Client-tailored maternity care to increase maternal empowerment: cluster randomized controlled trial protocol; the healthy pregnancy 4 All-2 program.
Cities
Cluster Analysis
Depression, Postpartum
/ epidemiology
Female
Humans
Netherlands
Patient Participation
/ methods
Patient-Centered Care
/ methods
Postnatal Care
/ methods
Pragmatic Clinical Trials as Topic
Pregnancy
Pregnancy Complications
/ epidemiology
Pregnancy Outcome
Prenatal Care
/ methods
Primary Health Care
/ methods
Program Evaluation
Quality of Life
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors
Urban Population
Empowerment
Health inequalities
Maternity care
Risk factors
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
03 Jan 2019
03 Jan 2019
Historique:
received:
27
12
2017
accepted:
17
12
2018
entrez:
5
1
2019
pubmed:
5
1
2019
medline:
16
4
2019
Statut:
epublish
Résumé
The postpartum period is an important period for preventive strategies as common maternal and child health risks may become manifest. Women with a lower socioeconomic status tend to have lower maternal empowerment. Increasing their risks of adverse maternal and child health outcomes. This study aims to assess the effectiveness of a primary care level intervention. Delivered to maternity care assistants, aiming to increase maternal empowerment postpartum. This study is part of the Dutch nationwide "Healthy Pregnancy 4 All-2" (HP4All-2) program, which aims to identify vulnerable mothers and young children at risk of adverse health outcomes, and subsequently improve their care. This program targets women from deprived neighborhoods. A pragmatic cluster randomized controlled trial will be undertaken in 12 maternity care organizations. Maternity care organizations in urban municipalities (i.e. the clusters) will be randomized to either a systematic risk assessment during pregnancy with emphasis on identification of non-medical risk factors for adverse maternal and neonatal health outcomes, and subsequent adaptation of care towards a client-tailored approach during pregnancy and the postpartum period, or solely the systematic risk assessment. The primary outcome is the prevalence of a low maternal empowerment score postpartum. Secondary maternal outcomes cover health-related quality of life, postnatal depression, smoking, alcohol consumption, illicit drug use. Finally, maternal and neonatal health care utilization postpartum are recorded. All outcomes will be analyzed according to the intention-to-treat principle, using multi-level mixed effects models. The study will contribute to evidence regarding the effectiveness of client-tailored, risk-based maternity care to increase maternal empowerment postpartum. Netherlands Trial Registry (NTR) 6311 , registered 03-27-2017.
Sections du résumé
BACKGROUND
BACKGROUND
The postpartum period is an important period for preventive strategies as common maternal and child health risks may become manifest. Women with a lower socioeconomic status tend to have lower maternal empowerment. Increasing their risks of adverse maternal and child health outcomes. This study aims to assess the effectiveness of a primary care level intervention. Delivered to maternity care assistants, aiming to increase maternal empowerment postpartum.
METHODS
METHODS
This study is part of the Dutch nationwide "Healthy Pregnancy 4 All-2" (HP4All-2) program, which aims to identify vulnerable mothers and young children at risk of adverse health outcomes, and subsequently improve their care. This program targets women from deprived neighborhoods. A pragmatic cluster randomized controlled trial will be undertaken in 12 maternity care organizations. Maternity care organizations in urban municipalities (i.e. the clusters) will be randomized to either a systematic risk assessment during pregnancy with emphasis on identification of non-medical risk factors for adverse maternal and neonatal health outcomes, and subsequent adaptation of care towards a client-tailored approach during pregnancy and the postpartum period, or solely the systematic risk assessment. The primary outcome is the prevalence of a low maternal empowerment score postpartum. Secondary maternal outcomes cover health-related quality of life, postnatal depression, smoking, alcohol consumption, illicit drug use. Finally, maternal and neonatal health care utilization postpartum are recorded. All outcomes will be analyzed according to the intention-to-treat principle, using multi-level mixed effects models.
DISCUSSION
CONCLUSIONS
The study will contribute to evidence regarding the effectiveness of client-tailored, risk-based maternity care to increase maternal empowerment postpartum.
TRIAL REGISTRATION
BACKGROUND
Netherlands Trial Registry (NTR) 6311 , registered 03-27-2017.
Identifiants
pubmed: 30606140
doi: 10.1186/s12884-018-2155-9
pii: 10.1186/s12884-018-2155-9
pmc: PMC6318875
doi:
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4Subventions
Organisme : Ministry of Health, Welfare and Sports
ID : grant number: 323911
Organisme : Netherlands Lung Foundation
ID : 4.2.14.063JO
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