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- Title
Smartphone-Based Video Antenatal Preterm Birth Education: The Preemie Prep for Parents Randomized Clinical Trial.
- Authors
Flynn, Kathryn E.; McDonnell, Siobhan M.; Brazauskas, Ruta; Ahamed, S. Iqbal; McIntosh, Jennifer J.; Pitt, Michael B.; Pizur-Barnekow, Kris; Kim, U. Olivia; Kruper, Abbey; Leuthner, Steven R.; Basir, Mir A.
- Abstract
Key Points: Question: What are the effects of a smartphone-based preterm birth education program in early pregnancy on recommended parental preterm birth knowledge, preparation for decision-making, and parental anxiety? Finding: In a parallel-group randomized clinical trial of 120 pregnant participants with a risk factor for preterm birth, those assigned to the smartphone preterm birth video education program (intervention group) had more knowledge of core competencies and were more prepared to make decisions that affect maternal and infant health, without experiencing increased anxiety, compared with participants assigned to the control group. Meaning: Anticipatory preterm birth education in early pregnancy may empower parents with known preterm birth risk factors to participate in medical care decisions in the event of preterm birth. Importance: Preterm birth is a leading cause of infant mortality and child morbidity. Preterm birth is not always unexpected, yet standard prenatal care does not offer anticipatory education to parents at risk of delivering preterm, which leaves parents unprepared to make health care choices during the pregnancy that can improve survival and decrease morbidity in case of preterm birth. Objective: To evaluate the effect of the Preemie Prep for Parents (P3) program on maternal knowledge of preterm birth, preparation for decision-making, and anxiety. Design, Setting, and Participants: Recruitment for this randomized clinical trial conducted at a US academic medical center took place from February 3, 2020, to April 12, 2021. A total of 120 pregnant persons with a risk factor for preterm birth were enrolled between 16 and 21 weeks' gestational age and followed up through pregnancy completion. Intervention: Starting at 18 weeks' gestational age, P3 program participants received links delivered via text message to 51 gestational age–specific short animated videos. Control participants received links to patient education webpages from the American College of Obstetricians and Gynecologists. Main Outcomes and Measures: At 25 weeks' gestation, scores on the Parent Prematurity Knowledge Questionnaire (scored as percent correct), Preparation for Decision Making Scale (scored 0-100), and Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety computerized adaptive test. Analysis was based on an intention to treat. Results: A total of 120 pregnant participants (mean [SD] age, 32.5 [4.9] years) were included in the study; 60 participants were randomized to each group. Participants in the P3 group scored higher than those in the control group on knowledge of long-term outcomes at 25 weeks (88.5% vs 73.2%; estimated difference, 15.3 percentage points; 95% CI, 8.3-22.5 percentage points; P <.001). Participants in the P3 group reported being significantly more prepared than did participants in the control group for neonatal resuscitation decision-making at 25 weeks (Preparation for Decision Making Scale score, 76.0 vs 52.3; difference, 23.7; 95% CI, 14.1-33.2). There was no difference between the P3 group and the control group in anxiety at 25 weeks (mean [SE] PROMIS Anxiety scores, 53.8 [1.1] vs 54.0 [1.1]; difference, −0.1; 95% CI, −3.2 to 2.9). Conclusions and Relevance: In this randomized clinical trial, pregnant persons randomly assigned to the P3 program had more knowledge of core competencies and were more prepared to make decisions that affect maternal and infant health, without experiencing worse anxiety. Mobile antenatal preterm birth education may provide a unique benefit to parents with preterm birth risk factors. Trial Registration: ClinicalTrials.gov Identifier: NCT04093492 This randomized clinical trial evaluates the effect of the Preemie Prep for Parents program on parental knowledge of preterm birth, preparation for decision-making, and parent anxiety.
- Subjects
PREMATURE infants; ACADEMIC medical centers; CONFIDENCE intervals; PATIENT decision making; SMARTPHONES; PREGNANT women; GESTATIONAL age; HEALTH literacy; RANDOMIZED controlled trials; PATIENT-family relations; DECISION making; DESCRIPTIVE statistics; QUESTIONNAIRES; PRENATAL care; ANXIETY; SECOND trimester of pregnancy; INTENTION; ODDS ratio; STATISTICAL sampling; EDUCATIONAL outcomes; AMERICAN College of Obstetricians &; Gynecologists
- Publication
JAMA Pediatrics, 2023, Vol 177, Issue 9, p921
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2023.1586