Exploring the implementation of an educational film within antenatal care to reduce the risk of cytomegalovirus infection in pregnancy: A qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967799 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2393 (Electronic) Linking ISSN: 14712393 NLM ISO Abbreviation: BMC Pregnancy Childbirth Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Cytomegalovirus Infections*/prevention & control ; Qualitative Research* ; Prenatal Care*/methods ; Pregnancy Complications, Infectious*/prevention & control; Humans ; Female ; Pregnancy ; United Kingdom ; Motion Pictures ; Midwifery/education ; Midwifery/methods ; Adult ; Health Knowledge, Attitudes, Practice ; Patient Education as Topic/methods ; State Medicine

Background: Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss and neuro-disability in childhood. In the absence of a licensed vaccine, adoption of hygiene-based measures may reduce the risk of CMV infection in pregnancy, however these measures are not routinely discussed with pregnant women as part of National Health Service (NHS) antenatal care in the United Kingdom (UK).
Methods: An exploratory qualitative study was conducted, underpinned by Normalization Process Theory (NPT), to investigate how an educational intervention comprising of a short film about CMV may best be implemented, sustained, and enhanced in real-world routine antenatal care settings. Video, semi-structured interviews were conducted with participants who were recruited using a purposive sample that comprised of midwives providing antenatal care from three NHS hospitals (n = 15) and participants from professional colleges and from organisations or charities providing, or with an interest in, antenatal education or health information in the UK (n = 15).
Findings: Midwives were reluctant to include CMV as part of early pregnancy discussions about reducing the risk of other infections due to lack of time, knowledge and absence of guidance or policies relating to CMV in antenatal education. However, the educational intervention was perceived to be a useful tool to encourage conversations and empower women to manage risk by all stakeholders, which would overcome some identified barriers. Macro-level challenges such as screening policies and lack of official guidelines to legitimise dissemination were identified.
Discussion: Successful implementation of education about CMV as part of routine NHS care in the UK will require an increase in awareness and knowledge about CMV amongst midwives. NPT revealed that 'coherence' and 'cognitive participation' between service members are vital to imbed CMV education in routine practice. 'Collective action' and 'reflexive monitoring' is required to sustain service changes.
(© 2024. The Author(s).)

Aust N Z J Obstet Gynaecol. 2022 Jun;62(3):445-452. (PMID: 35348198)
Implement Sci. 2019 Dec 11;14(1):103. (PMID: 31823787)
BMC Pregnancy Childbirth. 2016 Mar 28;16:65. (PMID: 27021727)
J Clin Virol. 2020 Aug;129:104335. (PMID: 32590295)
Clin Infect Dis. 2006 Nov 1;43(9):1143-51. (PMID: 17029132)
BMC Infect Dis. 2020 Jun 16;20(1):418. (PMID: 32546244)
Midwifery. 2022 Mar;106:103249. (PMID: 35032932)
Can J Occup Ther. 2020 Apr;87(2):137-143. (PMID: 31858827)
Front Pediatr. 2020 Jan 31;8:13. (PMID: 32083040)
J Matern Fetal Neonatal Med. 2018 Oct;31(19):2515-2520. (PMID: 28693346)
Implement Sci. 2018 Jun 7;13(1):80. (PMID: 29879986)
Int J Pediatr Otorhinolaryngol. 2021 Mar;142:110594. (PMID: 33422993)
Front Cell Infect Microbiol. 2020 Mar 31;10:130. (PMID: 32296651)
Pediatr Infect Dis J. 2019 Sep;38(9):944-951. (PMID: 31261362)
J Med Internet Res. 2022 Apr 11;24(4):e35554. (PMID: 35404257)
Pediatr Infect Dis J. 2020 Oct;39(10):949-954. (PMID: 32502127)
Rev Med Virol. 2007 Sep-Oct;17(5):355-63. (PMID: 17542052)
BMJ Paediatr Open. 2020 Nov 12;4(1):e000844. (PMID: 33225083)
Patient Educ Couns. 2014 Jul;96(1):29-35. (PMID: 24820638)
Midwifery. 2014 Dec;30(12):1196-201. (PMID: 24832932)
J Clin Virol. 2009 Dec;46 Suppl 4:S11-5. (PMID: 19818680)
Implement Sci Commun. 2020 Feb 25;1:27. (PMID: 32885186)
Nurse Educ Pract. 2013 Sep;13(5):481-6. (PMID: 23219415)
BMC Med Inform Decis Mak. 2019 Nov 14;19(1):222. (PMID: 31727063)
Dev Med Child Neurol. 2017 Dec;59(12):1261-1268. (PMID: 28990181)
JMIR Mhealth Uhealth. 2020 Jul 10;8(7):e18255. (PMID: 32673251)
Health Psychol Rev. 2018 Dec;12(4):333-356. (PMID: 29912621)
EBioMedicine. 2015 Aug 06;2(9):1205-10. (PMID: 26501119)
Rev Med Virol. 2014 Sep;24(5):291-307. (PMID: 24760655)
BMC Pregnancy Childbirth. 2021 Aug 18;21(1):565. (PMID: 34407771)
Clin Infect Dis. 2009 Aug 15;49(4):522-8. (PMID: 19583520)
BMJ. 2021 Sep 30;374:n2061. (PMID: 34593508)
J Clin Virol. 2006 Feb;35(2):216-20. (PMID: 16368262)
Infect Dis Obstet Gynecol. 2006;2006:80383. (PMID: 17485810)
BMC Health Serv Res. 2011 Sep 30;11:245. (PMID: 21961827)
Matern Child Health J. 2013 Oct;17(8):1363-72. (PMID: 23090284)
Br J Obstet Gynaecol. 1991 Feb;98(2):135-40. (PMID: 1848445)
PLoS One. 2019 Aug 26;14(8):e0221725. (PMID: 31449545)
J Clin Virol. 2012 Oct;55(2):158-63. (PMID: 22819537)

Keywords: Congenital Cytomegalovirus CMV; Healthcare education; Implementation science; Improvement science; Normalisation Process Theory

Date Created: 20240810 Date Completed: 20240810 Latest Revision: 20240813

20240813

PMC11316991

10.1186/s12884-024-06715-5

39127657