Health Literacy in Pregnant Women: A Systematic Review.
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ABSTRACT:
SUBMITTER: Nawabi F
PROVIDER: S-EPMC8038834 | biostudies-literature | 2021 Apr
REPOSITORIES: biostudies-literature
Publications
Health Literacy in Pregnant Women: A Systematic Review.
Nawabi Farah F Krebs Franziska F Vennedey Vera V Shukri Arim A Lorenz Laura L Stock Stephanie S
International journal of environmental research and public health 20210406 7
Health literacy plays a crucial role during pregnancy, as the mother's health behavior influences both her own health and that of her child. To the authors' best knowledge, no comprehensive overview on evidence of the health literacy of pregnant women and its impact on health outcomes during pregnancy exists. Therefore, this review aims to assess health literacy levels in pregnant women, whether health literacy is associated with outcomes during pregnancy and whether effective interventions exis ...[more]
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Project description:BackgroundLow health literacy can present significant risks throughout pregnancy, impacting both maternal and fetal health outcomes. Those who do not speak the main language of their country of residence are more likely to have lower health literacy. Considering the heightened challenges faced by this demographic in accessing, understanding, and engaging with health information and services, designing and implementing tailored interventions is crucial to mitigate health disparities. This review aims to identify and examine health literacy interventions developed for pregnant women whose first language differs from the language predominantly spoken in their residing country.MethodsElectronic databases of Embase and Medline were searched using relevant search terms from their inception to July 2023. Data were extracted and analysed using narrative synthesis.ResultsOf the 1964 identified records, three were included. The studies were conducted in Australia and Denmark, and ranged in design, including: a cluster randomised controlled trial, mixed methods design; and qualitative design. Health literacy intervention modalities included midwifery education combined with a smartphone application and leaflet, culturally adapted group classes, and informative videos. The interventions were translated into various languages to cater to the target populations. Two studies used the Health Literacy Questionnaire to assess the intervention effectiveness, yielding contrasting results: one showed no improvement, while the other reported increased post-intervention health literacy scores. The third had not yet evaluated intervention effectiveness.ConclusionsThis review identifies a significant scarcity in health literacy interventions for pregnant women whose first language differs to the predominant language of the country they live in, despite their greater need for support. While few studies were found, their diversity suggests multiple strategies for enhancing health literacy. Bridging this health literacy gap for linguistically diverse pregnant populations could reduce disparities in maternal and fetal outcomes, underscoring the need for targeted, evaluated interventions that actively engage affected women and their support networks.Trial registrationRegistered with PROSPERO: CRD42023475511. Date of registration: 10.11.23.
| S-EPMC11600627 | biostudies-literature
Project description: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.
| S-EPMC9141630 | biostudies-literature
Project description:Issue addressedThe 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.MethodsAn 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.Results194 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.ConclusionWomen 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.
| S-EPMC10100018 | biostudies-literature
Project description:BackgroundThe changes in hormones, diet, and hygiene associated with pregnancy are associated with oral diseases. There is insufficient awareness of the importance of oral health during pregnancy. This study investigated the oral health status and knowledge amongst pregnant women in Shanghai.MethodsThis cross-sectional study enrolled pregnant women at the Shanghai Red House Obstetrics & Gynecology Hospital in December 2020. The Fourth National Oral Health Questionnaire was used to evaluate the oral health status. Decayed/missing/filled teeth (DMFT) were the sum of the number of decayed, missing due to caries, and filled teeth. The chi-square test and Kruskal-Wallis test were used to compare the groups.ResultsA total of 224 pregnant women were enrolled. The rates of dental caries were 69.8%, periodontal health was 1.8%, calculus detection was 95.6%, shallow periodontal pocket was 51.1%, deep periodontal pocket was 4.9%, regular oral examination was 22.8%, correct brushing was 49.6%, and prepregnancy oral examination was 20.1%. DMFT was 2.27, and the caries filling ratio was 45.4%. The number of missing teeth increased with age (P < .001). Only 26.3% used dental floss more than once a day, 47.3% rinsed the mouth more than twice a day, and 46.9% cleaned their tongue coating every week. In addition, 99% of the pregnant women agreed that "oral health was vital to their lives" and 97.7% agreed that "regular oral examination was necessary."ConclusionsThe oral health status amongst pregnant women in Shanghai was poor, but oral health awareness and attitudes were relatively high.
