The effects of a health literacy promotion program for prevention of preterm birth among pregnant women who received antenatal care services in the hospital-based

Women and Children Nursing Pub Date : 2025-03-01 DOI:10.1016/j.wcn.2025.01.003

Narisa Timsin , Supichaya Wangpitipanit

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Abstract

Background

Premature birth, defined as delivery before 37 weeks of gestation, is a critical global health issue that poses significant risks to maternal and neonatal well-being. Although substantial research has been conducted on interventions to prevent preterm births in high-income countries, evidence on culturally adapted strategies tailored for pregnant women in low- and middle-income settings, such as Thailand, remains limited. This study addresses this gap by evaluating a culturally tailored health literacy promotion program developed using Nutbeam's health literacy model to enhance health literacy and risk perception among Thai pregnant women.

Methods

A quasi-experimental one-group pretest-posttest study was conducted from March to September 2024 at health promotion hospitals in Thailand. Thirty-one pregnant women receiving prenatal care were recruited through convenience sampling. The intervention was a 12-week health literacy program based on Nutbeam's health literacy model and prenatal care standards, emphasizing cognitive, behavioral, and motivational aspects of health literacy. The program included a care booklet, risk screening manual, assessment stickers, and educational materials. Weekly interactive "4-Checks" sessions (20–45 min) and personalized counseling every four weeks were central components. Health literacy and risk perception were assessed using validated questionnaires with a content validity index of 0.90 and high reliability (Cronbach's alpha = 0.85, health literacy; 0.87, risk perception). Measurements were taken before and after the program to assess baseline levels and immediate effects of the intervention. Statistical analyses, including Wilcoxon signed-rank tests, were performed using IBM SPSS Statistics version 29.0.2.0.

Results

The mean age of participants was 30.23 years (SD = 5.26), with 51.6% in their second or subsequent pregnancies. Key information sources included hospital staff, healthcare providers, relatives, and social media. The program significantly improved health literacy scores (0–64 to 40–80; Z = −4.01, P < 0.001) and risk perception scores (10–50 to 33–50; Z = −3.54, P < 0.001).

Conclusion

The health literacy program effectively enhanced health literacy and risk perception among Thai pregnant women, providing a viable framework for reducing premature birth risks. Future research should incorporate control groups and longitudinal assessments to evaluate sustained effects and long-term program impacts.

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保健知识普及促进方案对在医院接受产前保健服务的孕妇预防早产的效果

早产的定义是在妊娠37周之前分娩，是一个严重的全球健康问题，对孕产妇和新生儿的健康构成重大风险。尽管对高收入国家预防早产的干预措施进行了大量研究，但针对泰国等低收入和中等收入国家孕妇量身定制的文化适应战略的证据仍然有限。本研究通过评估一项文化量身定制的健康素养促进计划来解决这一差距，该计划使用Nutbeam的健康素养模型来提高泰国孕妇的健康素养和风险认知。方法于2024年3月至9月在泰国健康促进医院进行准实验性一组前测后测研究。采用方便抽样的方法，招募31名接受产前护理的孕妇。干预是一项为期12周的健康素养计划，以Nutbeam的健康素养模型和产前护理标准为基础，强调健康素养的认知、行为和动机方面。该计划包括一本护理手册、风险筛查手册、评估贴纸和教育材料。每周互动“4-检查”会议（20-45分钟）和每四周个性化咨询是核心组成部分。采用内容效度指数为0.90、信度高的有效问卷对健康素养和风险感知进行评估(Cronbach’s alpha = 0.85，健康素养；0.87，风险感知)。在项目前后进行测量，以评估基线水平和干预的即时效果。使用IBM SPSS Statistics version 29.0.2.0进行统计分析，包括Wilcoxon sign -rank检验。结果参与者平均年龄为30.23岁（SD = 5.26），其中51.6%为第二次或后续妊娠。主要信息来源包括医院工作人员、医疗保健提供者、亲属和社交媒体。该方案显著提高了健康素养得分(0-64至40-80；Z =−4.01，P；0.001)和风险感知评分(10-50至33-50；Z =−3.54,P <；0.001)。结论健康素养项目有效提高了泰国孕妇的健康素养和风险认知，为降低早产风险提供了可行的框架。未来的研究应纳入对照组和纵向评估，以评估持续效果和长期项目影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Women and Children Nursing

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