TY - JOUR
T1 - Let's talk aspirin
T2 - A survey of barriers and facilitators faced by midwives when engaging in conversations about aspirin with women at risk of pre-eclampsia
AU - Vinogradov, Raya
AU - Smith, Vikki
AU - Hui, Shaun
AU - McParlin, Catherine
AU - Farnworth, Allison
AU - Araujo-Soares, Vera
N1 - Funding information: R Vinogradov is a research practitioner within the National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC) (NIHR Applied Research Collaboration North East & North Cumbria (Research Practitioner Fellowship APF2209).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Objective: Adherence to low-dose aspirin is key in preventing pre-eclampsia. Midwives are well positioned to support women to take aspirin as prescribed. This study aimed to understand the barriers and facilitators that midwives face during consultations with pregnant women about prophylactic aspirin. Design, setting, and participants: A cross-sectional, UK-wide, quantitative and qualitative study of midwives was conducted between November 2020 and April 2021 using social media platforms. The survey was designed using the Theoretical Domains Framework by a team of researchers experienced in using it. An open-ended question was embedded in the survey to allow midwives to expand on matters related to the study subject. Findings: Out of 160 responders, 37.5 % indicated inadequate engagement in conversations with women about aspirin prophylaxis. Domains ‘Knowledge’ (OR 13.7, 95 %CI 5.7–32.7, p < 0.001), ‘Professional role and Identity’ (OR 15.3, 95 %CI 6.4–36.7, p < 0.001) and ‘Beliefs about capabilities’ (OR 13.6, 95 %CI 6.1–30.6, p < 0.001) were most prominently associated with effective engagement. Best fit model was comprised of ‘Beliefs about Capabilities’, ‘Social/professional role and identity’, and ‘Knowledge’. Midwives’ comments focused on barriers within ‘environmental context’ related to ‘conflicting views’ and ‘deficit in resources’ that compromise positive reinforcement of aspirin use. Responders also provided helpful ‘Top tips’ that streamline their daily practice. Conclusion and implications for practice: Beliefs about Capabilities, Social/professional role and identity, Knowledge, and Environmental Context and resources are key domains related to midwives’ engagement in conversations about aspirin in pregnancy. Clear, up-to date information for midwives and the public should be available in an easy access format to allow provision of unequivocal advice related to the use of aspirin in pregnancy.
AB - Objective: Adherence to low-dose aspirin is key in preventing pre-eclampsia. Midwives are well positioned to support women to take aspirin as prescribed. This study aimed to understand the barriers and facilitators that midwives face during consultations with pregnant women about prophylactic aspirin. Design, setting, and participants: A cross-sectional, UK-wide, quantitative and qualitative study of midwives was conducted between November 2020 and April 2021 using social media platforms. The survey was designed using the Theoretical Domains Framework by a team of researchers experienced in using it. An open-ended question was embedded in the survey to allow midwives to expand on matters related to the study subject. Findings: Out of 160 responders, 37.5 % indicated inadequate engagement in conversations with women about aspirin prophylaxis. Domains ‘Knowledge’ (OR 13.7, 95 %CI 5.7–32.7, p < 0.001), ‘Professional role and Identity’ (OR 15.3, 95 %CI 6.4–36.7, p < 0.001) and ‘Beliefs about capabilities’ (OR 13.6, 95 %CI 6.1–30.6, p < 0.001) were most prominently associated with effective engagement. Best fit model was comprised of ‘Beliefs about Capabilities’, ‘Social/professional role and identity’, and ‘Knowledge’. Midwives’ comments focused on barriers within ‘environmental context’ related to ‘conflicting views’ and ‘deficit in resources’ that compromise positive reinforcement of aspirin use. Responders also provided helpful ‘Top tips’ that streamline their daily practice. Conclusion and implications for practice: Beliefs about Capabilities, Social/professional role and identity, Knowledge, and Environmental Context and resources are key domains related to midwives’ engagement in conversations about aspirin in pregnancy. Clear, up-to date information for midwives and the public should be available in an easy access format to allow provision of unequivocal advice related to the use of aspirin in pregnancy.
KW - Aspirin
KW - Pre-eclampsia prevention
KW - Midwives' engagement
KW - Theoretical domains framework
KW - Barriers and facilitators
UR - http://www.scopus.com/inward/record.url?scp=85175538874&partnerID=8YFLogxK
U2 - 10.1016/j.midw.2023.103860
DO - 10.1016/j.midw.2023.103860
M3 - Article
SN - 0266-6138
VL - 127
JO - Midwifery
JF - Midwifery
M1 - 103860
ER -
