scholarly journals Using Text Messaging to Improve Access to Prenatal Health Information in Urban African American and Afro-Caribbean Immigrant Pregnant Women: Mixed Methods Analysis of Text4baby Usage (Preprint)

2019 ◽  
Author(s):  
Tenya M Blackwell ◽  
LeConte J Dill ◽  
Lori A Hoepner ◽  
Laura A Geer
Keyword(s):  
Health Care ◽  
African American ◽  
Mixed Methods ◽  
Pregnant Women ◽  
Health Information ◽  
Behavioral Intent ◽  
Prenatal Health ◽  
Intent To Use ◽  
Prenatal Health Care

BACKGROUND The Text4baby (T4B) mobile health (mHealth) program is acclaimed to provide pregnant women with greater access to prenatal health care, resources, and information. However, little is known about whether urban African American and Afro-Caribbean immigrant pregnant women in the United States are receptive users of innovative health communication methods or of the cultural and systematic barriers that inhibit their behavioral intent to use T4B. OBJECTIVE This study aimed to understand the lived experiences of urban African American and Afro-Caribbean immigrant pregnant women with accessing quality prenatal health care and health information; to assess usage of mHealth for seeking prenatal health information; and to measure changes in participants’ knowledge, perceptions, and behavioral intent to use the T4B mHealth educational intervention. METHODS An exploratory sequential mixed methods study was conducted among pregnant women and clinical professionals for a phenomenological exploration with focus groups, key informants, interviews, and observations. Qualitative themes were aligned with behavioral and information technology communications theoretical constructs to develop a survey instrument used. repeated-measures pre- and post-test design to evaluate changes in participants’ knowledge, attitudes, and beliefs, of mHealth and T4B after a minimum of 4 weeks’ exposure to the text message–based intervention. Triangulation and mixing of both qualitative and quantitative data occurred primarily during the survey development and also during final analysis. RESULTS A total of 9 women participated in phase 1, and 49 patients signed up for T4B and completed a 31-item survey at baseline and again during follow-up. Three themes were identified: (1) patient-provider engagement, (2) social support, and (3) acculturation. With time as a barrier to quality care, inadequate patient-provider engagement left participants feeling indifferent about the prenatal care and information they received in the clinical setting. Of 49 survey participants, 63% (31/49) strongly agreed that T4B would provide them with extra support during their pregnancy. On a Likert scale of 1 to 5, participants’ perception of the usefulness of T4B ranked at 4.26, and their perception of the compatibility and relative advantage of using T4B ranked at 4.41 and 4.15, respectively. At follow-up, there was a 14% increase in participants reporting their intent to use T4B and a 28% increase from pretest and posttest in pregnant women strongly agreeing to speak more with their doctor about the information learned through T4B. CONCLUSIONS Urban African American and Afro-Caribbean immigrant pregnant women in Brooklyn endure a number of social and ecological determinants like low health literacy, income, and language that serve as barriers to accessing quality prenatal health care and information, which negatively impacts prenatal health behaviors and outcomes. Our study indicates a number of systematic, political, and other microsystem-level factors that perpetuate health inequities in our study population.

scholarly journals Using Text Messaging to Improve Access to Prenatal Health Information in Urban African American and Afro-Caribbean Immigrant Pregnant Women: Mixed Methods Analysis of Text4baby Usage

10.2196/14737 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14737 ◽  
Author(s):  
Tenya M Blackwell ◽  
LeConte J Dill ◽  
Lori A Hoepner ◽  
Laura A Geer
Keyword(s):  
Health Care ◽  
African American ◽  
Mixed Methods ◽  
Pregnant Women ◽  
Health Information ◽  
Behavioral Intent ◽  
Prenatal Health ◽  
Intent To Use ◽  
Prenatal Health Care

