Health literacy in pregnant women facing prenatal screening may explain their intention to use a patient decision aid: a short report

Delanoë, Agathe; Lépine, Johanie; Portocarrero, Maria Esther Leiva; Robitaille, Hubert; Turcotte, Stéphane; Lévesque, Isabelle; Wilson, Brenda J.; Giguère, Anik

doi:10.1186/s13104-016-2141-0

Cited by 32 publications

(36 citation statements)

References 45 publications

(34 reference statements)

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“…Fourth, health literacy was not a factor that influenced women’s intention in our study, although many studies have shown associations between health literacy and related notions, such as patient involvement in decision making [27,38,40-43,47,68]. Hence, a single population based DA implementation program would benefit any pregnant women in the province of Quebec to help them make informed values-congruent decision about prenatal screening for Down syndrome.…”

Section: Discussionmentioning

confidence: 73%

“…After watching the whole video, eligible women answered the Web-based questionnaire based on the TPB but which included additional psychosocial factors known to influence the uptake of a new behavior [57,60-63]. In a previous step of the project, we had conducted a pilot study to validate this questionnaire [68]. We also measured underlying salient beliefs related to the direct constructs as elicited in a previous qualitative study (Leiva Portocarrero, M.…”

Section: Methodsmentioning

confidence: 99%

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Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

et al. 2016

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BackgroundDeciding about undergoing prenatal screening is difficult, as it entails risks, potential loss and regrets, and challenges to personal values. Shared decision making and decision aids (DAs) can help pregnant women give informed and values-based consent or refusal to prenatal screening, but little is known about factors influencing the use of DAs.ObjectiveThe objective of this study was to identify the influence of psychosocial factors on pregnant women’s intention to use a DA for prenatal screening for Down syndrome (DS). We also added health literacy variables to explore their influence on pregnant women’s intention.MethodsWe conducted a survey of pregnant women in the province of Quebec (Canada) using a Web panel. Eligibility criteria included age >18 years, >16 weeks pregnant, low-risk pregnancy, and having decided about prenatal screening for the current pregnancy. We collected data based on an extended version of the Theory of Planned Behavior assessing 7 psychosocial constructs (intention, attitude, anticipated regret, subjective norm, descriptive norm, moral norm, and perceived control), 3 related sets of beliefs (behavioral, normative, and control beliefs), 4 health literacy variables, and sociodemographics. Eligible women watched a video depicting the behavior of interest before completing a Web-based questionnaire. We performed descriptive, bivariate, and ordinal logistic regression analyses.ResultsOf the 383 eligible pregnant women who agreed to participate, 350 pregnant women completed the Web-based questionnaire and 346 were retained for analysis (completion rate 350/383, 91.4%; mean age 30.1, SD 4.3, years). In order of importance, factors influencing intention to use a DA for prenatal screening for DS were attitude (odds ratio, OR, 9.16, 95% CI 4.02-20.85), moral norm (OR 7.97, 95% CI 4.49-14.14), descriptive norm (OR 2.83, 95% CI 1.63-4.92), and anticipated regret (OR 2.43, 95% CI 1.71-3.46). Specific attitudinal beliefs significantly related to intention were that using a DA would reassure them (OR 2.55, 95% CI 1.73-4.01), facilitate their reflections with their spouse (OR 1.55, 95% CI 1.05-2.29), and let them know about the advantages of doing or not doing the test (OR 1.53, 95% CI 1.05-2.24). Health literacy did not add to the predictive power of our model (P values range .43-.92).ConclusionsImplementation interventions targeting the use of a DA for prenatal screening for DS by pregnant women should address a number of modifiable factors, especially by introducing the advantages of using the DA (attitude), informing pregnant women that they might regret not using it (anticipated regret), and presenting the use of DAs as a common practice (descriptive norm). However, interventions on moral norms related to the use of DA should be treated with caution. Further studies that include populations with low health literacy are needed before decisive claims can be made.

