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Open Access

Peer-reviewed

Research Article

Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis

  • Klaartje M. Olde Loohuis ,

    Roles Conceptualization, Formal analysis, Methodology, Writing – original draft, Writing – review & editing

    k.m.oldeloohuis@umcutrecht.nl

    Affiliation Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands

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  • Bregje C. de Kok,

    Roles Conceptualization, Formal analysis, Methodology, Writing – review & editing

    Affiliation Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands

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  • Winter Bruner,

    Roles Formal analysis, Methodology, Writing – review & editing

    Affiliation Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, United States of America

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  • Annemoon Jonker,

    Roles Formal analysis, Methodology, Writing – review & editing

    Affiliation Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands

    ⨯
  • Emmanuella Salia,

    Roles Formal analysis, Methodology, Writing – review & editing

    Affiliation Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, United States of America

    ⨯
  • Özge Tunçalp,

    Roles Conceptualization, Methodology, Writing – review & editing

    Affiliation Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland

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  • Anayda Portela,

    Roles Conceptualization, Methodology, Writing – review & editing

    Affiliation Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland

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  • Hedieh Mehrtash,

    Roles Conceptualization, Methodology, Writing – review & editing

    Affiliation Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland

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  • Diederick E. Grobbee,

    Roles Methodology, Writing – review & editing

    Affiliation Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands

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  • Emmanuel Srofeneyoh,

    Roles Methodology, Writing – review & editing

    Affiliation Department of Obstetrics and Gynecology, Greater Regional Hospital, Accra, Ghana

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  • Kwame Adu-Bonsaffoh,

    Roles Methodology, Writing – review & editing

    Affiliation Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana

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  • Hannah Brown Amoakoh,

    Roles Methodology, Writing – review & editing

    Affiliations Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands, Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Accra, Accra, Ghana

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  • Mary Amoakoh-Coleman,

    Roles Conceptualization, Methodology, Writing – review & editing

    Affiliations Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands, Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Accra, Accra, Ghana

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  • Joyce L. Browne

    Roles Conceptualization, Formal analysis, Methodology, Writing – original draft, Writing – review & editing

    Affiliation Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands

    ⨯

Abstract

Effective interpersonal communication is essential to provide respectful and quality maternal and newborn care (MNC). This scoping review mapped, categorized, and analysed strategies implemented to improve interpersonal communication within MNC up to 42 days after birth. Twelve bibliographic databases were searched for quantitative and qualitative studies that evaluated interventions to improve interpersonal communication between health workers and women, their partners or newborns’ families. Eligible studies were published in English between January 1st 2000 and July 1st 2020. In addition, communication studies in reproduction related domains in sexual and reproductive health and rights were included. Data extracted included study design, study population, and details of the communication intervention. Communication strategies were analysed and categorized based on existing conceptualizations of communication goals and interpersonal communication processes. A total of 138 articles were included. These reported on 128 strategies to improve interpersonal communication and were conducted in Europe and North America (n = 85), Sub-Saharan Africa (n = 12), Australia and New Zealand (n = 10), Central and Southern Asia (n = 9), Latin America and the Caribbean (n = 6), Northern Africa and Western Asia (n = 4) and Eastern and South-Eastern Asia (n = 2). Strategies addressed three communication goals: facilitating exchange of information (n = 97), creating a good interpersonal relationship (n = 57), and/or enabling the inclusion of women and partners in the decision making (n = 41). Two main approaches to strengthen interpersonal communication were identified: training health workers (n = 74) and using tools (n = 63). Narrative analysis of these interventions led to an update of an existing communication framework. The categorization of different forms of interpersonal communication strategy can inform the design, implementation and evaluation of communication improvement strategies. While most interventions focused on information provision, incorporating other communication goals (building a relationship, inclusion of women and partners in decision making) could further improve the experience of care for women, their partners and the families of newborns.

