Postpartum Video Education

Study Overview
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Brief Summary
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This is a prospective, single-center, randomized control study to determine if video education at the time of postpartum discharge improves patient knowledge on the warning signs for the top three causes of severe maternal morbidity (infection, hemorrhage, and blood pressure disorders) in the first seven days following delivery. Participants will be randomized to written discharge education + video education (intervention) vs standard discharge education (control). They will complete a baseline questionnaire and a post-discharge education questionnaire during their postpartum stay to assess for knowledge improvement. The investigators hypothesize that video education will improve patient's knowledge of severe maternal morbidity warning signs.

Detailed Description
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Prior to the day of postpartum discharge, a designated staff person will approach eligible patients and review the objectives of the study. If patients are willing to participate, they will complete a consent form and the baseline questionnaire. The baseline questionnaire will assess patient knowledge on postpartum hemorrhage, infection, hypertensive disorders of pregnancy, and depression. Following delivery, patients will be randomized. Randomization will be done in a 1:1 allocation ratio between written discharge instructions + video education vs. written discharge instructions (standard of care at YNHH). A computer algorithm will assign participant based on random permuted blocks design with block size between 2-4. Each participant will have an assigned Study ID number that is linked to their random assignment. Group 1 will be the written discharge + video education group (intervention group). Group 2 will be the written discharge education (control group). On the day of discharge, the nursing staff will provide discharge education based on their randomized group: Group 1 will be the written discharge education + video education group (intervention group). These patients will view a 12-minute educational video on SMM warning signs, in addition to the written discharge instructions provided by nursing staff. At the completion of the video, they will complete a post-video questionnaire to assess their knowledge on the covered topics. Group 2 will be the written discharge instruction group (control group). They will receive the written discharge instructions provided by nursing staff and complete the post-discharge instruction questionnaire. Following discharge, patients will complete a post-discharge questionnaire to assess knowledge retention on the covered topics. Patients' antepartum, delivery, and postpartum course will be reviewed until 1 year postpartum, including outpatient visits, emergency department visits, and any hospitalizations. All subjects will be assigned a unique study ID code upon enrollment. Data will be collected from patients' medical records and from self-report. It will be recorded/stored in REDCap and on a Yale server accessible only to members of the research team. All data will be de-identified at the conclusion of chart review. Data analysts will have access to only de-identified information.

Official Title
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YOU MATTER: Using Video Education to Improve Patient Knowledge of Severe Maternal Morbidity (SMM) Warning Signs

Conditions
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Postpartum Care, Postpartum Hemorrhage, Postpartum Preeclampsia, Postpartum Sepsis, Postpartum Depression, Patient Empowerment, Patient Education

Intervention / Treatment
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* Other: Video Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >18 years Speaks English or Spanish Informed and written consent Delivered at Yale New Haven Hospital (YNHH) Received prenatal, and will receive postpartum, care through a YNHH-affiliated obstetric and/or midwifery practice Exclusion Criteria: Patients who do not plan to receive postpartum care within the YNHH system Patients who experience an intrauterine fetal demise Patients who have a pregnancy with multiple severe congenital anomalies with an anticipated poor prognosis Patients who speak a primary language other than English or Spanish

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Written Discharge Education + Video Education<br>These patients will view a 12-minute educational video on SMM warning signs, in addition to the written discharge instructions provided by nursing staff. At the completion of the video, they will complete a post-video questionnaire to assess their knowledge on the covered topics. | Other: Video Education<br>* 12-minute educational video covering postpartum topics of hemorrhage, infection, hypertension, and depression. Created by Cicatelli Associates Inc.<br>|
| No Intervention: Written Discharge Education<br>They will receive the written discharge instructions provided by nursing staff and complete the post-discharge instruction questionnaire. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in baseline and post-education questionnaire score | Patients will complete a baseline and post-discharge education 15 item questionnaire that will assess knowledge on postpartum hemorrhage, infection, hypertensive disorders of pregnancy, and depression. The questionnaire will be scored 0-15 based on the number of correct responses. A lower score indicates lower knowledge, while a higher score indicates a better knowledge of the subject items. Outcome will be binary based on whether or not the patient improved their score between the two questionnaires. | Baseline, discharge (up to one week) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in post-education and post-discharge questionnaire score | Patients will complete a post-discharge questionnaire via email. The 15-item questionnaire will assess knowledge on postpartum hemorrhage, infection, hypertensive disorders of pregnancy, and depression. The questionnaire will be scored 0-15 based on the number of correct responses. A lower score indicates lower knowledge, while a higher score indicates a better knowledge of the subject items. | 3-7 days | 
| Compliance with Postpartum Care | The investigators will perform a retrospective chart review to determine if the study participant attended the 6 week postpartum visit | 6 weeks | 
| Healthcare utilization | The investigators will perform a retrospective chart review to determine number of phone call, clinic visits, urgent care and/or emergency room visits by each study participant | 6 weeks | 
| Patient satisfaction | Patients will rate their satisfaction with their knowledge and postpartum discharge on baseline and post-education questionnaires. | Baseline, post-education |