The Turkish validity and reliability of the maternal health literacy inventory in pregnancy

BACKGROUND

There is no Turkish scale measuring maternal health literacy during pregnancy. This study adapted the Maternal Health Literacy Inventory in Pregnancy (MHELIP) to Turkish.

METHODS

A methodological study's sample consisted of 500 pregnant women admitted to the antenatal clinics of a Maternity Hospital in Ankara, Türkiye. Data were collected using a personal information form, the MHELIP and the Turkish Health Literacy Index (HLI). Language, content, and construct validity were determined. Cronbach's alpha coefficient and item analysis were used to assess reliability. Equivalent-form reliability was evaluated using the HLI.

RESULTS

The scale has a four-factor structure that fits well with 48 items (factor loadings: 0.57-0.92; fit index: 4.15 x2/df, 0.08 RMSEA, 0.07 SRMR). The total scale has a Cronbach's alpha of 0.96. The subscales "maternal health knowledge," "search for maternal health information," "assessment of maternal health information," and "maternal health decision making and behavior" have Cronbach's alpha of 0.96, 0.91, 0.86, and 0.94, respectively. There is a correlation between MHELIP and HLI scores (r = 0.570, p<0.001).

CONCLUSION

The MHELIP is a valid and reliable tool for measuring and screening the maternal health literacy of Turkish pregnant women.

Using the teach-back method to improve postpartum maternal-infant health among women with limited maternal health literacy: a randomized controlled study

AIM

This study aimed to evaluate the effects of using the teach-back method among women with limited maternal health literacy (LMHL) on maternal health literacy(MHL), postpartum health behaviours and maternal-infant health outcomes.

METHODS

A randomized controlled study was conducted in the obstetrics department of Anhui Provincial Hospital, China. A total of 258 pregnant women with LMHL were recruited at the point of admission to the hospital for birth and randomly assigned to the control group (n = 130), where women received routine education sessions, and the teach-back group (n = 128), where women received routine education sessions plus a teach-back intervention. The two groups were assessed in terms of MHL before and after the intervention, breastfeeding execution, uptake of 42-day postpartum check-ups, complete uptake of one-time recommended vaccines, and physical health outcomes. Statistical tests were employed for data analysis.

RESULTS

There was no significant difference between the two groups in terms of MHL and other social, demographic, and medical status at baseline. After the intervention, the teach-back group had a higher level of MHL (p < 0.001), better postpartum health behaviours in terms of exclusive breastfeeding within 24 hours postpartum (x² = 22.853, p<0.001), exclusive breastfeeding within 42 days postpartum (x² = 47.735, p<0.001), uptake of 42-day postpartum check-ups (x² = 9.050, p = 0.003) and vaccination (x² = 5.586, p = 0.018) and better maternal-infant health outcomes in terms of the incidence of subinvolution of the uterus (x² = 6.499, p = 0.011), acute mastitis (x² = 4.884, p = 0.027), postpartum constipation (x² = 5.986, p = 0.014), overweight (x² = 4.531, p = 0.033) and diaper dermatitis (x² = 10.896, p = 0.001).

CONCLUSIONS

This study shows that the teach-back method is effective for enhancing MHL, leading to positive postpartum health behaviours, and improving postpartum maternal-infant health outcomes among women with LMHL. The teach-back method may play an important role in improving postpartum maternal-infant health and could be considered in maternal health education.

TRIAL REGISTRATION NUMBER

Our trial has been prospectively registered at ClinicalTrials.gov (Ref. No.: NCT04858945) and the enrollment date was 26/04/2021.

Midwives' self-reported knowledge and skills to assess and promote maternal health literacy: A national cross-sectional survey

BACKGROUND

Little is known about midwives' knowledge and skills to assess and promote maternal health literacy.

AIMS

To test the reliability and validity of a new tool to assess midwives' health literacy knowledge, skills and attitudes.

METHODS

Using a cross-sectional design, midwives were recruited through professional and social media networks. The online survey included demographic and professional questions and a new measure on midwives' health literacy knowledge, skills and attitudes. Convergent validity was assessed using ten items from the Caring Assessment Scale. Perceived barriers to promoting maternal health literacy were sought.

FINDINGS

Three hundred and seven participants completed the survey. A two-factor solution accounted for 41% of variance and resulted in 14 items, including all attitude items, being removed. Cronbach's alpha reliability was acceptable (Skills=.76; Knowledge=.66). Convergent validity was established. Most midwives (77.1%, n=221) reported giving limited attention to formally assessing women's health literacy. Between 30 to 60% of midwives never or only sometimes used specific techniques to promote maternal health literacy. Most (75%, n=201) had not received education about health literacy.

DISCUSSION AND CONCLUSIONS

The new Transforming Maternity Care Collaborative Health Literacy tool was valid and reliable. Few midwives formally assessed or promoted women's health literacy. Midwives require education about maternal health literacy assessment and promotion to ensure women understand information being conveyed. A large national survey of midwives using the new tool is recommended.