Date Approved

4-2016

Graduate Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Patricia Schafer

Second Advisor

Karyn Butler

Third Advisor

Heather Wallace

Fourth Advisor

Debra Lenz

Abstract

The United States has higher fetal and infant mortality than the majority of developed countries around the world. As of 2008, the United States was ranked 27th internationally for infant mortality among all developed countries (MacDorman, Hoyert, & Mathews, 2013). Infant morbidity and mortality is associated with numerous factors within a country; including access and quality of health care, maternal health status, public health, and socioeconomic status.

Despite recent declines in infant mortality across the country, the infant mortality rates for both Michigan and the project county remain alarmingly higher than the national averages. It is clear that innovative measures to decrease risk factors associated with infant morbidity and mortality are desperately needed in the county. The purpose of this project was to design, implement, and evaluate an innovative, community-based, antenatal education program that appealed to the high risk pregnant women in the county. The main goal of the antenatal education program was to educate pregnant women about various risk factors associated with adverse birth outcomes, infant morbidity, and infant mortality. A secondary goal was to provide a venue to promote the development of social support among pregnant women in the county, while linking them to community resources that may help them have a more successful pregnancy.

An eight week community-based antenatal education class was developed, implemented, and evaluated by a Doctor of Nursing (DNP) student. After identifying the practice problem, the DNP student completed an integrative literature review to analyze, critique, and synthesize relevant, evidence-based literature to determine if there is a sufficient evidence base to guide practice. Next, the DNP student began developing the class curriculum. Topics to be included in the curriculum were chosen based on the results of the integrative literature review, the objectives of the Healthy Babies Healthy Start grant, and the principles of adult learning.

The antenatal education program was launched on Tuesday, January 26, 2016 and completed on Tuesday March 22, 2016. The goal was that four to six pregnant women would attend each antenatal education class and the main indicator to determine the effectiveness of the antenatal education program was participant satisfaction and perceived self efficacy. A range of three to seven pregnant women attended each antenatal education class and satisfaction feedback was collected after six of the eight classes and at the end of the project. The satisfaction feedback was analyzed throughout the project to be used for quality improvement in the current class and for future classes. Self-efficacy feedback was also collected at the end of the project to determine if the antenatal education program increased the pregnant women’s perceived ability to decrease risky health and social behaviors and engage in health promotion behaviors outside of the class.

Overall, the pregnant women indicated that they were satisfied with the class and felt that the class helped them have healthier pregnancies. They perceived themselves as being able to decrease risky health and social behaviors and engage in health promotion behaviors outside of the class. Feedback was gathered through weekly surveys handed out at the end of six of the eight classes and utilized for quality improvement throughout the project and for future educational classes.

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