A study of factors influencing utilization of pre-natal educational services
Creators: name: Yarie, Sarah Fulton
Publisher: name: University of British Columbia
Year: 2010

description: A comparative study of two groups of primiparas was conducted in Vancouver, British Columbia (Canada), during the summer of 1976. The first group was comprised of those women who attended 50 per cent or more of a series of prenatal classes (the attenders), and was compared to a group of non-attenders, those who had not attended prenatal classes during their pregnancy. The objective of the study was to examine those factors which are expected to influence utilization of prenatal educational programs. The long-term objective was to generate data which could be used to improve these programs; and, consequently, also to improve the health of the mother and child. From a total sample of 154 primiparas drawn from the mothers having given birth to a live baby in April, May or June 1976, 127 were interviewed: 54 non-attenders and 73 attenders. The comparison of the groups of attenders and non-attenders showed the following results: 1) There were differences between the two groups in regard to basic socio-economic and demographic characteristics. In general, the non-attenders tended to be younger, less educated, poorer, new immigrants, and less fluent in English than the attenders. 2) When tested on a set of knowledge questions, the two groups showed differences in the areas of pregnancy, childbirth and child care knowledge. In general, the attenders responded correctly to more of the questions than did the non-attenders. However, on some questions, the differences were not very large and it would be interesting to re-examine these differences when confounding factors are controlled (e.g., English fluency). The comparison of behavioural health practices revealed the following: The non-attenders were less likely to smoke during pregnancy than were the attenders. - The two groups were fairly comparable in terms of a positive change in their nutrition habits during pregnancy. - As expected, more attenders than non-attenders used controlled breathing techniques during the delivery. Seventy-six per cent of the non-attenders either partially or totally breastfed their babies compared with 55 per cent of the attenders. When asked about their reasons for not attending prenatal classes, the non-attenders most frequently mentioned a lack of awareness of the existence of the classes and a general feeling that it was unnecessary to attend. Difficulty in speaking and understanding English was also a factor in non-utilization of classes. In regard to wife-husband relationships, husbands were given as a source of support by more attenders than non-attenders, although the difference was not statistically significant. It could be worthwhile to investigate this area more thoroughly to determine whether the presence of support from a husband/partner is a reason for attendance or occurs as a result of the attendance. The data on knowledge and behavioural health practices could raise questions concerning the effectiveness of the prenatal programs. However, this study has not been designed to evaluate these programs. Most of the factors studied regarding knowledge and health practices are known to be associated with socio-economic and cultural factors. An analysis of the true effect of the program should take these factors into consideration. In conclusion, this study has shown ways of increasing utilization of prenatal educational programs. Emphasis should be placed on the following: The target population - More effort and resources should be devoted to reach lower socio-economic groups, new immigrants, and those less fluent in the English language. The method - New communication and information dissemination techniques, as well as diversified teaching methods, should be developed (e.g., more courses should be taught in a language other than English). The content - Given the differences in knowledge levels and health practices, the content should be geared more to meet the needs of specific sub-groups in the population. Publicity - The study demonstrates the need for making better known the existence of the program as well as its present objectives. This study has raised a number of questions regarding both utilization of prenatal care and outcome measures relating to this care. Therefore, a larger and well designed study to investigate these questions more extensively is recommended.