Pregnant women's use of information and communications technologies to access pregnancy-related health information in South Australia.

This paper examines how pregnant women living in South Australia use information and communication technologies (ICTs), principally Internet and mobile phones, to access pregnancy-related information. It draws on 35 semistructured interviews conducted as part of the 'Health-e Baby' project, a qualitative study designed to assess the information needs and ICT preferences of pregnant women cared for at a South Australian metropolitan teaching hospital. Our research shows that although ICTs offer exciting possibilities for health promotion and the potential for new forms of communication, networking and connection, we cannot assume the effectiveness of communicating through such channels, despite near universal levels of ICT access. In turn, this highlights that if e-mediated health promotion is to be effective, health promoters and practitioners need to better understand ICT access, usage and content preferences of their clients.

How midwives tailor health information used in antenatal care.

OBJECTIVE: to examine the informal approaches taken by midwives and other antenatal staff to adapt health communication to the needs of their patients, as well as their perception of the barriers faced when trying to provide tailored health promotion. DESIGN: qualitative research methods (participant observation, individual and group interviews) were utilised to gain an understanding of how media and communication resources were used in practice within the study hospital. SETTING: a major metropolitan teaching hospital located in the Northern suburbs of Adelaide, South Australia. PARTICIPANTS: individual semi-structured interviews with antenatal staff (n=8) were combined with group interviews (n=2; total number of staff=13), and observational research. FINDINGS: midwives and other antenatal staff use a range of strategies to meet the perceived health literacy level of their patients. However, their attempts to tailor health information to individual needs are frequently based on incomplete information about patients' health literacy, may be inconsistent in delivery and content and are seldom assessed to determine whether communication has been understood or led to patient behaviour change. KEY CONCLUSIONS: midwives fully recognise the need to adapt standard printed materials to meet the diverse health literacy needs of patients but lack the resources required to evaluate whether these adaptations have positive effect. IMPLICATIONS FOR PRACTICE: midwives' commitment to improving health communication provides a latent resource that institutions can build on to improve health outcomes for patients with low health literacy. This requires improvements in health communication training, willingness to use a range of validated instruments for measuring health literacy, and commitment to use of innovative approaches to health promotion where these have been shown to have a positive impact on health behaviours.

Methicillin-resistant Staphylococcus aureus: a questionnaire and microbiological survey of nursing and residential homes in Barking, Havering and Brentwood.

The study determined the policies and procedures for the control and prevention of methicillin-resistant Staphylococcus aureus (MRSA) and its prevalence among nursing and residential homes, and evaluated whether certain home characteristics such as bed size, staffing level, and type of home are related to the prevalence of MRSA. A 21-questionnaire survey, with primarily categorical responses, was mailed to the home managers of all the 121 nursing and residential homes in the district, following which a simple, stratified random sample of 28 (23.14%) homes was taken and all agreeing residents screened from multiple sites for MRSA. Seventy-seven (63.6%) homes returned a completed questionnaire, 13 (46.4%) of whom agreed to participate in the microbiological study. The response rates for returning questionnaires and agreeing to participate in the microbiological study were similar for nursing and residential homes (65% vs. 60%; 67% vs. 40%; P = 0.12; P = 0.62), respectively. Nursing homes had a mean bed size of 30 (95% Confidence Interval (CI) 17-43), not significantly different from residential homes of 23 (95% CI 18-27; P = 0.26). The nursing homes employed a mean of 8.6 (95% CI 4.7-12.5) staff nurses per home; significantly higher than residential homes with a mean of 1.6 (95% CI 0.3-2.8; P = 0.006). No significant differences in mean number of home care assistants employed per home (22.8; 95% CI 12.4-33.13; and 14.4; 95% CI 11.83-16.90; P = 0.098, for nursing and residential homes, respectively) were observed. None of the homes had employed infection control practitioners. Only four (6.8%) of the responding homes stated that MRSA was a problem. Nursing homes were not significantly more likely to have admission policies for colonized person than residential homes (10/13 vs. 40/55, P = 1.00). Of the fifty-five (71.4%) homes who had admission policies, 40 (72.7%) stated that persons colonized/infected with MRSA would not be accepted, while 12 (21.8%) would accept such persons in single-room isolation and/or barrier nursing. Greater proportions of residential homes than nursing homes would not accept admission of persons with documented MRSA colonization (30/35 vs. 4/10, P = 0.007). Four (9.1%) homes (three nursing) had identified a total of five residents colonized/infected with MRSA in 5 years prior to the survey. Two hundred and forty-six residents were screened (552 sites), two (0.81%) of whom were found to be colonized in the nose (one resident) and in the groin (two residents) with MRSA, giving a 2-month weighted point prevalence rate of 0.14% (95% CI 0.01-0.26%). We conclude that in our district the nursing staffing levels and control measures vary widely within these homes, while the prevalence of residents who are colonized/infected with MRSA is lower than in other areas. We suggest that the exclusion admission policy for MRSA positive patients should be abandoned and targeted infection control programmes be instituted.

"Who's afraid?": attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information.

BACKGROUND: Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage. AIM: The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care. METHODS: Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data. FINDINGS: Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client. CONCLUSION: Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts.