Evidence map›Paper›PMID 38182969›Full record

Trial reportBMC pregnancy and childbirth2024

Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana.

Jody R Lori, Vida Ami Kukula, Liya Liu, Veronica E A Apetorgbor, Bidisha Ghosh, Elizabeth Awini, Nancy Lockhart, Georgina Amankwah, Ruth Zielinski, Cheryl A Moyer and 1 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
17.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Jody R LoriDepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America. jrlori@umich.edu.
Vida Ami KukulaDodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana.
Liya LiuDepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America.
Veronica E A ApetorgborDodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana.
Bidisha GhoshDepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America.
Elizabeth AwiniDodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana.
Nancy LockhartDepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America.
Georgina AmankwahDodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana.
Ruth ZielinskiDepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls Bldg, Ann Arbor, MI, United States of America.
Cheryl A MoyerDepartment of Learning Health Sciences, University of Michigan Medical School, University of Michigan, Ann Arbor, MI, United States of America.
John WilliamsDodowa Health Research Centre, Ghana Health Service, P.O.Box DD1, Dodowa, Ghana.
University of Michigan · USDodowa Health Research Centre · GH

Funding

Group Antenatal Care to Promote a Healthy Pregnancy and Optimize Maternal and Newborn Outcomes: A Cluster Randomized Controlled TrialR01HD096277 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LORI, JODY RAE · 2018 to 2022
$2.6M
NICHD NIH HHS R01 HD096277
6 · The paper itself

Abstract

backgroundAlthough the majority of Ghanaian women receive antenatal care (ANC), many exhibit low health literacy by misinterpreting and incorrectly operationalizing ANC messages, leading to poor maternal and newborn health outcomes. Prior research in low-resource settings has found group antenatal care (G-ANC) feasible for women and providers. This study aims to determine the effect of G-ANC on increasing maternal health literacy. We hypothesized that pregnant women randomized into G-ANC would exhibit a greater increase in maternal health literacy than women in routine, individual ANC.

methodsA 5-year cluster randomized controlled trial was conducted in 14 rural and peri-urban health facilities in the Eastern Region of Ghana. Facilities were paired based on patient volume and average gestational age at ANC enrollment and then randomized into intervention (G-ANC) vs. control (routine, individual ANC); 1761 pregnant women were recruited. Data collection occurred at baseline (T0) and post-birth (T2) using the Maternal Health Literacy scale, a 12-item composite scale to assess maternal health literacy. Logistic regression compared changes in health literacy from T0 to T2.

resultsOverall, women in both the intervention and control groups improved their health literacy scores over time (p < 0.0001). Women in the intervention group scored significantly higher on 3 individual items and on overall composite scores (p < 0.0001) and were more likely to attend 8 or more ANC visits.

conclusionWhile health literacy scores improved for all women attending ANC, women randomized into G-ANC exhibited greater improvement in overall health literacy post-birth compared to those receiving routine individual care. Life-saving information provided during ANC must be presented in an understandable format to prevent women and newborns from dying of preventable causes. TRIAL REGISTRY: Ethical approval for the study was obtained from the Institutional Review Boards of the University of Michigan (HUM#00161464) and the Ghana Health Service (GHS-ERC: 016/04/19).

Indexed as

Health LiteracyData CollectionFamilyFemaleGhanaHumansInfant, NewbornPregnancyPrenatal CareGhanaGroup antenatal careGroup careHealth literacyMaternal healthNewborn healthPrenatal care

Identifiers

PMID38182969
PMCPMC10768124
OpenAlexW4390612330

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.