Video-based preterm birth educational aid improves anxiety, knowledge, decision-making

Key takeaways:

• At 25 weeks’ gestation, the video-based educational aid led to better knowledge on long-term outcomes.
• Women were better prepared for neonatal resuscitation, birthing hospital and breastfeeding decisions.

After using smartphone-based multimedia educational aids about preterm birth, pregnant women reported they were more knowledgeable, less anxious and better prepared for decision-making about maternal and infant health, study results show.

“Smartphone-based education allows for learning in small increments at a time and place that suits the patient. Short, animated videos have broad appeal and educational efficacy among patients with lower health literacy,” Kathryn E. Flynn, PhD, professor of medicine in the division of hematology and oncology at the Medical College of Wisconsin, and colleagues wrote. “Moreover, previous work has found higher anxiety among patients hospitalized for preterm labor but also found that targeted education reduces anxiety.”

Flynn and colleagues conducted a randomized clinical trial, published in JAMA Pediatrics, with 120 pregnant women (mean age, 32.5 years) between 16 and 21 weeks gestation from February 2020 to April 2021. All participants had a risk factor for preterm birth and were followed through pregnancy completion. Participants were randomly assigned to the Preemie Prep for Parents (P3) program on maternal knowledge of preterm birth, preparation for decision-making and anxiety (intervention group; n = 60) or links to patient education websites (control group; n = 60).

Beginning at 18 weeks gestation, the intervention group received links via text message to 51 gestational age-specific short, animated videos, and the control group received links to patient education webpages from the American College of Obstetricians and Gynecologists.

Researchers assessed scores on the Parent Prematurity Knowledge Questionnaire, Preparation for Decision Making scale and Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety computerized adaptive test at 25 weeks gestation.

At 25 weeks gestation, participants in the intervention group scored higher on knowledge of long-term outcomes compared with the control group (88.5% vs. 73.2%; P < .001). In the intervention group, participants who watched more educational videos demonstrated significantly higher knowledge scores at 34 weeks gestation. In addition, the Parent Prematurity Knowledge Questionnaire total scores increased by about 2.2 percentage points for every five more intervention videos watched.

Also at 25 weeks gestation, participants in the intervention group reported being significantly more prepared for neonatal resuscitation decision-making compared with those in the control group (Preparation for Decision Making Scale score, 76 vs. 52.3). Compared with the control group, the intervention group reported being more prepared for choosing an appropriate birth hospital at 30 weeks gestation (Preparation for Decision Making Scale score, 76.3 vs. 54.4) and being more prepared for their breastfeeding decision at 34 weeks gestation (Preparation for Decision Making Scale score, 68.9 vs. 54.2).

Researchers observed no difference between those in the intervention group and those in the control group for anxiety at 25 weeks gestation based on mean PROMIS Anxiety computerized adaptive test scores (53.8 vs. 54).

“Mobile antenatal prematurity education as offered by the P3 program may provide a unique benefit to parents with preterm birth risk factors,” the researchers wrote.