94; 95%CI, 0.90, 0.99; p = .018) and depression (OR, 0.84; 95%CI, 0.78, 0.91; p < .001; and OR, 0.96; 95%CI, 0.91, 0.99; p = .044), respectively. Pregnant women being employed had a lower FCoV-19S score (regression coefficient, B, -1.46; 95%CI, -2.51, -0.40; p = .007). Besides, other significant predictors of anxiety were eating healthier during the pandemic, unchanged or more physical activity, elevated gestational age and smoking. Other significant predictors of depression were eating healthier during the pandemic, elevated gestational age and smoking. CONCLUSIONS Among others, HES and HL had positive impacts on protecting pregnant women against anxiety and depression. Improving HES and HL should be addressed as a strategic approach to improve reproductive health during the pandemic.KEY MESSAGEThe COVID-19 pandemic influences antenatal mental disorders with the higher level as opposed to that before the pandemic.Healthy eating behaviour and better health literacy (HL) had critical roles in lowering prenatal anxiety and depression during the COVID-19 crisis.Strategic approaches for improving healthy eating and HL should be recommended for protecting pregnant women from mental health problems during the pandemic.
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Affiliation(s)
- Thuc C. Luong
- Department of Cardiology, Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam
- Director Office, Military Hospital 103, Hanoi, Vietnam
| | - Thu T. M. Pham
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Minh H. Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Anh Q. Do
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Linh V. Pham
- Department of Pulmonary and Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
- Director Office, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
| | - Hoang C. Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Huu C. Nguyen
- Director Office, E Hospital, Hanoi, Vietnam
- Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam
| | - Tung H. Ha
- Director Office, General Hospital of Agricultural, Hanoi, Vietnam
| | - Hung K. Dao
- Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam
| | - Manh V. Trinh
- Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam
| | - Thinh V. Do
- Director Office, Bai Chay Hospital, Quang Ninh, Vietnam
| | - Hung Q. Nguyen
- Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam
| | - Thao T. P. Nguyen
- Health Management Training Institute, University of Medicine and Pharmacy, Hue University, Thua Thien Hue, Vietnam
| | - Cuong Q. Tran
- Director Office, Thu Duc District Health Center, Ho Chi Minh City, Vietnam
- Faculty of Health, Mekong University, Vinh Long, Vietnam
| | - Khanh V. Tran
- Director Office, Le Van Thinh Hospital (previously Hospital District 2), Ho Chi Minh City, Vietnam
| | - Trang T. Duong
- Nursing Office, Tan Phu District Hospital, Ho Chi Minh City, Vietnam
| | - Hai X. Pham
- Director Office, Thu Duc District Health Center, Ho Chi Minh City, Vietnam
| | - Thao T. Do
- Department of Oral Pathology and Periodontology, Faculty of Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | | | - Anh L. Tra
- Department of Rehabilitation & Physiotherapy, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Dung T. Phan
- Nursing Office, Thien An Obstetrics and Gynecology Hospital, Hanoi, Vietnam
- Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam
| | - Binh N. Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam
- Division of Military Science, Military Hospital 103, Hanoi, Vietnam
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
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Implementation, Mechanisms and Context of the MAMAACT Intervention to Reduce Ethnic and Social Disparity in Stillbirth and Infant Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168583. [PMID: 34444335 PMCID: PMC8391863 DOI: 10.3390/ijerph18168583] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022]
Abstract
The MAMAACT intervention aimed to address ethnic and social disparity in stillbirth and infant health by improving management of pregnancy complications. This process evaluation of the intervention was guided by the British Medical Research Council’s framework. We examined implementation through dose, reach, and fidelity, important mechanisms and the influence of contextual factors. The intervention included a six-hour training session for antenatal care (ANC) midwives in intercultural communication and cultural competence, two follow-up dialogue meetings, and health education materials (leaflet and app) on warning signs of severe pregnancy complications and how to respond for pregnant women. A mixed-methods approach was applied. Cross-sectional survey data and administrative data were used to assess intervention reach and dose. Qualitative data (records from dialogue meetings with midwives, participant observations and field notes from ANC visits, focus group interviews with midwives, and individual interviews with non-Western immigrant women) evaluated intervention fidelity, mechanisms, and contextual barriers. More than 80% of women received the MAMAACT leaflet and many found the content useful. The app was used more selectively. Midwives described being more aware and reflective in their communication with women from various cultural backgrounds. Organizational factors in ANC (time pressure, lack of flexibility in visits, poor interpreter services), barriers in women’s everyday life (lack of social network, previous negative experiences/lack of trust and domestic responsibilities), and habitual interaction patterns among midwives served as contextual barriers. The reach of the intervention was high and it was evaluated positively by both pregnant women and midwives. Organizational factors hindered changes towards more needs-based communication in ANC potentially hindering the intended mechanisms of the intervention. When interpreting the intervention effects, attention should be drawn to both organizational and interpersonal factors in the clinic as well as the pregnant women’s life situations.
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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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