Dataset Information

The public health role of caseloading midwives in advancing health equity in childbearing women and babies living in socially deprived areas in England: The Mi-CARE Study protocol.

ABSTRACT: This article outlines the protocol for a qualitative Constructivist Grounded Theory study, examining the public health role of caseloading midwives working in a continuity model of care in areas of urban social deprivation. The study is currently being conducted in a city in the south of England during the COVID-19 pandemic. Focusing specifically on the Social Determinants of Health impacting women and babies in this context and from the perspectives of women themselves, the study is developing a theoretical framework examining the actions caseloading midwives take in response to these determinants and how these actions contribute to advancing equity and equality for women and babies at increased risk of adverse perinatal outcomes. Examining and integrating the experiences of women and midwives from a Constructivist Grounded Theory perspective, the study findings will inform current NHS maternity policy and contribute to our understanding about the social processes and mechanisms underpinning the known benefits of midwifery continuity of care models in different contexts.

SUBMITTER: Clayton CE

PROVIDER: S-EPMC8973215 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The public health role of caseloading midwives in advancing health equity in childbearing women and babies living in socially deprived areas in England: The Mi-CARE Study protocol.

Clayton Charlotte E CE Hemingway Ann A Hughes Mel M Rawnson Stella S

European journal of midwifery 20220404

This article outlines the protocol for a qualitative Constructivist Grounded Theory study, examining the public health role of caseloading midwives working in a continuity model of care in areas of urban social deprivation. The study is currently being conducted in a city in the south of England during the COVID-19 pandemic. Focusing specifically on the Social Determinants of Health impacting women and babies in this context and from the perspectives of women themselves, the study is developing ...[more]

PMID: 35434538

Similar Datasets

Project description:ObjectiveTo use evidence on addressing racism in social care intervention research to create a framework for advancing health equity for all populations with marginalized social identities (e.g., race, gender, and sexual orientation). Such groups have disproportionate social needs (e.g., food insecurity) and negative social determinants of health (SDOH; e.g., poverty). We recommend how the Agency for Healthcare Research and Quality (AHRQ) could advance health equity for marginalized populations through social care research and care delivery.Data sources and study settingThis commentary is informed by a literature review of social care interventions that were affiliated with healthcare systems; input from health equity researchers, policymakers, and community leaders attending the AHRQ Health Equity Summit; and consensus of the authors.Principal findingsWe recommend that AHRQ: (1) create an ecosystem that values research on SDOH and the effectiveness and implementation of social care interventions in the healthcare sector; (2) work with other federal agencies to (a) develop position statements with actionable recommendations about racism and other systems that perpetuate marginalization based on social identity and (b) develop aligned, complementary approaches to research and care delivery that address social marginalization; (3) advance both inclusive care delivery and inclusive research teams; (4) advance understanding of racism as a social determinant of health and effective strategies to mitigate its adverse impact on health; (5) advance the creation and scaling of effective strategies for addressing SDOH in healthcare systems, particularly in co-creation with community partners; and (6) require social care intervention researchers to use methods that advance our understanding of social health equity.ConclusionsAHRQ, as a federal agency, could help advance health equity using a range of strategies, including using the agency's levers to ensure AHRQ stakeholders examine and address the unique experiences of socially marginalized populations in SDOH and social care intervention research.

Project description:BackgroundThe use of mobile technology such as phone applications (apps) has been proposed as an efficient means of providing health and clinical information in a variety of healthcare settings. We developed the Health-e Babies app as an Android smart phone application for pregnant women attending a tertiary hospital in a low socio-economic community, with the objective of providing health information about early pregnancy that would increase maternal confidence and reduce anxiety. Based on our earlier research, this form of health communication was viewed as a preferred source of information for women of reproductive age. However, the pilot study had a poor participation rate with 76% (n = 94) not completing the study requirements. These initial findings raised some very important issues in relation to the difficulties of engaging women with a pregnancy app. This paper analyses the characteristics of the participants who did not complete the study requirements in an attempt to identify potential barriers associated with the implementation of a pregnancy app.MethodsThis retrospective review of quantitative and qualitative data collected at the commencement of the Health-e Babies App trial, related to the participant's communication technology use, confidence in knowing where to seek help and mental health status, maternal-fetal attachment and parenting confidence. Engagement and use of the Health-e Babies App was measured by the completion of a questionnaire about the app and downloaded data from participant's phones. Mental health status, confidence and self-efficacy were measured by questionnaires.ResultsAll women were similar in terms of age, race, marital status and level of education. Of the 94 women (76%) who did not complete the trial, they were significantly more anxious as indicated by State Trait Anxiety Inventory (p = 0.001 Student T-test) and more likely to be unemployed (50% vs 31%, p = 0.012 Student T-Test).ConclusionThis study provides important information about the challenges associated with the implementation of a pregnancy app in a socially disadvantaged community. The data suggests that factors including social and mental health issues, financial constraints and technological ability can affect women's engagement with a mobile phone app.