| S-EPMC10023588 | biostudies-literature
Project description:BackgroundHealth 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.ObjectiveThis study aimed to investigate antenatal health literacy levels and identify associated factors among pregnant Emirati women in the United Arab Emirates.DesignThis 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.MethodsParticipants 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).ResultsA 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).ConclusionNearly 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.
| S-EPMC10822065 | biostudies-literature
Project description:BackgroundOlder adults, identified as 65 years and over, a population for which low health literacy is prevalent, represented most people attending primary health care services provided by the Health Service Executive (HSE) in Ireland in 2019. Any limitation in a person's health literacy, specifically their ability to access, understand and use health information, can affect their ability to make healthcare related decisions. Information on the evidence for health literacy interventions is also required by healthcare providers and policy makers to inform decision-making and service development to improve outcomes for older people. This review aimed to synthesise the evidence on health literacy interventions and health literacy-related outcomes for older adults. The specific objectives were to (1) identify what health literacy interventions exist in relation to older adults' ability to access, understand, and use health information, (2) determine the health literacy-related outcomes of these interventions, and (3) identify any trends or patterns which may exist between intervention type and outcome.MethodsThis review was conducted by following PRISMA guidelines. The electronic databases PubMed, Embase and Scopus were searched for relevant studies concerning health literacy interventions for older persons. Study data were subsequently analysed using a narrative thematic approach in the context of the three key health literacy characteristics; the ability to access, understand and use health information.ResultsThirty-four studies were identified that met the inclusion criteria. The findings show a potential link between individual-focussed health literacy interventions and positive health literacy-related outcomes in relation to older persons' ability to understand and use health information. The review also found that use of health literacy level assessment tools varied with studies either using different tools for the same older adult cohort, or failing to assess pre-intervention health literacy levels altogether.ConclusionsThe potential trend found between individual-focused interventions and positive health literacy outcomes suggests that implementing health literacy-related interventions directly to the individual is key. Furthermore, our study found an inconsistency amongst the included studies in relation to the implementation of health literacy assessment tools, with different tools used across most studies, and some studies choosing not to utilise any assessment tool.
| S-EPMC11863724 | biostudies-literature
Project description:ObjectiveThis study is to identify the apps used by pregnant women during the technology era and to choose the best app from the point of view of pregnant women and experts.MethodsThe article is a research article that uses PRISMA flowchart. Given that there are many apps in the field of pregnancy and due to technological advances, the articles of the last 13 years that have been scientifically published in the databases of Google Scholar, PubMed, and Science Direct have been analyzed. The most widely used and, at the same time, the best app is introduced in terms of its high usability in users' attitude. Finally, Apps will be compared in terms of accuracy, precision, and usability of the dimensions of Jacob Nielsen's five principles.ResultsAccording to the search strategy, 23 articles were identified qualitatively by reviewing both authors. Then, the types of apps were divided into three general categories, pregnant entertainment apps, pregnant information apps, and monitoring apps for mothers' physical health. Finally, 10 apps were selected and the Amila app was introduced as the best due to its high usability (Effectiveness %66.66) and users' satisfaction or women's choice (%98).ConclusionUsing trusted apps to maintain their health and reduce traffic will be very important. Given that this research article was written with the aim of choosing the best app, that not only provides the required information to mothers, but also the ability to interact with doctors and specialists.