Background The Text4baby (T4B) mobile health (mHealth) program is acclaimed to provide pregnant women with greater access to prenatal health care, resources, and information. However, little is known about whether urban African American and Afro-Caribbean immigrant pregnant women in the United States are receptive users of innovative health communication methods or of the cultural and systematic barriers that inhibit their behavioral intent to use T4B. Objective This study aimed to understand the lived experiences of urban African American and Afro-Caribbean immigrant pregnant women with accessing quality prenatal health care and health information; to assess usage of mHealth for seeking prenatal health information; and to measure changes in participants’ knowledge, perceptions, and behavioral intent to use the T4B mHealth educational intervention. Methods An exploratory sequential mixed methods study was conducted among pregnant women and clinical professionals for a phenomenological exploration with focus groups, key informants, interviews, and observations. Qualitative themes were aligned with behavioral and information technology communications theoretical constructs to develop a survey instrument used. repeated-measures pre- and post-test design to evaluate changes in participants’ knowledge, attitudes, and beliefs, of mHealth and T4B after a minimum of 4 weeks’ exposure to the text message–based intervention. Triangulation and mixing of both qualitative and quantitative data occurred primarily during the survey development and also during final analysis. Results A total of 9 women participated in phase 1, and 49 patients signed up for T4B and completed a 31-item survey at baseline and again during follow-up. Three themes were identified: (1) patient-provider engagement, (2) social support, and (3) acculturation. With time as a barrier to quality care, inadequate patient-provider engagement left participants feeling indifferent about the prenatal care and information they received in the clinical setting. Of 49 survey participants, 63% (31/49) strongly agreed that T4B would provide them with extra support during their pregnancy. On a Likert scale of 1 to 5, participants’ perception of the usefulness of T4B ranked at 4.26, and their perception of the compatibility and relative advantage of using T4B ranked at 4.41 and 4.15, respectively. At follow-up, there was a 14% increase in participants reporting their intent to use T4B and a 28% increase from pretest and posttest in pregnant women strongly agreeing to speak more with their doctor about the information learned through T4B. Conclusions Urban African American and Afro-Caribbean immigrant pregnant women in Brooklyn endure a number of social and ecological determinants like low health literacy, income, and language that serve as barriers to accessing quality prenatal health care and information, which negatively impacts prenatal health behaviors and outcomes. Our study indicates a number of systematic, political, and other microsystem-level factors that perpetuate health inequities in our study population.

scholarly journals Factors Affecting Patient Portal Use Among Low-Income Pregnant Women: Mixed-Methods Pilot Study (Preprint)

2015 ◽  
Author(s):  
Juhee Kim ◽  
Holly Mathews ◽  
Lindsay M Cortright ◽  
Xiaoming Zeng ◽  
Edward Newton
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Literacy ◽  
Pregnant Women ◽  
Low Income ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Convenience Sample ◽  
Prenatal Health

BACKGROUND Patient portals offer patients personalized and secure Web access to their medical information and enable patients to manage their health care online. However, there is a lack of information about patient acceptance and use of patient portals among low-income pregnant women. OBJECTIVE This formative research aims to assess the potential of a patient portal, MyChart, for improving prenatal health care and pregnancy outcomes, and identify the barriers and facilitators of MyChart use among low-income pregnant women. METHODS A mixed-methods study was conducted with a convenience sample of 18 low-income pregnant women comprising low- and high-risk patients enrolled in a prenatal clinic in eastern North Carolina. MyChart use, patient demographics, and pregnancy information were collected by reviewing electronic medical charts. Health literacy was measured. Reported use and attitudes toward MyChart were collected using a semi-structured interview. RESULTS Although 39% (7/18) of participants interviewed signed up for MyChart, only 22% (4/18) of them became active users. Another 33% (6/18) had never heard of MyChart or was unsure of how to access it. Users primarily accessed test results and appointment schedules. The main facilitating factors for patient portal use were information and motivation from health care providers and concerns about pregnancy due to a history of miscarriage. Reported barriers were lack of educational resources, lack of care provider encouragement, and technical difficulties possibly exacerbated by low health literacy. Participants also suggested improvements for MyChart, especially the provision of discussion-based support for pregnant women. CONCLUSIONS The one-time verbal introduction of MyChart does not meet current patients’ needs. Data reveal the need for more consistent patient education and support programs, tailored to patients’ previous pregnancy histories. The clinic also needs to facilitate better provider-patient communication about the importance of MyChart use.

scholarly journals Mixed methods assessment of impact on health awareness in adult childhood cancer survivors after viewing their personalized digital treatment summary and follow-up recommendations

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helena M. Linge ◽  
Cecilia Follin
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Literacy ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
The Self ◽  
Health Related ◽  
Treatment Summary

Abstract Background The survival rate after childhood cancer has improved to 80%. The majority of childhood cancer survivors (CCS) will experience late complications which require follow up care, including access to their individual cancer treatment summary. The need to understand CCS needs and preferences in terms of ways to receive information e.g. digitally, becomes important. This study aims to through a mixed methods approach a) examine how CCS’ health awareness was impacted by viewing their personalized digital treatment summary and follow-up recommendations, b) explore E health literacy, and c) determine self-reported survivorship experiences and health care usage. Methods Survivors with a recent visit to the Late effects clinic were eligible for the study (n = 70). A representative sample of primary diagnoses were invited (n = 28). 16 CCS were enrolled. Recent medical visits, e health literacy and impressions of the digital treatment summary were assessed by a survey in conjunction with viewing their digital treatment summary on a computer screen. Their experience of reading and understanding their digital treatment summary in the context of their health related survivorship experiences were assessed in focus groups. The transcribed data was analyzed with conventional qualitative content analysis. Results The self-reported medical problems largely reflected that, only 6,3% reported no cancer-related reasons for seeking medical attention. Of the medical specialists, the primary care physician was the most frequently visited specialist (68.8%). High E health literacy was not associated with treatment features but with educational level (p = 0.003, CI: 3.9–14.6) and sex (p = 0.022, CI: − 13.6- -1.3). All survivors graded the digital treatment summary above average in terms of being valuable, agreeable and comprehensive. The focus group interviews identified three themes: 1) The significance of information, 2) The impact of awareness; and 3) Empowerment. Conclusions Reading the treatment summaries furthered the survivors understanding of their health situation and consequently aided empowerment. A digital treatment summary, provided by knowledgeable health care professionals, may increase the self-managed care and adherence to follow-up recommendations. Further insights into e health literacy in larger samples of CCS may determine to what extent health-related information can be communicated via digital resources to this at risk population.

A Follow up to Semi-Automatic Systems for Exchanging Health Information

2016 ◽  
pp. 1316-1334
Author(s):  
Dimitrios Emmanouil ◽  
Antonia Mourtzikou
Keyword(s):  
Health Care ◽  
Health Information ◽  
Mobile Devices ◽  
Automatic System ◽  
Health Care Services ◽  
Care Services ◽  
Fully Automatic ◽  
Citizen Service ◽  
Automatic Systems

The present research is an attempt to explore the applicability of the best possible service in the area of organized health care services, at fixed predefined points of service. The suggestion is that there should be a system that will receive and provide information about health matters of general public concern. Thus following the lead of Citizen Service Centers in Greece, it can be extended conveniently to mobile devices. The main survey was conducted on a sample of Municipalities and Citizens in the year 2013. The results indicate that the new proposed system could be more secure for citizens for future use, based on supervising procedure by proper employee who will provide more help to the users, instead of a fully automatic system.

scholarly journals Follow-up of Abnormal Estimated GFR Results Within a Large Integrated Health Care Delivery System: A Mixed-Methods Study