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Section: Discussionmentioning

confidence: 73%

Section: Methodsmentioning

confidence: 99%

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

et al. 2016

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“… 23 It has high sensitivity, but it can misclassify people with adequate HL. 29 SILS: it asks patients how often they need help when reading health instructions. The response is recorded on a 5-point Likert-type scale (1-never, 2-rarely, 3-sometimes, 4-often and 5-always) and categorised as adequate or inadequate.…”

Section: Methodsmentioning

confidence: 99%

Influence of health literacy on acceptance of influenza and pertussis vaccinations: a cross-sectional study among Spanish pregnant women

et al. 2018

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ObjectivesImmunisations against influenza and Bordetella pertussis infection are recommended to pregnant women in Valencia (Spain), yet vaccination rates remain low. Health literacy (HL) appears as a crucial factor in vaccination decision-making. We explored the relation between HL of pregnant women and decisions to receive influenza and pertussis immunisations.SettingUniversity hospital in Valencia (Spain).Participants119 women who gave birth at a hospital in Valencia (Spain) between November 2015 and May 2016. Women in the immediate postpartum period (more than 27 weeks of gestation), between November 2015 and May 2016 were included in the study. Women with impairments, language barriers or illiteracy which prevented completion of the questionnaires, or those who were under 18 years were excluded from enrolment.Primary and secondary outcome measuresHL level; influenza and pertussis immunisation rate; reasons for rejection of vaccination.Results119 participants were included (mean age 32.3±5.5 years, 52% primiparous, 95% full-term deliveries). A higher education level was associated with Short Assessment of Health Literacy for Spanish Adults _50 (adjusted R2=0.22, p=0.014) and Newest Vital Sign (adjusted R2=0.258, p=0.001) scores. Depending on the scale, 56%–85% of participants had adequate HL. 52% (62/119) and 94% (112/119) of women received influenza and pertussis immunisation, respectively. Women rejecting influenza vaccine had a higher HL level (measured by SALHSA_50 tool) than those accepting it (Kruskal-Wallis test p=0.022). 24% of women who declined influenza vaccination felt the vaccine was unnecessary, and 23% claimed to have insufficient information.ConclusionsInfluenza vaccination rate was suboptimal in our study. Women with high HL were more likely to decline immunisation. Information from professionals needs to match patients' HL levels to reduce negative perceptions of vaccination.

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“…This tool has been validated for the Hispanic population residing in the United States. It has high sensitivity, but it may misclassify people with adequate literacy [35]. This tool has also been validated for the Spanish speaking population, with moderate reliability (Cronbach α = 0.69) [22].…”

Section: Data Collectionmentioning

confidence: 99%

Influence of Puerperal Health Literacy on Tobacco Use during Pregnancy among Spanish Women: A Transversal Study

Vila‐Candel

Navarro-Illana

Mena‐Tudela

et al. 2020

IJERPH

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Background: Despite the fact that tobacco use during pregnancy produces adverse perinatal effects, some women continue to smoke. Health literacy (HL) is essential for health outcomes in adults. However, little is known about HL in pregnant women or postpartum women. The study aimed to analyse the relationship between the degree of HL of women during the early puerperium and tobacco use during pregnancy. Methods: A multicentre, descriptive, cross-sectional study was carried out with women in the early puerperium in a region of eastern Spain, between November 2017 and May 2018. Their HL level was obtained using the Newest Vital Sign (NVS) tool. Multivariate logistic models were adjusted to estimate the magnitude of association with tobacco use in pregnancy. Odds ratios (OR) were estimated with a 95% confidence interval. Results: 193 were included in the total. 29.5% (57) of pregnant women smoked tobacco during pregnancy, with a smoking cessation rate of 70.1% (40) while pregnant. 42.0% (81) of pregnant women had inadequate or limited HL. A low level of HL was strongly associated with tobacco use, adjusted by catchment area and age of first pregnancy (LRT p < 0.001; ROC curve = 0.71, 95% CI: 0.64–0.79). Conclusion: A low HL is associated with tobacco consumption during pregnancy. Whether low HL reflects the wide constellation of already-known socioeconomic, political and commercial determinants of tobacco use, or whether incorporating HL support interventions strengthens tobacco cessation activities in pregnancy, warrants further research. Still, it should be considered as essential to understanding the health disparities related to its consumption.

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Health literacy in pregnant women facing prenatal screening may explain their intention to use a patient decision aid: a short report

Cited by 32 publications

References 45 publications

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

Influence of health literacy on acceptance of influenza and pertussis vaccinations: a cross-sectional study among Spanish pregnant women

Influence of Puerperal Health Literacy on Tobacco Use during Pregnancy among Spanish Women: A Transversal Study

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