Effects of an educational program on midwives intentions to prevent premature birth: A randomized controlled trial

BackgroundPremature birth is a leading cause of neonatal mortality and long-term disability worldwide. Midwives in Japan have few opportunities to receive systematic education on premature birth prevention. We developed an online interactive midwifery education program to enhance midwives intention, knowledge, and attitudes toward evidence-based practice (EBP) for premature birth prevention. MethodsWe conducted a randomized controlled trial with a 1:1 allocation ratio. A total of 158 midwives were randomly assigned to either the intervention group (IG; n = 79) or the control group (CG; n = 79). The IG received a 120-minute online interactive education program, whereas the CG received an informational pamphlet. The primary outcome was the intention to practice midwifery care for premature birth prevention two weeks after intervention, assessed using the Continuing Professional Development-Reaction Questionnaire. Secondary outcomes included knowledge and attitudes toward EBP, measured using the Evidence-Based Practice Attitude Scale (EBPAS). Due to the nature of the intervention, blinding of participants and researchers was not feasible; allocation concealment was maintained. ResultsAll randomized participants were included in the analysis. The median intention score was significantly higher in the IG than in the CG immediately after the program (6.5 [IQR: 5.5- 7.0] vs. 5.5 [IQR: 5.0-6.5]; p = .005, effect size = 0.23 [small]) and two weeks after the intervention (6.0 [IQR: 5.5-7.0] vs. 5.5 [IQR: 5.0-6.0]; p = .001, effect size = 0.27 [small]). Knowledge scores were also significantly higher in the IG both immediately after (9.0 [IQR: 9.0-10.0] vs. 6.0 [IQR: 6.0-7.0]; p < .001, effect size = 0.81[large]) and two weeks after the program (9.0 [IQR: 8.0-10.0] vs. 6.0 [IQR: 4.3-7.0]; p < .001, effect size = 0.72 [large]). No significant differences between groups were observed in EBPAS scores at any time point. ConclusionsThe online interactive education program effectively improved midwives intention and knowledge regarding premature birth prevention. Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR): UMIN000058251. FundingThis study was supported by the Yamaji Fumiko Specialized Nursing Education Research Grant Fund.