2019 ◽  
Vol 74 (5) ◽  
pp. 589-600 ◽  
Author(s):  
Kim N. Danforth ◽  
Erin E. Hahn ◽  
Jeffrey M. Slezak ◽  
Lie Hong Chen ◽  
Bonnie H. Li ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Delivery System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Mixed Methods Study ◽  
Estimated Gfr ◽  
System A

scholarly journals Does Sense make sense? Mixed methods study of a Dutch sexual health program

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Joosten ◽  
L Jochems ◽  
C Wijsen ◽  
T Heijman ◽  
A Timen
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Young People ◽  
Sexual Health ◽  
Health Care Professionals ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Open Atmosphere ◽  
Study Results

Abstract In the Netherlands, the Sense program addresses several key elements of sexual health for young people <25 year. This program offers free consultations at the PHS concerning STI, contraceptives, pregnancy or sexuality. The performance of this program has not been studied yet. This mixed methods study investigates facilitators and barriers of a Sense consultation from the perspective of clients and health care professionals (HCP) and investigates the outcome of the consultation at three points in time. Semi-structured interviews were conducted after consultation among 16 clients and 6 HCP. Questionnaires were collected directly after consultation and at 3, 6 and 12 months after consultation. Two cohorts were recruited; clients with STI consultation only and clients with questions related to sexuality, contraception and pregnancy (Sense consultation, SC). Satisfaction of the consultation and applicability of the given advice was measured. In the follow up presence of STI, pregnancy, sexual problem and contraceptive use was measured. A minority of the interviewed clients were familiar with Sense, highly valued the expertise of the HCP and the open atmosphere during the consultation. Reasons for visiting Sense included expertise, more anonymity and feeling more comfortable than at the GP. The questionnaire after consultation was returned by 144 STI clients and 32 SC clients. Both type of consultation were highly valued and advice was easily applicable. The follow up cohort included 97 STI clients and 23 SC clients. Response rate of the 3- and 6 month-questionnaires was 61%. Results of the full one year follow-up are expected in September 2019. Study results provide evidence for a highly valued Sense program, by both clients and HCP. Sense is a platform to discuss STI, contraception and sexuality in an open atmosphere, though familiarity with Sense is low. A major conclusion is that an STI consultation provides the opportunity to address questions related to sexuality. Key messages The Sense program is highly valued by young people, and yet the program is not widely known among young people. There is need for more publicity to the program to enable more young people to use this program and to improve the sexual health care of young Dutch people.

scholarly journals Understanding Prenatal Health Care for American Indian Women in a Northern Plains Tribe

2011 ◽  
Vol 23 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Jessica D. Hanson
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
American Indian ◽  
Qualitative Interviews ◽  
Northern Plains ◽  
American Indian Women ◽  
Indian Women ◽  
Prenatal Health ◽  
Health Care Experiences ◽  
Prenatal Health Care

Early and regular prenatal care appointments are imperative for the health of both the mother and baby to help prevent complications associated with pregnancy and birth. American Indian women are especially at risk for health disparities related to pregnancy and lack of prenatal health care. Previous research has outlined a basic understanding of the reasons for lack of prenatal care for women in general; however, little is known about care received by pregnant women at Indian Health Service hospitals. Qualitative interviews were carried out with 58 women to better understand the prenatal health experiences of American Indian women from one tribe in the Northern Plains. Several themes related to American Indian women’s prenatal health care experiences were noted, including communication barriers with physicians, institutional barriers such as lack of continuity of care, and sociodemographic barriers. Solutions to these barriers, such as a nurse midwife program, are discussed.

scholarly journals Knowledge of prenatal health care among Costa Rican and Panamanian women

2008 ◽  
Vol 23 (6) ◽  
pp. 369-376
Author(s):  
William Harold Guilford ◽  
Kara Elizabeth Downs ◽  
Trevor Joseph Royce
Keyword(s):  
Health Care ◽  
Costa Rican ◽  
Prenatal Health ◽  
Prenatal Health Care
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