Empowering Women's Prenatal Communication: Does Literacy Matter?

Area of Science:

• Health Communication
• Maternal Health
• Health Literacy

Background:

• Effective prenatal communication is crucial for maternal and infant health outcomes.
• Women with limited literacy skills often face barriers in understanding health information and engaging with clinicians.
• Existing prenatal education methods may not adequately address the communication needs of diverse patient populations.

Purpose of the Study:

• To evaluate the impact of a computer-based communication activation intervention (Healthy Babies Healthy Moms [HBHM]) on prenatal communication.
• To assess whether the HBHM intervention empowers women with restricted literacy skills during prenatal visits.
• To compare communication patterns and patient satisfaction between the HBHM intervention and a standard prenatal education program (Baby Basics [BB]).

Main Methods:

• A randomized controlled trial involving 83 pregnant women and 17 clinicians.
• Participants were assigned to either the HBHM intervention or the BB program before their prenatal visit.
• Visit communication was analyzed using the Roter Interaction Analysis System, and postvisit satisfaction was measured.

Main Results:

• Women with literacy deficits in the HBHM group were more verbally active, disclosed more medical and psychosocial information, and were rated as more dominant.
• Clinicians exhibited less verbal dominance and more patient-centered communication with literate women in the HBHM group.
• Clinicians communicated less medical information and made fewer reassurance statements to lower literate women in the HBHM group compared to the BB group.

Conclusions:

• The HBHM intervention effectively empowered communication and facilitated engagement and disclosure for women with literacy deficits.
• While the intervention improved communication dynamics, there was a trend toward lower visit satisfaction among women with restricted literacy.
• Tailoring health communication strategies to address literacy barriers is essential for improving patient experience and outcomes in prenatal care.