Citation: Olde Loohuis KM, de Kok BC, Bruner W, Jonker A, Salia E, Tunçalp Ö, et al. (2023) Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis. PLOS Glob Public Health 3(10): e0002449. https://doi.org/10.1371/journal.pgph.0002449

Editor: Patience A. Afulani, University of California San Francisco (UCSF), UNITED STATES

Received: July 6, 2022; Accepted: September 12, 2023; Published: October 11, 2023

Copyright: © 2023 Olde Loohuis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The authors confirm that the data supporting the findings of this study are available within the article (Table 1).

Funding: KMOL, BCdK, JLB, MAC, KAB, HBA and DEG were supported by the Dutch Research Council (NWO, NWA.1160.18.159, https://www.nwo.nl/en/projects/nwa116018159). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Improving the quality of maternal and neonatal health services would accelerate reductions in maternal and neonatal deaths in low- and middle-income countries (LMICs) [1]. Quality of care, as the 2015 World Health Organization (WHO) quality of care framework identifies, has two major domains: provision of care and experience of care [2]. The experience of care dimension includes effective interpersonal communication, which is also closely linked to mistreatment of women during childbirth [3]. In a multi-country study, almost one in five women felt that health workers or staff did not listen and respond to their concerns, and more than half reported no consent for episiotomies performed during childbirth [4].

Effective interpersonal communication is a cornerstone of medical practice [5, 6]. Effective communication can serve three different goals: facilitating the exchange of information, creating a good interpersonal relationship including building of trust, and enabling the inclusion of patients in decision making [7–12]. Communication is furthermore an important theme in respectful maternity care, and a way to protect the human rights of women, for example, through ensuring confidentiality, fulfilling the right to be fully informed and allowing for informed consent [9].

Interpersonal communication between health workers and patients can affect health care outcomes, including patients’ satisfaction, knowledge and understanding, adherence to treatment, quality of life and psychological and physical health [8, 10, 11]. Within maternal and newborn care (MNC), good interpersonal communication contributes to better experiences, improved respectful care and reduced mistreatment [7, 8, 13]. This is particularly relevant in low-resource settings where poor communication and mistreatment are common [4], contributing to negative or traumatic birth experiences [12]. To illustrate, in Kenya, person-centred care, which included many interpersonal communication related aspects, was associated with improved MNC outcomes [13].

Various aspects of interpersonal communication processes between health workers and patients have been described. The communication framework of Feldman-Stewart and Brundage is particularly useful to illustrate ‘how’ interpersonal communication works [14, 15], and can thus be helpful in understanding how interpersonal communication could be improved. First, this framework suggests that both health workers and patients have goals in terms of what they want to achieve during the interaction. Second, each participant has certain needs, beliefs, values, skills and emotions that shape ways to interact. Third, each participant receives and sends messages. And finally, the framework underscores that the environment in which the interaction takes place matters for communication, and thus for strategies designed to improve interpersonal communication [14, 15]. Further guidance on effective communication within MNC is emphasized within WHO’s recommendations across the continuum of MNC [16–18]. While these recommendations do not provide a definition of effective communication within the context of MNC, they provide guidance to ensure effective communication is prioritized between health workers, women, their partners and families [16].

Despite the increased recognition of the importance of interpersonal communication for MNC there is no clear overview of the different strategies that can be adopted to reduce mistreatment and improve respectful care [19]. Therefore, the objective of this review was to map and categorize implemented strategies to improve interpersonal communication between health workers, women and their partners within MNC up to 42 days after birth.

Methods

Protocol and registration

This review was drafted and conducted in accordance with the PRISMA guidelines [20] and the Cochrane Handbook for Systematic Reviews [21]. The study protocol was registered in PROSPERO in July 2020 (CRD42020191622). The protocol was initially developed for a systematic review including a possible meta-analysis on effectiveness. We converted to a scoping review with narrative analysis due to the number and heterogeneous nature of the primary research articles, and because this provided a sufficient basis for answering the research questions.

