Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 29, 2019
Date Accepted: Mar 20, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Midwives’ Attitudes toward a Tablet Intervention to Promote Safety Behaviors and Experiences to Include Pregnant Women of Different Ethnic Backgrounds in a Randomized Controlled Trial: a qualitative study
ABSTRACT
Background:
Violence against women is considered a global health problem, and intimate partner violence (IPV) around the time of childbirth can have severe consequences for mother and child. Prenatal care is considered a window of opportunity to address IPV and ask women about violence exposure since women are in regular contact with healthcare providers. Mobile Health (mHealth) might overcome barriers to talk about IPV face-to-face.
Objective:
Our objective was to explore midwives’ attitudes toward a tablet intervention with information about IPV, safety behaviors, and their experiences to include pregnant women of different ethnic backgrounds in a randomized controlled trial (RCT).
Methods:
Individual interviews were conducted with nine midwives participating in an RCT to test a video on a tablet to promote safety behaviors in prenatal care. Analysis was guided by thematic analysis, according to Brown and Clark.
Results:
Midwives perceived a tablet intervention as an appropriate supplement to provide information about IPV and to promote safety behaviors in prenatal care. They participated in the RCT primarily to obtain more knowledge regarding how to communicate about IPV. The intervention was perceived as an anonymous door-opener to talk about IPV and a good solution to ensure that every woman gets the same information. However, the content of the intervention had to be trustworthy and in alignment with the information midwives provide to women. Given the sensitivity of IPV, midwives outlined the importance to follow up the intervention with face-to-face communication. Midwives reported technical and time-consumption problems as the main challenges to recruiting women. They experienced challenges to recruit women of different ethnic backgrounds due to linguistic barriers and women’s skepticism about scientific research.
Conclusions:
The tablet intervention might help midwives communicate about IPV. Even though the video was considered as an anonymous door-opener to talk about IPV, midwives outlined the importance that the intervention had to be followed up by face-to-face communication. Midwives’ time scarcity during the consultations has to be considered when implementing the intervention. Further research is needed to overcome barriers that limit inclusion of women from different ethnic backgrounds. Clinical Trial: ClinicalTrials.gov.Identifier: NCT03397277 (registered 11th January 2018)
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