Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Standard

Implementing the MAMAACT intervention in Danish antenatal care : a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences. / Johnsen, Helle; Christensen, Ulla; Juhl, Mette; Villadsen, Sarah F.

I: Midwifery, Bind 95, 2021.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Johnsen, H, Christensen, U, Juhl, M & Villadsen, SF 2021, 'Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences', Midwifery, bind 95. https://doi.org/10.1016/j.midw.2021.102935

APA

Johnsen, H., Christensen, U., Juhl, M., & Villadsen, S. F. (2021). Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences. Midwifery, 95. https://doi.org/10.1016/j.midw.2021.102935

Vancouver

Johnsen H, Christensen U, Juhl M, Villadsen SF. Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences. Midwifery. 2021;95. https://doi.org/10.1016/j.midw.2021.102935

Author

Johnsen, Helle ; Christensen, Ulla ; Juhl, Mette ; Villadsen, Sarah F. / Implementing the MAMAACT intervention in Danish antenatal care : a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences. I: Midwifery. 2021 ; Bind 95.

Bibtex

@article{86b7287fd4fe437d9df0ff5ee201b010,
title = "Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences",
abstract = "Introduction: Immigrant women have an increased risk of negative pregnancy and birth outcomes compared to women from European host populations. Similar trends are seen in Denmark, where especially some groups of non-Western immigrant women have an increased risk of stillbirth and infant mortality. This study reports on an implementation analysis of The MAMAACT Intervention, which was developed to increase midwives' and women's responses to pregnancy complications (trial registration number: NCT03751774). The intervention consisted of a training session and two dialogue meetings for midwives, and a leaflet and mobile application for women. Objective: To explore midwives' and non-Western immigrant women's attitudes towards and experiences of using the MAMAACT intervention to enhance mutual interactions and improve responses to potential pregnancy complications. Design: A multi-method qualitative study was used to collect data. Data consisted of non-participant observations of midwifery visits, field notes, focus group interviews with midwives and in-depth interviews with non-Western immigrant women. Data were initially analysed using systematic text condensation according to Malterud. Subsequently, Shim's concept of cultural health capital was applied to the data analysis. Setting: Data were collected from ten Danish antenatal care facilities affiliated with five maternity care wards. Participants: Twenty-three midwives participated in observations of 40 midwifery visits, and 27 midwives participated in nine focus group interviews. Twenty-one non-Western immigrant women each participated in one in-depth interview. Findings: Two main themes were identified: 'the MAMAACT intervention as a tool to build knowledge and skills' and 'intervention experiences'. Training sessions and dialogue meetings promoted midwives' reflection on practice, however, at the visits, habitual ways of interacting impacted encounters between midwives and non Western immigrant women. Among midwives, informing was a more dominant communication strategy than the use of dialogue, and competing tasks affected their follow-up on women's use of the information material. Women seemed hesitant to use the MAMAACT leaflet and app to actively engage with midwives at the visits although they used this material to distinguish between normal and abnormal conditions in pregnancy and to contact emergency maternity care services when at home. Conclusions and implications for practice: The acceptability and usability of the intervention were high among participants. The leaflet and app showed potential in prompting women to contact emergency care maternity services. Despite midwives' increased reflections on immigrant women's care provision, this did not appear to increase their use of a needs-based dialogue at the antenatal visits. Institutional structures, especially power relationships between midwives and non-Western immigrant women, affected mutual interactions. Attention to midwives' task loads and time resources are needed if midwives are to have the necessary space to adapt their interactional styles to immigrant women's individual needs.",
keywords = "Antenatal care, Reproductive health, Immigrants, Inequity, Complex interventions, Implementation",
author = "Helle Johnsen and Ulla Christensen and Mette Juhl and Villadsen, {Sarah F.}",
year = "2021",
doi = "10.1016/j.midw.2021.102935",
language = "English",
volume = "95",
journal = "Midwifery",
issn = "0266-6138",
publisher = "Churchill Livingstone",

}

RIS

TY - JOUR

T1 - Implementing the MAMAACT intervention in Danish antenatal care

T2 - a qualitative study of non -Western immigrant women's and midwives' attitudes and experiences

AU - Johnsen, Helle

AU - Christensen, Ulla

AU - Juhl, Mette

AU - Villadsen, Sarah F.

