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Identifying Key Components of a Healthy and Positive Pregnancy and Birth Dr Ekaterina Bordea

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Location: Online

Dr Ekaterina Bordea is a Research Associate in Health Economics at the Comprehensive Clinical Trials Unit at UCL. She is primarily working on economic evaluations alongside randomised controlled trials, decision modelling and teaching statistics and health economics. Ekaterina’s undergraduate degree is in Pharmacy but then she did both her MSc and PhD in Economics at City, University of London. Her PhD thesis explored health and health-related behaviours of immigrants in the UK. Ekaterina is currently working as a Health Economist on REACH programme (https://fundingawards.nihr.ac.uk/award/RP-PG-1211-20015) aimed at improving antenatal care for socially disadvantaged and ethnically diverse women. This presentation is related to the randomised controlled trial called Pregnancy Circles, which is a part of the programme.

Abstract

Background. Patient Reported Outcome Measures are rarely used in evaluating maternal health services. The most common questionnaire used in economic evaluations, the EuroQol EQ-5D, does not reflect what is important to women during pregnancy, such as quality of care or the 2018 World Health Organisation recommendation on the importance of a positive childbirth experience.

Aims. Feasibility of identifying what women consider are the important attributes of a positive pregnancy and birth and asking them to rank them.

Methods. Women in the REACH Pregnancy Circles feasibility trial and who had recently given birth were asked to be involved in a patient and public involvement (PPI) session to identify what outcomes were important to them as part of pregnancy, birth and postnatal care. Based on the attributes a purposely designed questionnaire was built using a web-based survey tool Opinio. The online questionnaire was distributed to mailing groups and advertised on social media platforms. Best-worst scaling and a Balanced Incomplete Block Design was used for ranking the attributes and to provide estimates of their weights. A sample size of 400 participants was required for comparison between groups (women who recently gave birth (<12 months), medical professionals and general population).

Results. Women in the PPI group identified the attributes identified are mother’s health, baby’s health, choice, feeling in control, provision of information, feeling supported, continuity of care and feeding support. It was feasible to ask women who recently gave birth and the general population to rank these attributes, but we struggled to recruit medical professionals. We report provisional estimates for weights.

Conclusions. Women could identify the attributes most important to them as part of a positive pregnancy and were able to rank these attributes. Provisional estimates will be used in the REACH Pregnancy Circles trial, but further work is required to validate the attributes and weights.

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Dr Asmaa El-Banna I Research Fellow

Centre for Health Economics at Warwick, University of Warwick

Email: Asmaa.El-Banna@warwick.ac.uk

Working week: Tuesday to Friday

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