Midwifery care education program for preventing preterm birth: A feasibility randomized controlled trial

Abstract

Purpose

Preterm birth complications are the leading cause of death in infants under five years of age worldwide. Midwifery interventions during pregnancy are effective in preventing preterm birth. The aim of this study was to evaluate the feasibility of a 90-minute online midwifery education program to prevent preterm birth.

Methods

We developed a midwifery education program to prevent preterm birth. The educational program was created based on the theory of planned behavior and was conducted online in an interactive format. The program included lectures on past research on midwifery care to prevent preterm birth and guidelines for midwifery care during pregnancy, discussion among midwives on midwifery care during pregnancy, and practical exercises. The study was an open-label, parallel, randomized controlled trial. Participants in the study were midwives. Sixteen midwives were randomly assigned to take part in an online education program (intervention group) or to read a pamphlet summarizing the guidelines (control group). Midwives in the control group could access the online education program after the end of the study if they wished. The feasibility evaluation assessed the acceptability, demand, adaptability, implementation, and limited-efficacy testing of the program. Surveys were conducted at three time points: before, immediately after, and two weeks after the educational program. Acceptability, demand, adaptability, and implementation of the program were evaluated based on a questionnaire administered to the intervention group immediately after the educational program. The participants' baseline was assessed before the educational program. Limited-efficacy testing of the program compared the scores of the Japanese version of the Continuing Professional Development (CPD) REACTION Questionnaire, knowledge scores on midwifery care to prevent preterm birth, and scores on the Japanese version of the Evidence-Based Practice Attitude Scale between the intervention and control groups. The primary outcome of the limited-efficacy testing of the program was the score on the Japanese version of CPD-REACTION Questionnaire two weeks after implementation.

Results

The acceptability and practicality of the educational program were scored highly. In addition, positive opinions were obtained regarding demand and adaptability. However, some participants (n=2) found the educational materials difficult to read. Although satisfaction with group work was high, some participants (n=3) said they would have liked more time to discuss with the midwives. Immediately after and two weeks after the implementation of the educational program, midwifery care knowledge to prevent preterm birth was significantly higher in the intervention group than in the control group (Immediately after of the education program; p=.03, two weeks after the implementation of the education program; p=.001). There was no difference in the Japanese version of CPD-REACTION Questionnaire after 2 weeks compared with the intervention and control groups (p=.35).

Conclusion

The online midwifery education program to prevent preterm birth is feasible in terms of acceptability, demand, adaptability, and limited efficacy testing. It is desirable to improve materials and extend the time required for group work.