| S-EPMC10768378 | biostudies-literature
Project description:ObjectiveTo examine available health engagement tools suitable to, or modifiable for, vulnerable pregnant populations.DesignSystematic review.Eligibility criteriaOriginal studies of tool development and validation related to health engagement, with abstract available in English, published between 2000 and 2022, sampling people receiving outpatient healthcare including pregnant women.Data sourcesCINAHL Complete, Medline, EMBASE and PubMed were searched in April 2022.Risk of biasStudy quality was independently assessed by two reviewers using an adapted COSMIN risk of bias quality appraisal checklist. Tools were also mapped against the Synergistic Health Engagement model, which centres on women's buy-in to maternity care.Included studiesNineteen studies were included from Canada, Germany, Italy, the Netherlands, Sweden, the UK and the USA. Four tools were used with pregnant populations, two tools with vulnerable non-pregnant populations, six tools measured patient-provider relationship, four measured patient activation, and three tools measured both relationship and activation.ResultsTools that measured engagement in maternity care assessed some of the following constructs: communication or information sharing, woman-centred care, health guidance, shared decision-making, sufficient time, availability, provider attributes, discriminatory or respectful care. None of the maternity engagement tools assessed the key construct of buy-in. While non-maternity health engagement tools measured some elements of buy-in (self-care, feeling hopeful about treatment), other elements (disclosing risks to healthcare providers and acting on health advice), which are significant for vulnerable populations, were rarely measured.Conclusions and implicationsHealth engagement is hypothesised as the mechanism by which midwifery-led care reduces the risk of perinatal morbidity for vulnerable women. To test this hypothesis, a new assessment tool is required that addresses all the relevant constructs of the Synergistic Health Engagement model, developed for and psychometrically assessed in the target group.Prospero registration numberCRD42020214102.
| S-EPMC10008331 | biostudies-literature
Project description:BackgroundTuberculosis (TB) during pregnancy may lead to severe consequences affecting both mother and child. Prenatal care could be a very good opportunity for TB care, especially for women who have limited access to health services. The aim of this review was to gather and evaluate studies on TB care for pregnant women.MethodsWe used a combination of the terms "tuberculosis" and "pregnancy", limited to human, to search for published articles. Studies reflecting original data and focusing on TB care for pregnant women were included. All references retrieved were collected using the Reference Manager software (Version 11).ResultsThirty five studies were selected for review and their data showed that diagnosis was often delayed because TB symptoms during pregnancy were not typical. TB prophylaxis and anti-TB therapy appeared to be safe and effective for pregnant women and their babies when suitable follow up and early initiation were present, but the compliance rate to TB prophylaxis is still low due to lack of follow up and referral services. TB care practices in the reviewed studies were in line in principle with the WHO International Standards for Tuberculosis Care (ISTC).ConclusionsIntegration of TB care within prenatal care would improve TB diagnosis and treatment for pregnant women. To improve the quality of TB care, it is necessary to develop national level guidelines based on the ISTC with detailed guidelines for pregnant women.
| S-EPMC4241224 | biostudies-literature
Project description:BackgroundEnvironmental factors can play an important role in pathogenesis. However, the understanding of the relationship between environmental risks and health in the general population appears to be poor. The aim of this systematic review is to describe the state of research on the relationship between health literacy (HL) or environmental health literacy (EHL) and environmental risks differentiated by the researched environmental risks, the affected population, the measurement and level of HL or EHL, and their interaction with other variables.MethodsA systematic literature search was conducted using the Pubmed, Scopus, and LIVIVO databases. Original studies in German or English that investigated HL or EHL in the context of an environmental risk or pollutant in a population were included. The Navigation Guide was used to assess the methodological quality of the studies.ResultsTwenty-four studies were included in the qualitative analysis. The operationalization of HL or EHL was heterogeneous in 22 studies. Nine studies referred to environmental issues in general, and 15 studies analyzed individual environmental risks. Eleven studies referred to the general population, 12 to specified target groups, and 1 study examined both. The level of HL or EHL proved to be in need of improvement in all populations. Interventions such as trainings were able to increase HL or EHL.DiscussionThe heterogeneous operationalizations impede the comparability of the studies. Future work should target the standardization of methodological aspects. Overall, it appears that interventions such as trainings were conducive to improving HL or EHL. In practice, this should therefore be given greater focus in order to increase HL or EHL.
| S-EPMC10776732 | biostudies-literature