Thesis Title: ​ ​Evaluation of a Mothering Class for Refugee/Immigrant/Migrant Women on Patient Communication Self -Efficacy and Knowledge Acquisition

Student Concentration: Health Promotion & Behavior

Thesis Chair: ​ ​Dr. Ashli Owen-Smith

Thesis Abstract:   

INTRODUCTION: With the pregnancy-related and racial disparities present in the United States, refugee/ immigrant/ and migrant (RIM) women are particularly disadvantaged. For this population to receive equitable maternal and child health care during pregnancy and childbirth, they must be educated on sexual and reproductive health (SRH) and maternal health topics and be able to effectively communicate with their health care provider. To address these barriers to care, Embrace Refugee Birth Support provides a culturally tailored educational program, Health Moms, that informs expecting refugee women on pregnancy and common obstetric interventions used during childbirth, while emphasizing their health care right to make informed health decisions.

METHODS: An impact evaluation of the Healthy Moms educational class series was conducted to understand if the overall objective to empower refugee women during pregnancy and childbirth is being achieved. Using a pre-post evaluation design, participants (n=8) were evaluated on patient communication self-efficacy and sexual and maternal health knowledge acquisition. Data was collected separately between participants that were native to Afghanistan or African countries. Data was analyzed using paired sample t-tests to identify changes in indicators.

RESULTS: Baseline SRH and maternal and child health (MCH) care was measured among 18 participants. A one-way ANOVA revealed that there was a statistically significant difference in knowledge base between the two groups [F(1, 15) = [11.833], p = 0.004)]. A paired samples t-test showed that the participants’ level of knowledge increased from pre-program (Mean = 9.75, SD = 1.98) to post-program (Mean = 11.38, SD = 2.67;  t (7) = -1.72, p = .129), though results were not statistically significant. A paired samples t-test showed that the participants’ level of communication self-efficacy with providers increased from pre-program (Mean = 36.57, SD = 8.73) to post-program (Mean = 46.00, SD = 2.77; t (6)= -2.92, p = 0.027). Participants (n=8) reported a high level of program satisfaction (Mean = 11.38, SD = 0.74).

DISCUSSION: Across participants, the results indicated a significant increase in patient communication self-efficacy from the start of the program until the end. This evaluation did not find significant increases in knowledge acquisition. Most notably, however, at program entry, the results revealed topic areas in which participants were relatively knowledgeable or demonstrated deficits. This finding may have important implications for the Healthy Moms curriculum development.