[Development and Evaluation of Prenatal Education for Environmental Health Behavior Using Cartoon Comics]

The effect of DECO-MOM mobile application for a prenatal environmental health program on environmental health behaviors: a pilot test

BACKGROUND

The DECO-MOM mobile program was developed to enhance prenatal environmental health behaviors among pregnant women, addressing the challenges of climate change and environmental pollution. This pilot study aimed to assess the feasibility and preliminary impacts of the DECO-MOM app on personal and community health behaviors, quality of life, subjective health status, depression, anxiety, and e-learning satisfaction, guided by the revised protection motivation theory.

METHODS/DESIGN

This non-randomized controlled study employed a pre-post-test design with experimental and control groups. The study analyzed data from 31 participants in the experimental group and 34 in the control group after a four-week mobile application intervention conducted from September 26 to October 24, 2023, in three cities in South Korea.

RESULTS

The experimental group demonstrated significant improvements in personal environmental health behaviors (p = .003), community environmental health behaviors (p = .001), quality of life (p = .043), and e-learning satisfaction (p = .005) compared to the control group. Significant increases were observed in subcategories such as lifestyle (p = .005), dust (p < .001), reduction (p = .011), involvement (p = .007), recycling (p = .005), reuse (p = .035), content (p < .001), and communication (p = .039). However, no significant increases were found in subjective health status, depression, or anxiety.

DISCUSSION

The DECO-MOM app demonstrated feasibility and potential as a mobile health tool to promote environmental health behaviors among pregnant women. Future studies should explore the long-term effects, scalability, and integration of psychological support features to optimize outcomes.

TRIAL REGISTRATION

Trial registration Number: KCT0007725, Registered September 22, 2022. Prospectively registered.

Examining the Effectiveness of Interactive Webtoons for Premature Birth Prevention: Protocol for a Randomized Controlled Trial

BACKGROUND

Premature birth poses significant health challenges globally, impacting infants, families, and society. Despite recognition of its contributing factors, efforts to reduce its incidence have seen limited success. A notable gap exists in the awareness among women of childbearing age (WCA) regarding both the risks of premature birth and the preventative measures they can take. Research suggests that enhancing health beliefs and self-management efficacy in WCA could foster preventive health behaviors. Interactive webtoons offer an innovative, cost-effective avenue for delivering engaging, accessible health education aimed at preventing premature birth.

OBJECTIVE

This protocol describes a randomized controlled trial to assess the effectiveness and feasibility of a novel, self-guided, web-based intervention-Pregnancy Story I Didn't Know in Interactive Webtoon Series (PSIDK-iWebtoons)-designed to enhance self-management efficacy and promote behaviors preventing premature birth in WCA.

METHODS

Using an explanatory sequential mixed methods design, this study first conducts a quantitative analysis followed by a qualitative inquiry to evaluate outcomes and feasibility. Participants are randomly assigned to 2 groups: one accessing the PSIDK-iWebtoons and the other receiving Pregnancy Story I Didn't Know in Text-Based Information (PSIDK-Texts) over 3 weeks. We measure primary efficacy through the self-management self-efficacy scale for premature birth prevention (PBP), alongside secondary outcomes including perceptions of susceptibility, severity, benefits, and barriers based on the health belief model for PBP and PBP intention. Additional participant-reported outcomes are assessed at baseline, the postintervention time point, and the 4-week follow-up. The feasibility of the intervention is assessed after the end of the 3-week intervention period. Outcome analysis uses repeated measures ANOVA for quantitative data, while qualitative data are explored through content analysis of interviews with 30 participants.

RESULTS

The study received funding in June 2021 and institutional review board approval in October 2023. Both the PSIDK-iWebtoons and PSIDK-Texts interventions have been developed and pilot-tested from July to November 2023, with the main phase of quantitative data collection running from November 2023 to March 2024. Qualitative data collection commenced in February 2024 and will conclude in May 2024. Ongoing analyses include process evaluation and data interpretation.

CONCLUSIONS

This trial will lay foundational insights into the nexus of interactive web-based interventions and the improvement of knowledge and practices related to PBP among WCA. By demonstrating the efficacy and feasibility of a web-based, interactive educational tool, this study will contribute essential evidence to the discourse on accessible and scientifically robust digital platforms. Positive findings will underscore the importance of such interventions in fostering preventive health behaviors, thereby supporting community-wide efforts to mitigate the risk of premature births through informed self-management practices.

TRIAL REGISTRATION

Korea Disease Control and Prevention Agency (KDCA) KCT0008931; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=25857.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/58326.

The effects of environmental prenatal program on environmental health perception and behavior using internet-based intervention in South Korea: A non-randomized controlled study

PURPOSE

This study aimed to develop and examine the effects of an internet-based intervention program on environmental perception and behavior among Korean pregnant women based on revised protection motivation theory.

METHOD

This study was a non-equivalent control group pre-post-test design. The experimental program consisted of prenatal education, reduction of fine dust, birth education, environmental health promotion, and postnatal management education using zoom video conferences. The face-to-face interventions were provided through regular prenatal classes at public health services for the control group. The total participant was 49 pregnant women: 25 in the experimental group and 24 in the control group. The program adaptation was conducted between April 2021 and November 2021 in Korea. The data were analyzed by ANCOVA and t-test to examine the effects using SPSS 26.0 program.

RESULTS

After intervention of the program, environmental severity (F = 17.96, p < .001), response efficacy (F = 15.69, p < .001), and total environmental perception (F = 7.80, p = .008) were higher in the experimental group than in the control group. There were no significant differences in feasibility, accessibility, satisfaction, susceptibility, self-efficacy, barrier, personal environmental behavior, and community environmental behavior between the two groups.

CONCLUSION

The internet-based educational program can be the alternative for the face-to-face prenatal class to promote environmental health perceptions during pregnancy in the pandemic situations.

Development and effects of a webtoon education program on preventive self-management related to premature labor for women of childbearing age: a randomized controlled trial

PURPOSE

The purpose of this study was to develop a webtoon education program on preventive self-management related to premature labor (PSM-PL) for women of childbearing age, to evaluate its effects, and to assess the usability of webtoon education for women of childbearing age.

METHODS

The study design was a stratified randomized trial with repeated measures. The participants were Korean women of childbearing age (between the ages of 19 and 49 years), with 49 participants each. The preventive health management self-efficacy related to premature labor (PHMSE-PL) scale, the preventive self-management knowledge related to premature labor (PSMK-PL) scale, and usability of webtoon education were assessed. The intervention group read six episodes of the PSM-PL webtoon within 2 days after clicking an online link. The control group did not receive anything but was given the webtoon after the last measurement. To test the effect of the repeatedly measured variables, a generalized estimating equation model was used.

RESULTS

The experimental group had statistically significantly greater increases in PHMSE-PL and PSMK-PL scores from baseline to immediately after and 2 weeks later than the control group. The average score for usability of webtoon education was high (4.52; standard deviation, 0.62) on a scale of 1-5.

CONCLUSION

This webtoon education program on PSM-PL was a feasible and acceptable program that increased self-efficacy and knowledge of preventive health management of premature labor in women of childbearing age. Future studies that adopt a webtoon format can be beneficial for childbearing women with other risk factors.