Project description:IntroductionHealthcare systems around the world exhibit inherent systemic inequities that disproportionately impact marginalised populations. Digital health technologies (DHTs) hold promising potential to address these inequities and to play a pivotal role in advancing health equity. However, there is a notable gap regarding a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation. To this end, our primary objectives are first to identify prevalent frameworks and guidelines that promote health equity and second to pinpoint the contemporary role of DHTs as an avenue for implementing these frameworks and guidelines. This synthesis will guide future DHTs, ensuring equitable accessibility and effectiveness and ultimately contributing to enhancing health equity among marginalised populations.Methods and analysisThis work adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews. To identify pertinent evidence, we will employ seven electronic databases (PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO) encompassing the fields of medicine, healthcare and social sciences. Moreover, selected grey literature will be considered. We will include primary and secondary studies published in English between 2010 and 2023 that focus on (technology and non-technology-based) frameworks and guidelines for health equity improvement. Each article will undergo an independent assessment for eligibility, followed by the extraction of pertinent data from eligible sources. Subsequently, the extracted data will be subjected to qualitative and quantitative analyses, and findings will be presented using narrative and descriptive formats.Ethics and disseminationEthical approval is deemed unnecessary for this scoping review, as it involves synthesising existing knowledge. The findings from this study will be disseminated through peer-reviewed publications.Protocol registrationhttps://osf.io/94pht.

Project description:ObjectivesThis study aims to analyse the geographical co-occurrence of cancers and their individual and shared risk factors in a highly deprived area of the North West of England to aid the identification of potential interventions.Study designAn ecological study design was employed and applied at postcode sector level in the Morecambe Bay region.MethodsA novel spatial joint modelling framework designed to account for large frequencies of left-censored cancer data was employed. Nine cancer types (breast, colorectal, gynaecology, haematology, head and neck, lung, skin, upper gastrointestinal, urology) alongside demographic, behavioural factors and socio-economic variables were included in the model. Explanatory factors were selected by employing an accelerated failure model with lognormal distribution. Post-processing included principal components analysis and hierarchical clustering to delineate geographic areas with similar spatial risk patterns of different cancer types.Results15,506 cancers were diagnosed from 2017 to 2022, with the highest incidence in skin, breast and urology cancers. Factors such as age, ethnicity, frailty and comorbidities were associated with cancer risk for most of the cancer types. A positive geographical association was found mostly between the colorectal, haematology, upper GI, urology and head and neck cancer types. That is, these cancers had their largest risk in the same areas, similarly to their lowest risk values. The spatial distribution of the risk and cumulative risk of the cancer types revealed regional variations, with five clusters identified based on cancer type risk, demographic and socio-economic characteristics. Rural areas were the least affected by cancer and the urban area of Barrow-in-Furness was the area with the highest cancer risk, three times greater than the risk in the surrounding rural areas.ConclusionsThis study emphasizes the utility of joint disease mapping by geographically identifying common or shared factors that, if targeted, could lead to reduced risk of multiple cancers simultaneously. The findings suggest the need for tailored public health interventions, considering specific risk factors and socio-economic disparities. Policymakers can utilize the spatial patterns identified to allocate resources effectively and implement targeted cancer prevention programmes.

Dataset Information

The public health role of caseloading midwives in advancing health equity in childbearing women and babies living in socially deprived areas in England: The Mi-CARE Study protocol.

Publications

The public health role of caseloading midwives in advancing health equity in childbearing women and babies living in socially deprived areas in England: The Mi-CARE Study protocol.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets