eLearning significantly improves maternity professionals’ knowledge of the congenital cytomegalovirus prevention guidelines

Abstract

Aims: Cytomegalovirus (CMV) is a preventable cause of neurodevelopmental disability. Australian guidelines recommend that pregnant women are informed about CMV to reduce their risk of infection; however, less than 10% of maternity health professionals routinely provide prevention advice. The aim was to develop and evaluate the effectiveness of an eLearning course for midwives to improve knowledge and confidence about CMV. Materials and Methods: Participants undertaking the course between March and November 2020 were invited to complete an evaluation questionnaire: before the course (T1), immediately after (T2) and three months post completion (T3). A linear mixed model was used to evaluate change in participant scores; P < 0.05 was considered statistically significant. Results: Midwives (316/363, 87%), midwifery students (29/363, 8%) and nurses (18/363, 5%) participated. At T1 80% indicated they had not received education about CMV. Total adjusted mean scores for questionnaires completed between T1 (n = 363) and T2 (n = 238) increased significantly (from 17.2 to 22.8, P < 0.001). Limited available T3 scores (n = 27) (−1.7, P < 0.001), while lower than T2, remained higher than at T1 (+3.6, P < 0.001). Participants' awareness of CMV information resources improved from 10 to 97% from T1 to T2. Confidence in providing CMV advice increased from 6 to 95% between T1 and T2 (P < 0.001) and was maintained at T3. Almost all (99%) participants indicated they would recommend the course to colleagues. Conclusion: Participants who completed the eLearning course had significantly improved knowledge and confidence in providing advice about CMV. Programs targeting other maternity health professionals should be considered, to further support the implementation of the congenital CMV prevention guidelines.

Primary, Secondary, and Tertiary Prevention of Congenital Cytomegalovirus Infection

“…Knowledge of CMV and its mode of transmission is the cornerstone of primary prevention, enabling women of childbearing age and in early pregnancy to apply adapted hygienic measures to avoid CMV primary infection or re-infection [20]. Despite an evolution in awareness over the last decade, the most recent studies still show significant gaps in the knowledge of pregnant women [21][22][23], which considerably reduces the effectiveness of primary prevention. At the same time, constant progress in CMV vaccines may provide a promising option to prevent maternal infections during pregnancy in the near future.…”

“…However, the results of numerous studies conducted worldwide have shown that the practices of health professionals regarding CMV information and prevention differ considerably from one professional to another [21,72]. In order to understand the reasons for these divergent practices, some authors have looked at the training of future health professionals as well as the place allocated to CMV education in academic curriculum [23,73]. One study reported that gaps were identified early in the training of future physicians.…”

“…Using a questionnaire to assess their general knowledge of CMV and cCMV during their first four years of training, it was shown that although there was a significant increase in medical students' awareness of CMV during their years of study, due to a pre-clinical course on infectious disease given and the encounter with cCMV patients during clinical rotations, there was, nevertheless, a significant lack of knowledge regarding modes of transmission and available treatments at the end of the university curriculum [73]. Among the strategies investigated by different authors to improve knowledge of CMV among health professionals, early education on the virus and its mode of transmission in medical school, as well as the implementation of relevant educational materials and target education, is among the training opportunities to be developed in the future [23,73,74].…”

“…About 32% to 70% of the health professionals surveyed never gave information about CMV to their pregnant patients [21][22][23]76,78,79]. The reasons given by the participants for not practicing prevention with their patients were insecurity about their lack of knowledge of risk factors and preventive measures to avoid infection [23,71,76,79], fear of being a source of anxiety for the mother [23,71,79], lack of time [79], the belief that the disease is rare [79], the fact that it is not considered a common practice [79], and the fact that it is not a mandatory recommendation [23,78]. Lack of knowledge is a recurrent theme mentioned by the participants to explain their absence of preventive discourse [71,76,[79][80][81].…”

“…In order to determine whether increased knowledge of the virus by health professionals could have a positive impact on preventive messages delivered to pregnant women, studies were conducted on the same group of professionals before and after attending an educational program on the virus [23,71,80]. One of the studies found that the rate of correct responses related to CMV increased by 26.9% (p-value < 0001) and that 100% of the participants intended to increase their antenatal counselling on CMV after attending the program [80].…”