ABSTRACT
BACKGROUND: Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss and neuro-disability in childhood. In the absence of a licensed vaccine, adoption of hygiene-based measures may reduce the risk of CMV infection in pregnancy, however these measures are not routinely discussed with pregnant women as part of National Health Service (NHS) antenatal care in the United Kingdom (UK). METHODS: An exploratory qualitative study was conducted, underpinned by Normalization Process Theory (NPT), to investigate how an educational intervention comprising of a short film about CMV may best be implemented, sustained, and enhanced in real-world routine antenatal care settings. Video, semi-structured interviews were conducted with participants who were recruited using a purposive sample that comprised of midwives providing antenatal care from three NHS hospitals (n = 15) and participants from professional colleges and from organisations or charities providing, or with an interest in, antenatal education or health information in the UK (n = 15). FINDINGS: Midwives were reluctant to include CMV as part of early pregnancy discussions about reducing the risk of other infections due to lack of time, knowledge and absence of guidance or policies relating to CMV in antenatal education. However, the educational intervention was perceived to be a useful tool to encourage conversations and empower women to manage risk by all stakeholders, which would overcome some identified barriers. Macro-level challenges such as screening policies and lack of official guidelines to legitimise dissemination were identified. DISCUSSION: Successful implementation of education about CMV as part of routine NHS care in the UK will require an increase in awareness and knowledge about CMV amongst midwives. NPT revealed that 'coherence' and 'cognitive participation' between service members are vital to imbed CMV education in routine practice. 'Collective action' and 'reflexive monitoring' is required to sustain service changes.
Subject(s)
Cytomegalovirus Infections , Pregnancy Complications, Infectious , Prenatal Care , Qualitative Research , Humans , Female , Pregnancy , Cytomegalovirus Infections/prevention & control , Prenatal Care/methods , Pregnancy Complications, Infectious/prevention & control , United Kingdom , Motion Pictures , Midwifery/education , Midwifery/methods , Adult , Health Knowledge, Attitudes, Practice , Patient Education as Topic/methods , State MedicineABSTRACT
Emerging research suggests young adults, in particular women, may be especially sensitive to changes associated with the COVID-19 outbreak. This study, which is part of an ongoing research project focusing on young adulthood and substance use during the UK COVID-19 lockdown, aimed to provide an in-depth snapshot of factors that young adult women may describe as influential in their alcohol consumption during this period. Virtual semi-structured interviews were carried out on a sample of 12 (23-25 years) women between April and May 2020. The data were analysed through thematic analysis and preliminary findings led to the identification of three themes: (1) Changes to working environment, (2) Limitations on social opportunities and efforts to socialise in a 'new normal', and (3) Effects of cohabitation on increased alcohol consumption. The preliminary findings of this study highlight factors relevant to changes in alcohol use during the COVID-19 outbreak in the UK.