Patient Activation in the Postpartum Period by Race, Ethnicity, and Spoken Language

Abstract

Objective

To describe needs for support, support-seeking actions, and level of patient activation in the postpartum period among four demographic groups defined by race, ethnicity, and spoken language.

Design

Cross-sectional study of survey data.

Setting

Online survey in the United States.

Participants

Adult women who gave birth in the past 12 months and were able to read and speak English or Spanish (N = 446).

Methods

We conducted descriptive analyses of all study variables and examined differences in sociodemographic characteristics, support needs, and patient activation across four demographic groups. We used chi-square or Fisher’s exact tests to evaluate differences in categorical variables and analysis of variance for continuous variables, with Bonferroni-adjusted post hoc comparisons. We calculated effect sizes for all significant group differences.

Results

English-speaking Hispanic respondents were the most likely to report the need for support for mental symptoms (n = 98, 83.5%; p = .03) among all groups. Nearly all respondents who endorsed the need for physical (n = 363, 97.8%) or mental health support (n = 319, 96.1%) reported that they took some action such as calling a provider or going to a clinic or hospital. Spanish-speaking Hispanic respondents had lower reported activation levels (n = 81, 47.4%; p = .01) than English-speaking Hispanic (n = 83, 71.6%), Black (n = 68, 70.1%), and White respondents (n = 49, 79.0%).

Conclusion

Perceived needs for support and levels of patient activation in the postpartum period differed by demographic group. Future researchers should explore other demographic, psychosocial, and health care system factors associated with patient activation in the postpartum period and strategies to support improved skills and confidence in receiving postpartum care.