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Conditions and Dynamics That Impact Maternal Health Literacy among High Risk Prenatal-Interconceptional Women

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  • Suzanne D. Thomas

    (CSRA Nursing Associates, PC, 300 Gardners Mill Court, Augusta, GA 30907, USA)

  • Sandra C. Mobley

    (Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA)

  • Jodi L. Hudgins

    (Education and Networking, Enterprise Community Healthy Start, Augusta University, Augusta, GA 30912, USA)

  • Donald E. Sutherland

    (Enterprise Community Healthy Start, The Perinatal Center, Augusta University, Augusta, GA 30912, USA)

  • Sandra B. Inglett

    (Enterprise Community Healthy Start, College of Nursing, Augusta University, EC-5338, 987 St. Sebastian Way, Augusta, GA 30912, USA)

  • Brittany L. Ange

    (Department of Population Health, Division of Biostatistics and Data Science, Augusta University, Augusta, GA 30912, USA)

Abstract

The purpose of the study was to describe conditions and dynamics in the lives of high-risk, low-income, Southern United States prenatal-interconceptional women ( n = 37) in a home visiting program that promoted maternal health literacy progression. In the Life Course Health Development (LCHD) Model, conditions were risk and protective factors that impacted health. Dynamics drove the complex, epigenetic relationships between risk and protective factors. Maternal health literacy promotion helped participants address conditions and dynamics to create positive life changes. This research was a retrospective, mixed methods study of women’s service records documenting care from prenatal admission to 24 months post-delivery. The Life Skills Progression Instrument (LSP) was scored to measure maternal health literacy progression. Ethnographic content analysis of visit notes triangulated with quantitative data enabled specificity of critical data elements. Subsequently, a complementary focus group was conducted with the Registered Nurse Case Managers (RNCM). Severe social conditions included devastating poverty, low educational achievement, transient housing, unstable relationships, incarceration, lack of continuous health insurance, and shortage of health care providers. Dynamics included severe psycho-social stressors, domestic violence, lack of employment, low income, low self-esteem and self-expectations, and social/family restraints upon women’s intended positive changes. An important protective factor was the consistent, stable, evidence-informed relationship with the RNCM. Findings from the focus group discussion supported content analysis results.

Suggested Citation

  • Suzanne D. Thomas & Sandra C. Mobley & Jodi L. Hudgins & Donald E. Sutherland & Sandra B. Inglett & Brittany L. Ange, 2018. "Conditions and Dynamics That Impact Maternal Health Literacy among High Risk Prenatal-Interconceptional Women," IJERPH, MDPI, vol. 15(7), pages 1-16, July.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:7:p:1383-:d:155600
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    1. Kotelchuck, M., 1994. "An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index," American Journal of Public Health, American Public Health Association, vol. 84(9), pages 1414-1420.
    2. Olds, D.L. & Henderson Jr., C.R. & Tatelbaum, R. & Chamberlin, R., 1988. "Improving the life-course development of socially disadvantaged mothers: A randomized trial of nurse home visitation," American Journal of Public Health, American Public Health Association, vol. 78(11), pages 1436-1445.
    3. Barak, Adi & Spielberger, Julie & Gitlow, Elissa, 2014. "The challenge of relationships and fidelity: Home visitors' perspectives," Children and Youth Services Review, Elsevier, vol. 42(C), pages 50-58.
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    Cited by:

    1. Liesbeth de Wit & Pania Karnaki & Archontoula Dalma & Peter Csizmadia & Charlotte Salter & Andrea de Winter & Louise Meijering, 2020. "Health Literacy in the Everyday Lives of Older Adults in Greece, Hungary, and the Netherlands," IJERPH, MDPI, vol. 17(7), pages 1-16, April.
    2. Alexander Testa & Dylan B. Jackson, 2020. "Incarceration Exposure and Barriers to Prenatal Care in the United States: Findings from the Pregnancy Risk Assessment Monitoring System," IJERPH, MDPI, vol. 17(19), pages 1-14, October.
    3. Don Nutbeam & Diane Levin-Zamir & Gill Rowlands, 2018. "Health Literacy in Context," IJERPH, MDPI, vol. 15(12), pages 1-3, November.

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