Browsing by Subject "maternal"

Parents who give birth (e.g., mothers, birthing parents, primary caregivers) experience a vast array of needs during the early postpartum period. While unique needs across all individuals are likely innumerable, generally needs focus on taking care of oneself, taking care of one's infant, and dyadic needs such as feeding an infant. One example of a generalized health need is the physiologic need for the birthing parent to receive sufficient sleep. Yet, birthing parents may experience significant deficits in sleep during the early postpartum period, and these unmet sleep needs can significantly impact the parent’s physical and mental well-being during this crucial and transformative period of life. Therefore, this dissertation study explores the concept of postpartum needs and how they emerge and, in particular, investigates maternal experiences of sleep during the first days postpartum. These topics are explored through two studies. First, in a qualitative descriptive study of 22 birthing parents we assessed their perspectives of postpartum needs and how these needs emerge. Then, using videotaped recordings of 15 postpartum families during an in-depth multiple case study, we used behavioral observation methods to code the experiences of 15 postpartum families and their health care team members as videotaped during postpartum hospitalizations. This study provided key insights into the patterns and context of postpartum maternal sleep and awakenings. These findings include describing the interactions that contributed to a median 2.6 hours of sleep for the birthing parents during the last 24 hours of their inpatient stay. In conclusion, we found that parents experience numerous unmet needs during the postpartum period, best understood within the complex socioecologic context in which they arise. These patient-focused findings elevate the importance of aligning health care services in hospital settings and at home with birthing parent needs.

Background: In Kenya, timely antenatal care, postnatal family planning, breastfeeding and maternal health literacy impact maternal and child health. mHealth interventions such as chatbots offer novel ways to address health literacy and other health determinants. A chatbot is a computer software that can simulate a human conversation. Identifying the feasibility of chatbots in Kenya for pregnancy support within Facebook’s social media platform is uncharted. To map the feasibility of a chatbot for pregnancy support, questions surrounding the current utilization of health resources and attitudes matter.

Methods: Phase 1 used focus group discussions (FGDs) to understand health resource usage, attitudes and preferences towards a chatbot application for pregnancy. Participant input was used to develop the chatbot in Phase 2. Phase 3 focused on the experience of those using the chatbot to inform feasibility and acceptability of the chatbot developed. Post-intervention we conducted FGDs and interviews, surveyed the sample and analyzed app usage data.

Results: Participants described unsatisfying relationships with health resources including health care providers. These experiences led to mistrust. Participants identified criteria that a chatbot for pregnancy support should have. After making these adaptations to the chatbot developed in Phase 2, the chatbot was tested during Phase 3. Results from Phase 3 indicate positive attitudes towards the chatbot experience and engagement.

Conclusions: The current context of Kenya regarding patient provider relationships, internet access and Facebook have proven beneficial for the feasibility of this innovation. Participant experiences were positive and relate to the use of Human Centered Design, Innovation Diffusion Theory and trust.