PY - 2021

Y1 - 2021

N2 - Introduction: Immigrant women have an increased risk of negative pregnancy and birth outcomes compared to women from European host populations. Similar trends are seen in Denmark, where especially some groups of non-Western immigrant women have an increased risk of stillbirth and infant mortality. This study reports on an implementation analysis of The MAMAACT Intervention, which was developed to increase midwives' and women's responses to pregnancy complications (trial registration number: NCT03751774). The intervention consisted of a training session and two dialogue meetings for midwives, and a leaflet and mobile application for women. Objective: To explore midwives' and non-Western immigrant women's attitudes towards and experiences of using the MAMAACT intervention to enhance mutual interactions and improve responses to potential pregnancy complications. Design: A multi-method qualitative study was used to collect data. Data consisted of non-participant observations of midwifery visits, field notes, focus group interviews with midwives and in-depth interviews with non-Western immigrant women. Data were initially analysed using systematic text condensation according to Malterud. Subsequently, Shim's concept of cultural health capital was applied to the data analysis. Setting: Data were collected from ten Danish antenatal care facilities affiliated with five maternity care wards. Participants: Twenty-three midwives participated in observations of 40 midwifery visits, and 27 midwives participated in nine focus group interviews. Twenty-one non-Western immigrant women each participated in one in-depth interview. Findings: Two main themes were identified: 'the MAMAACT intervention as a tool to build knowledge and skills' and 'intervention experiences'. Training sessions and dialogue meetings promoted midwives' reflection on practice, however, at the visits, habitual ways of interacting impacted encounters between midwives and non Western immigrant women. Among midwives, informing was a more dominant communication strategy than the use of dialogue, and competing tasks affected their follow-up on women's use of the information material. Women seemed hesitant to use the MAMAACT leaflet and app to actively engage with midwives at the visits although they used this material to distinguish between normal and abnormal conditions in pregnancy and to contact emergency maternity care services when at home. Conclusions and implications for practice: The acceptability and usability of the intervention were high among participants. The leaflet and app showed potential in prompting women to contact emergency care maternity services. Despite midwives' increased reflections on immigrant women's care provision, this did not appear to increase their use of a needs-based dialogue at the antenatal visits. Institutional structures, especially power relationships between midwives and non-Western immigrant women, affected mutual interactions. Attention to midwives' task loads and time resources are needed if midwives are to have the necessary space to adapt their interactional styles to immigrant women's individual needs.

AB - Introduction: Immigrant women have an increased risk of negative pregnancy and birth outcomes compared to women from European host populations. Similar trends are seen in Denmark, where especially some groups of non-Western immigrant women have an increased risk of stillbirth and infant mortality. This study reports on an implementation analysis of The MAMAACT Intervention, which was developed to increase midwives' and women's responses to pregnancy complications (trial registration number: NCT03751774). The intervention consisted of a training session and two dialogue meetings for midwives, and a leaflet and mobile application for women. Objective: To explore midwives' and non-Western immigrant women's attitudes towards and experiences of using the MAMAACT intervention to enhance mutual interactions and improve responses to potential pregnancy complications. Design: A multi-method qualitative study was used to collect data. Data consisted of non-participant observations of midwifery visits, field notes, focus group interviews with midwives and in-depth interviews with non-Western immigrant women. Data were initially analysed using systematic text condensation according to Malterud. Subsequently, Shim's concept of cultural health capital was applied to the data analysis. Setting: Data were collected from ten Danish antenatal care facilities affiliated with five maternity care wards. Participants: Twenty-three midwives participated in observations of 40 midwifery visits, and 27 midwives participated in nine focus group interviews. Twenty-one non-Western immigrant women each participated in one in-depth interview. Findings: Two main themes were identified: 'the MAMAACT intervention as a tool to build knowledge and skills' and 'intervention experiences'. Training sessions and dialogue meetings promoted midwives' reflection on practice, however, at the visits, habitual ways of interacting impacted encounters between midwives and non Western immigrant women. Among midwives, informing was a more dominant communication strategy than the use of dialogue, and competing tasks affected their follow-up on women's use of the information material. Women seemed hesitant to use the MAMAACT leaflet and app to actively engage with midwives at the visits although they used this material to distinguish between normal and abnormal conditions in pregnancy and to contact emergency maternity care services when at home. Conclusions and implications for practice: The acceptability and usability of the intervention were high among participants. The leaflet and app showed potential in prompting women to contact emergency care maternity services. Despite midwives' increased reflections on immigrant women's care provision, this did not appear to increase their use of a needs-based dialogue at the antenatal visits. Institutional structures, especially power relationships between midwives and non-Western immigrant women, affected mutual interactions. Attention to midwives' task loads and time resources are needed if midwives are to have the necessary space to adapt their interactional styles to immigrant women's individual needs.

KW - Antenatal care

KW - Reproductive health

KW - Immigrants

KW - Inequity

KW - Complex interventions

KW - Implementation

U2 - 10.1016/j.midw.2021.102935

DO - 10.1016/j.midw.2021.102935

M3 - Journal article

C2 - 33556845

VL - 95

JO - Midwifery

JF - Midwifery

SN - 0266-6138

ER -

ID: 259359035