464 - Text-Message Video Education in Early Pregnancy on Knowledge of Preterm Infants’ Long-Term Outcomes

Publication Number: 464.6568

Siobhan M. McDonnell, Medical College of Wisconsin, Milwaukee, WI, United States; Kathryn E. Flynn, Medical College of Wisconsin, Milwaukee, WI, United States; Ruta Brazauskas, Medical College of Wisconsin, Milwaukee, WI, United States; Mir A. Basir, Medical College of Wisconsin, Wauwatosa, WI, United States

Background: Preterm birth is the leading cause of US child morbidity. Half of the 500,000 US women who deliver preterm each year have a health condition in early pregnancy that increases their risk of preterm birth. However, they usually do not get education on long-term outcomes of children born preterm until the birth hospitalization. This leaves parents unprepared to make informed healthcare choices such as choosing a risk-appropriate birth hospital, known to improve outcomes. To bridge this gap, we created the Preemie Prep for Parents (P3) program.

Objective: Evaluate the engagement of patients at increased risk of preterm birth with the P3 program in early pregnancy and determine P3’s impact on their knowledge of preterm infants’ long-term outcomes.

Design/Methods: In this ancillary analysis of NCT04093492, 120 patients with conditions increasing risk of preterm birth (e.g. chronic hypertension and diabetes) were randomized 1:1 at 18-21 weeks gestational age (GA). Participants received the P3 program or links to American College of Obstetricians and Gynecologists (ACOG) patient webpages. The P3 program sent periodic text messages, each with a link to 1 of 51 short, animated videos. A subset of 5 videos on long-term intellectual, physical, visual, and hearing outcomes of preterm infants was sent twice between 21-29 weeks GA. Software tracked video use. Assessments were collected at enrollment (PROMIS Anxiety) and 30 weeks GA (PROMIS Anxiety and Parent Prematurity Knowledge Questionnaire). Ordinary least squares regression corelated video viewing and knowledge. Student’s t-tests compared outcomes by study group.

Results: Of the 60 patients in the P3 group, 27 patients (45%) watched all 5 videos and 44 (73%) watched ≥1 video. Lower levels of baseline anxiety predicted more videos viewed, Figure 1. However, anxiety did not change from baseline to 30 weeks GA for the P3 or ACOG groups, p>0.33. Long-term outcome knowledge was greater in the P3 group than the ACOG group; mean correct 81% vs. 60%, Figure 2. P3 participants who watched any of the 5 videos had higher mean knowledge scores than those who watched none, 85% vs. 65%, p< 0.001. The length of time watching videos explained 23% of the variance in long-term outcomes knowledge scores, Figure 3. For each additional 10 minutes of video watching, knowledge scores increased by 7%.

Conclusion(s): Women at risk of preterm birth engaged in early pregnancy to learn and showed greater knowledge of preterm infant long-term outcomes without an increase in anxiety. Smartphone-based prenatal education can be an effective mode of preterm birth education in early pregnancy.

Figure 1.
Figure 1.pdfAssociation between P3 participant PROMIS Anxiety scores at baseline and the number of the 5 videos they have viewed. US general population mean PROMIS Anxiety scores is 50; participants scoring below the national mean are in the blue shaded area and those scoring above the national mean are in the orange shaded area.

Figure 2.
Figure 2.pdfParticipants’ knowledge of long term intellectual, physical, visual, and hearing outcomes by assigned study group.

Figure 3.
Figure 3.pdfAssociation between P3 participants’ time spent viewing the long-term outcomes videos and knowledge scores. Videos were sent 2-3 times between 21 and 29 weeks GA.

Figure 1.
Figure 1.pdfAssociation between P3 participant PROMIS Anxiety scores at baseline and the number of the 5 videos they have viewed. US general population mean PROMIS Anxiety scores is 50; participants scoring below the national mean are in the blue shaded area and those scoring above the national mean are in the orange shaded area.

Figure 2.
Figure 2.pdfParticipants’ knowledge of long term intellectual, physical, visual, and hearing outcomes by assigned study group.

Figure 3.
Figure 3.pdfAssociation between P3 participants’ time spent viewing the long-term outcomes videos and knowledge scores. Videos were sent 2-3 times between 21 and 29 weeks GA.