The effect of "Green Future with Midwife's Hand" climate change animation on mothers' climate change awareness and...

Climate change increasingly affects maternal-newborn health, and midwives play a key role in promoting environmental awareness. Evidence on brief, animation-based climate education for postpartum women remains limited.

To examine the effect of the "Green Future with Midwife's Hand" climate change animation on postpartum mothers' climate change awareness (primary outcome) and climate-related emotional and behavioral responses (secondary outcomes).

A randomized controlled trial was conducted with 72 postpartum women, who were allocated to intervention (n = 36) and control (n = 36) groups. Outcomes were assessed at pre-test, pre-discharge, Day 21, and Day 30. Primary and secondary outcomes included climate change awareness, climate anxiety, and behavioral subdimensions (green consumption awareness, eco-friendly choices, and responsible consumption behavior). Repeated-measures analyses were performed, and additional covariate-adjusted models were applied to account for baseline imbalances in parity, education level, and climate change follow-up status. The trial was prospectively registered at ClinicalTrials.gov (NCT06640556).

Significant group × time interactions were observed across all outcomes (all p < 0.001). At Day 30, the intervention group demonstrated higher scores than the control group for climate change awareness (mean difference = 0.33, 95% CI: 0.18-0.48; η²_P = 0.71) and climate anxiety (mean difference = 0.42, 95% CI: 0.26-0.58; η²_P = 0.75). Behavioral outcomes also showed higher scores in the intervention group, including green consumption awareness (mean difference = 0.95, 95% CI: 0.62-1.28; η²_P = 0.36), eco-friendly choices (mean difference = 1.12, 95% CI: 0.75-1.49; η²_P = 0.30), and responsible consumption behavior (mean difference = 1.20, 95% CI: 0.85-1.55; η²_P = 0.31). These effects remained statistically significant after covariate adjustment.

The midwife-led animation was associated with improvements in postpartum mothers' self-reported climate change awareness and behavior-related outcomes over a 30-day follow-up period. These findings should be interpreted in light of the self-reported nature of the outcomes, and further research using objective measures and longer follow-up is warranted.