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Public health
Protocol
Rationale, development and feasibility of group antenatal care for immigrant women in Sweden: a study protocol for the Hooyo Project
  1. Ulrika Byrskog1,
  2. Malin Ahrne2,
  3. Rhonda Small3,
  4. Ewa Andersson2,
  5. Birgitta Essen4,
  6. Aisha Adan2,
  7. Fardosa Hassen Ahmed2,
  8. Karin Tesser5,
  9. Yvonne Lidén6,
  10. Monika Israelsson6,
  11. Anna Åhman-Berndtsson5,
  12. Erica Schytt7,8
  1. 1 School of Education, Health and Social sciences, Dalarna University, Falun, Sweden
  2. 2 Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
  3. 3 Mother and Child Health Research, La Trobe University, Melbourne, Victoria, Australia
  4. 4 Womens and Childrens Health, Uppsala University, Uppsala, Sweden
  5. 5 Antenatal Care Clinic, Domnarvet, Borlänge, Sweden
  6. 6 Antenatal Care Clinic, Spånga-Tensta, Sweden
  7. 7 Centre for Clinical Research Dalarna-Uppsala University, Falun, Sweden
  8. 8 Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
  1. Correspondence to Dr Ulrika Byrskog; uby{at}du.se

Abstract

Introduction Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes.

Overall aim To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study.

Methods and analysis An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016–2018) and women receiving group antenatal care (2018–2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group.

Ethics and dissemination The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenatal care units, national/international conferences, through publications in peer-reviewed journals, seminars involving stakeholders, practitioners, community and via the project website. Participating women will receive a summary of results in their language.

  • feasibility study
  • group antenatal care
  • immigrants
  • midwives
  • process evaluation
  • somali-born women

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2019-030314

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    Footnotes

    • Contributors ES, RS, EA and BE initiated the study. UB, ES, RS, EA MA, BE, AA, FHA, KT, YL, MI and AA-B contributed to planning and design. UB, MA, ES, RS, EA AA and FH developed questionnaires and topic guides. UB drafted the manuscript, MA, ES, RS, UB, EA, BE, AA, FHA, KT, YL, MI and AB revised it. All authors read and approved the final manuscript.

    • Funding This study has received funding from the Swedish Research Council (grant number 2015-02470), Forte (grant number 2016-00957) and the Doctoral School in Health Care Sciences, Karolinska Institutet (grant number 2-144/2016).

    • Disclaimer The funding bodies have played no role in the design of the study, nor in data collection, analysis and interpretation of the data or in writing the manuscript.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study is approved by the Regional Ethical Review Board, Stockholm, Sweden, 2015-12-04, Dnr 2015/1703-31/1.

    • Provenance and peer review Not commissioned; externally peer reviewed.