EMAeHealth, a digital tool for the self-management of women's health needs during pregnancy, childbirth and the puerperium: protocol for a hybrid effectiveness-implementation study.

INTRODUCTION: EHealth can help health service users take a more active role in decision-making and help health professionals guide the patient in this process. A digital tool has been designed to support maternal education (ME), and it is organised into four areas: (1) information, (2) communication, (3) health self-management and (4) clinical data. The main objective of the study is to evaluate the effectiveness of the EMAeHealth digital tool, and assess its usability and acceptability under routine conditions. METHODS AND ANALYSIS: Hybrid implementation-effectiveness design: (1) A cluster randomised, prospective, longitudinal, multicentre clinical trial to evaluate the effectiveness of EMAeHealth in (A) improving health-related quality of life (primary outcome), (B) improving self-efficacy for labour and childbirth and self-efficacy in breast feeding and (C) reducing the number of visits to the obstetric emergency services and health centre in situations of 'non-pathological pregnancy', 'false labour pains' and 'non-pathological puerperium'. The EMAeHealth intervention plus usual care will be compared with receiving only usual care, which includes traditional ME. N=1080 participants, 540 for each study arm. Two measurements will be made throughout the pregnancy and three in the first 16 weeks post partum. (2) A mixed-method study to evaluate the usability and acceptability of the tool, barriers and facilitators for its use, and implementation in our health system: focus groups (women, professionals and agents involved) and a quantitative analysis of implementation indicators. ANALYSIS: It will be carried out by intention to treat, using mixed models taking into account the hierarchical structure of the data and per protocol to evaluate the effectiveness of the express use of the digital tool. ETHICS AND DISSEMINATION: Clinical Research Ethics Committee of Euskadi, Spain, (Ref: PI2020044) approved this study. The results will be actively disseminated through manuscript publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT04937049.

Attitudes toward medicalization in childbirth and their relationship with locus of control and coping in a Spanish population.

The dominant model of childbirth in most Western countries is medicalized childbirth. Women's beliefs about whether childbirth should be a medicalized process to a greater or lesser degree may be related, in addition to contextual factors, to internal factors. The objective of the study is to find out if women's locus of control (LC) and stress coping strategies (CS) are related to having a more favourable or less favourable attitude towards medicalization (ATMC). A cross-sectional study was carried out with the participation of 248 women recruited in primary care centres by their midwives. All the women filled in answers on a mobile phone app with various different measurement instruments: the questionnaire created by Benyamini to evaluate their ATMC; the Spanish version of the Wallston MLC to evaluate their LC; and the Spanish adaptation of the "Revised Prenatal Coping Inventory (NuPCI)" scale for the assessment of their CS. The women presented a favourable attitude towards medicalization, with a mean ATMC score of 3.42. Both the LC and the CS of women during pregnancy are related to this attitude. Specifically, having an internal LC and using preparative CS both lower the probability of presenting a favourable attitude towards medicalization, while the lack of a paid job raises the probability. For each point in internal locus and preparatory coping, the ATMC score decreased by 0.02 and 0.23 points, respectively, while it increased by 0.18 for not having a paid job. The influence of these psychological factors must be taken into account in the development of content and interventions that promote a more natural birth.

Adaptación al contexto universitario español y propiedades psicométricas del MSLQ: Contribución a la medida y análisis de las diferencias de género del aprendizaje autorregulado / Adaptation to the Spanish university context and psychometric properties of the MSLQ: Contributions to the measurement and analysis of gender differences of self-regulated learning

Una dificultad para el avance en la investigación del aprendizaje autorregulado en general, y las diferencias de género en particular, está relacionada con la medida de los diferentes componentes y procesos autorregulatorios. Por ello, el presente estudio tiene como objetivo adaptar y analizar 1) la estructura interna, fiabilidad e invarianza en función del género del Motivated Strategies for Learning Questionnaire (MSLQ) en español y 2) las diferencias entre hombres y mujeres en las dimensiones y subdimensiones del MSLQ. Han participado 428 estudiantes universitarios (73,7% mujeres). Los resultados han evidenciado que esta adaptación es más breve que la versión original y presenta mejores propiedades métricas que otras versiones. La herramienta posee una estructura y pesos factoriales comunes (invariancia métrica) para varones y mujeres que garantiza la validez de las comparaciones por género. Se han hallado diferencias de moderadas a altas a favor de las mujeres en el valor concedido a la tarea, distintas estrategias de aprendizaje y ansiedad ante los exámenes. Este estudio da respuesta a la necesidad de contar en España con un instrumento adaptado culturalmente a nuestro contexto, válido y fiable y ahonda en las diferencias de género en el aprendizaje autorregulado, constructo clave para desarrollar con éxito la formación académica en la actualidad.(AU)

A challenge in advancing research into self-regulated learning in general, and gender differences in particular, is relatedto the measurement of various components and self-regulatory processes of it. Therefore, this study aims to adaptinto Spanish and analyzes 1) the internal structure, reli-ability, and gender invariance of the Motivated Strategies for Learning Questionnaire (MSLQ) and 2) the differences between males and females in the MSLQ dimensions and subdimensions. Participants consisted of 428 university students (73.7% women). Results showed that this adaptation is shorter than the original and has better metric properties than other ver-sions. Also, invariance analysis showed that for men and women, the in-strument possesses a common structure and loads (metric invariance) that guarantees valid score comparisons by gender. Moderate to high differ-ences were found in women’s favor in the value given to homework, dif-ferent learning strategies, and anxiety before examinations. This study re-sponds to theneed for a culturally adapted, valid, and reliable instrument in Spain and delves into gender differences in self-regulated learning, a key building block to successfully develop academic training at the presenttimes.(AU)