Domain and population

The domain of our review consisted of studies that implemented a strategy to improve interpersonal communication between health workers, women, and their partners in care across the continuum of MNC. We also anticipated that experiences to improve interpersonal communication from related domains in sexual and reproductive health and rights (SRHR) would facilitate cross-learning from MNC, and therefore extended the domain to include the reproduction-related SRHR subdomains of safe abortion, family planning and (in)fertility.

The study population included women and their partners as well as newborns and their parents/caregivers/families throughout the continuum of MNC and reproduction-related SRHR subdomains. This included antenatal, intrapartum and postnatal care up to 42 days. In this paper, we used ‘women and partners’ to describe the population. Health workers included different cadres as specified in the WHO recommendations to optimize health workers’ roles within MNC [22]: lay health workers, (auxiliary) nurses and midwives, and (associate) physicians (including obstetricians, paediatricians, general practitioners and residents).

Eligibility criteria

Studies were eligible for inclusion if they were primary, peer-reviewed articles reporting on interpersonal communication quality improvement strategies between health workers and women and partners in MNC and reproductive-related SRHR subdomains. All studies that included health workers who were engaged with in-service training (i.e., not training by students as part of a qualifying degree) were eligible. Studies conducted in any setting within MNC and reproductive-related SRHR subdomains were eligible. Studies that included a paediatric population were only eligible if >50% of participants were newborns (up to 42 days old) or newborns’ parents. Studies published from January 2000 to July 2020 were included to reflect contemporary practices.

We excluded studies that focused on mass communication, group communication, one-way communication, interprofessional communication and communication between mothers and babies. Furthermore, we excluded studies that reported on packages of strategies where communication was not a primary aim, because in these complex intervention studies communication was usually a small part of the intervention, and so difficult to disentangle from other activities. Furthermore, studies that implemented a new communication-based treatment programme (e.g., cognitive behaviour therapy) to treat a specific disease or problem were excluded because these constituted a new form of health service delivery, except when the intervention specifically focused on improving the interpersonal communication within the delivery of the health service. We excluded reviews, but primary studies from relevant systematic reviews were checked for eligibility. We included only English articles, because of language limitations within the team. In total, six studies were excluded in full text screening because of language restrictions.

Information sources

We searched the following information sources: PubMed/Medline, EMBASE, CINAHL, SCOPUS, PsychINFO, Anthropology PLUS, SocioINdex, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS), African Journals Online (AJOL), and Global Health Library.

Search

Search terms consisted of MeSH and combined text related to ‘communication’, ‘health workers’, ‘MNC or related SRHR domains’, ‘women and families’ and ‘intervention’. The search was developed with support from a librarian. For the complete search strategy see S1 Appendix. References of included articles were snowballed and checked for eligibility. De-duplication was performed using Endnote (V.X9).

Selection of sources of evidence

First, titles and/or abstracts of studies identified through the search strategy were independently screened to assess whether studies met the inclusion criteria by two of the four reviewers (AJ, ES, WB, KMOL). Next, full texts were screened in the same way. In case a full text article was missing or inaccessible, authors were contacted once through email or ResearchGate and were given the option to respond within a month to provide us with the full text. Rayyan QCRI (https://rayyan.qcri.org/welcome) was used to screen articles. Any disagreement that arose was discussed by the persons who screened the articles until consensus was reached, or a fifth review team member was consulted (JLB or BCdK) to resolve the issue through further discussion.

Data charting process including data items

Data were extracted using a standardized pre-piloted form (by AJ, ES, WB, KMOL, BCdK). The data extracted included study characteristics and information for evidence synthesis: first author, year of publication, country, study setting, aims and objectives, study design, study population characteristics, description of intervention and communication goals of the intervention, and the types of outcomes measured. Extracted data were double checked by one of the team members (KMOL).

Synthesis of results

We initially planned to perform a systematic review including a meta-analysis on interpersonal communication strategies’ effectiveness. However, the number and heterogeneity of designs and interventions among the retrieved articles led us to convert the study to a scoping review with narrative synthesis that focussed on providing an overview and categorization of the various strategies taken to improve interpersonal communication [23]. In this scoping review process, we summarized key findings of articles. We categorized strategies into the three communication goals proposed by Ong et al. [8]: 1) to facilitate the exchange of information, 2) create a good interpersonal relationship, and 3) enable the inclusion of women and partners in the decision making. These categories were pragmatically used as heuristic tools, i.e. functional methods (not necessarily perfect), and studies were assigned to one or more of these categories based on the information available. In addition, we analysed the results to understand ‘how’ interpersonal communication and the communication improvement strategies worked, using the model proposed by Feldman-Stewart and Brundage [14]. This model was updated (and re-visualized) with insights from this review and further deliberations within the review team.

Results

We identified a total of 19956 articles through our search (see flow diagram in Fig 1). After removing duplicates, we screened 16826 articles on title and abstract and 369 articles in full text. Twenty-nine articles were additionally included through snowballing and reference screening of review articles. A total of 138 articles were included, reporting on 128 strategies to improve interpersonal communication.

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Fig 1. PRISMA flow diagram of included studies.

https://doi.org/10.1371/journal.pgph.0002449.g001

Study characteristics

Table 1 presents an overview of the included studies. Interventions were implemented in Europe and North America (n = 85), Sub-Saharan Africa (n = 12), Australia and New Zealand (n = 10), Central and Southern Asia (n = 9), Latin America and the Caribbean (n = 6), Northern Africa and Western Asia (n = 4) and Eastern and South-Eastern Asia (n = 2). The majority were in high-income countries (n = 95), compared to 33 interventions in LMICs [24]. The majority of studies were performed within the domain of maternal health (n = 80 studies), with others performed in newborn health (n = 47), family planning (n = 20) and (in)fertility (n = 2). Thirty-seven were randomized controlled trials (RCTs), 73 were non-RCT intervention studies.

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Table 1. Overview of included studies.

https://doi.org/10.1371/journal.pgph.0002449.t001

Communication goals

Nearly all strategies (n = 126/128) addressed at least one of the communication goals (facilitating the exchange of information, creating a good interpersonal relationship, and enabling the inclusion of women and partners in the decision making [7]). Fifty-eight addressed two goals, and six studies [25–30] addressed all three goals. Box 1 provides an elaboration with examples of improvement strategies for each goal. S2 Appendix provides an overview of the communication goals of all studies.

Box 1: Examples of improvement strategies for the three communication goals

Communication goal: Facilitating the exchange of information

  • Example 1. Bakker et al. 2003. Manual, intervention card and training on a counselling protocol on smoking cessation in pregnancy, consisting of 7 steps.
  • Example 2. Maurer et al. 2019. Regular communication through messages/emails with information and tools to support discussions with health workers.

Communication goal: Creating a good interpersonal relationship

  • Example 1. Shao et al. 2018. Simulation based training for NICU nurses to improve their empathic communication skills.
  • Example 2. Bashour et al. 2013. Training for effective communication skills with a focus on the interaction between health workers and patients.

Communication goal: Enabling the inclusion of women and partners/families in MNC decision making

  • Example 1. Muthusamy et al 2012. Written information to receive before counselling including tips about questions to ask.
  • Example 2. Chinkam et al. 2016. Scripted counselling package about birth choices and trial of labour after caesarean using shared decision-making principles.

The goal ‘facilitating the exchange of information’ was present in most strategies (n = 98/128) [25–137]. Examples included visual aids [visuals], decision tools, and health worker training focused on the information aspect of communication.

In total, 58 studies aimed to improve the goal ‘creating a good interpersonal relationship’ (n = 58/128) [25–30, 38, 39, 73, 75, 77–79, 82–84, 90–94, 104, 106, 109, 110, 112–115, 120–122, 131, 132, 138–164]. These often sought to improve relationships by enhancing verbal and non-verbal communication, including touching the patient, showing empathy and compassion.

The goal ‘inclusion of women and partners in the decision making’ was addressed by 41 strategies (n = 41/128) [25–30, 32–35, 43–45, 69–71, 80, 81, 85, 88, 89, 95–98, 100, 102, 107, 108, 117, 134–137, 140, 141, 160–169], for example by asking women about their values and beliefs. Often a decision aid tool was used, such as the WHO Family Planning Care Guidance (FPCG) flipchart decision aid where both women and health workers have information presented on their ‘side’ of a flipchart to support provision of information and shared decision making [35, 70, 96, 170]. Training sessions were regularly used to improve this goal too, for example in Toivonen et al. (2020) [141], where health workers in a neonatal intensive care unit were trained to collaborate with parents using shared decision making and person-centred care principles.

Strategies to improve communication

Two main types of strategy were used to improve interpersonal communication: training of health workers (n = 81) and tools to facilitate interpersonal communication (n = 67), with a few employing other distinct approaches (n = 7). Box 2 provides examples of these two main strategies.

Box 2: Examples of the two main strategies used to improve communication

Training of health workers

Training of health workers to improve their communication.

  • Example 1: Toivonen et al. 2020. An education intervention to increase the quality of family-centred care in different NICU’s.
  • Example 2: Posner et al. 2011. Workshop for residents in obstetrics and gynaecology on disclosing an adverse event.

Tools to facilitate communication

An (electronic) aid that can be used by health workers or women and partners to improve communication

  • Example 1: Langston et al. 2010. WHO decision support tool to structure the family planning counselling session.
  • Example 2: Kakkilaya et al. 2011. Visual aid with visual/graphical information for parents when delivery at the threshold of viability is imminent.

Training of health workers.

The majority of studies (n = 81/128) trained health workers to improve interpersonal communication skills as a single strategy, or as one of their strategies [25, 26, 28–30, 36–42, 46, 47, 49–51, 53, 55, 56, 58, 59, 61, 63, 66, 68, 73, 77, 79–81, 83–85, 88, 90–94, 99, 104–106, 108, 110, 112–117, 120–122, 127, 128, 130, 132, 135, 137–143, 145–149, 151–153, 155–159, 161–163, 165, 168, 171, 172]. Training programmes had different durations, ranging from 30 minutes [46, 163] to several months [26]. Nineteen studies (n = 19/82) used simulation-based training to teach communication skills [29, 38–41, 47, 68, 77, 84, 90, 91, 105, 110, 112, 114, 115, 151, 153, 155, 157, 161]. Some studies employed specific underlying communication theories as a basis of their training, for example the 5-A method for counselling [46, 61, 79, 104] or motivational interviewing techniques [26, 81, 104, 121]. Often, training was combined with communication tools such as scripts or guidelines to provide guidance, structure or reminders [26, 51, 72, 79, 80, 83, 85, 88, 92, 93, 99, 104, 108, 116, 173].

Tools to facilitate interpersonal communication.

Sixty-seven studies (n = 67/128) used tools to improve interpersonal communication between health workers and women and partners: decision aids, visual aids, prompts and scripts, and guidelines based on specific theory-based approaches to communication [25, 26, 31–33, 35–37, 43–45, 48, 50–52, 54, 57, 60, 62, 64, 65, 67, 69–71, 75, 78–80, 82, 83, 85, 87–89, 92, 93, 95–100, 102–104, 108, 109, 116, 117, 123–126, 128–132, 134–136, 144, 154, 160, 164, 166–168, 172, 174].

Decision aids (n = 23/67) [32, 33, 35, 43–45, 60, 64, 69–71, 80, 87, 88, 95–97, 108, 123, 124, 126, 134, 136, 167, 168, 174] were often used as tools to support health workers, and/or women and partners in decision making about a health-related issue. Visual aids were used in 17 strategies (n = 17/67) [36, 37, 48, 50–52, 62, 65, 75, 80, 83, 92, 103, 108, 117, 128, 135, 136], and supported health workers in their interpersonal communication and explanations. An example of a culturally sensitive visual aid was a cloth embroidery depicting safe maternal practices in pregnancy [62]. Prompts (n = 11/67) were also regularly used [26, 31, 54, 67, 85, 87, 88, 92, 123, 129, 175]. In these studies, health workers (or women [88]) received a (computer-assisted) cue or prompt to deliver or ask for counselling. A fourth type of tool used in studies was a script, or guideline regarding a specific approach to interpersonal communication often based on underlying communication theory (n = 30/67) [25, 26, 31, 54, 57, 67, 78, 79, 82, 85, 89, 92, 98–100, 102–104, 109, 116, 125, 129–132, 144, 154, 160, 164, 166]. This was primarily developed for the health worker, for example a small card with sample questions [166], a more extended script package [102], a checklist [85], or the use of Gamble’s approach to guide counselling [82].

Other strategies to improve interpersonal communication.

Seven studies used other strategies to facilitate interpersonal communication, including facilitation, women and partner or family empowerment, and multidisciplinary consultations [27, 34, 57, 64, 67, 107, 150]. The strategy of La Rosa et al. [150] consisted of health workers wearing a white coat to increase patients’ confidence or to act as a non-verbal communication facilitator. Peremans et al. 2010 [64] aimed to improve the quality of communication for contraceptive counselling by general practitioners (GPs), who used a decision aid during contraceptive counselling or were confronted with a ‘standardized patient’ who was empowered to ask a few additional questions regarding their contraceptive options. Three of the seven studies used a multidisciplinary approach to improve interpersonal communication, with joint consultations involving various medical specialists, psychologists and/or nurses [27, 67, 107].

Interpersonal communication effectiveness and outcomes

Table 1 includes a narrative overview of key findings of the included studies. Outcomes assessed were diverse, and ranged from health workers’ confidence levels in their communication skills, the participants’ experiences of care, behaviour change (e.g., contraceptive uptake), to impact on health outcomes. Most studies reported a positive effect on at least one of the outcomes measured. One article reported negative consequences after the use of a decision making tool at the NICU [134].

Update of Feldman-Stewart and Brundage communication framework

Based on our findings, the reflections embedded in related articles, and the reflections of the review team, we adapted the communication framework developed by Feldman-Stewart and Brundage [14] to illustrate how interpersonal communication works. We identified four ways in which this framework could be further adapted for the context of respectful MNC (Fig 2). First, we changed the name of ‘patient’ into ‘women and partners’. This is important in MNC communication because it may help remind health workers that they relate to and communicate with not just the women, but also their partners. Second, we reformulated the communication process as the interaction between health workers, women and partners to emphasize its bidirectional nature. This bidirectional nature was already acknowledged in the original papers for the framework by using a double arrow. By explicitly mentioning it in our updated framework we aimed to create awareness that focussing on women and their partners (as well as on the health workers) might be an important alternative strategy to improve interpersonal communication. Third, we included the three communication goals (to facilitate information exchange, create a good interpersonal relationship, and enable the inclusion of women and partners in decision making) to further explain the nature of communication processes or interaction. Including the different goals of communication may remind health workers that these three goals will need different and specific attention in case they need to be improved. Inclusion of these goals in a communication framework will facilitate making deliberate choices when designing interventions to improve interpersonal communication. Fourth, we divided the ‘environment’ into different health system levels (micro, meso, and macro) to emphasize that multiple types of context influence interpersonal communication [176]. Again, for the design of interventions these can result in a more precise conceptualization of the communication process. As such, this can facilitate a better exploration of how environmental aspects at different ‘levels’ of health systems, and the environment beyond, might influence communication.

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Fig 2. Updated framework for interpersonal communication in MNC, based on Feldman-Stewart and Brundage [14].

https://doi.org/10.1371/journal.pgph.0002449.g002

Discussion

This review identified 128 different interventions to improve interpersonal communication between health workers and women and partners in MNC. We found studies across different thematic areas to facilitate cross-learning for MNC. The majority were in high-income countries. They addressed three main goals of communication: facilitating the exchange of information, creating a good interpersonal relationship, and enabling the inclusion of women and partners in the decision making. The majority of studies focused on facilitation of exchange of information, and only a few incorporated all three goals. Strategies to improve interpersonal communication primarily consisted of health worker training and providing communication tools to facilitate interpersonal communication. We observed substantial heterogeneity in intervention design, implementation and outcome evaluation and measurements. This reduced the opportunities for an evaluation of effectiveness across different interventions within this scoping review.

Interpersonal communication within health care settings is a broad and diversely defined concept. Our comprehensive approach, in which we incorporated studies about interpersonal communication within pregnancy-related reproductive health domains, facilitated learning from related domains. This helped us to build on insights from other more specific reviews of interpersonal communication improvement strategies for care during antenatal care [177], and labour and childbirth [19]. Furthermore, we added value for future communication improvement activities by exploring how different communication goals were addressed. Finally, we further improved understanding of how interpersonal communication works within the MNC context by updating the previously developed framework. As such, in the absence of a clear definition of what ‘effective communication’ is, our classification and adapted model can contribute to developing such a clearer definition.

Although arguably the principles of patient-centred care date back to the ancient Greeks [178], the concept has recently received more attention in a push to transform health care into a more individually-tailored and rights-based approach instead of the traditional paternalistic (bio)medical model. These principles are embedded in midwifery and are related to optimal outcomes for maternal and newborn care [179]. This shift to focus on the experience of care [2] and patient-centred care [7] is reflected by the growing attention to the communication goals of ‘creating a good interpersonal relationship’ and ‘enabling the inclusion of women and families in the decision making’. However, our review found that information provision was still the dominant goal used in interventions (75%), suggesting there is scope for improvement to address the other domains relevant for patient-centred care and shared decision making. The importance of this shift to patient-centred care is illustrated by a review of women’s satisfaction with maternity care in LMICs [180]. This review demonstrated that aspects of relational communication such as listening and kindness could improve maternal satisfaction [180]. Similarly, a review on the effect of patient-provider communication on health outcomes in diverse medical settings and specialisms showed that involvement of patients in decision making could lead to improved psychological and somatic health outcomes [10].

Communication is a cornerstone of healthcare [5]. Most strategies in our review focused on health workers and their interpersonal communication skills through training or tool provision, and emphasized information provision. However, interactive communication by default includes and affects women and partners as participants, and yet only a few studies in our review specifically targeted women (and their partners) in their strategies [57, 181, 182]. Therefore, a deliberate effort to address this gap and include women, partners or newborns’ families in the design of strategies could be beneficial, especially for strategies that aim to include women and partners in decision making. Such a deliberate effort could address potential factors that affect interpersonal communication and shared decision making, such as health literacy challenges or language preferences. In addition to benefits for the individual women and partners, this can also mitigate the risk of increased health inequities that arise as a consequence of interventions that are (more) easily taken up by more wealthy, educated or literate patients [183, 184]. A number of equity and inclusion-promoting communication approaches have been previously identified. These include the use of culturally appropriate and less complex language without medical jargon, messages of short duration, and clear layouts or formats. A deliberate effort to include equity promoting approaches in communication improvement interventions presents an opportunity for health workers to engage, include and empower women and partners otherwise at (high) risk of being disengaged or marginalised, and to tackle a widening health equity gap [184–186].

Effective interpersonal communication is a core principle of respectful MNC, and all three goals of communication support this [187]. The recently documented unacceptably high number of women experiencing mistreatment and (verbal) abuse in maternity care worldwide [4, 188–191] stresses the need to implement and test strategies to improve respectful communication [189]. A recent multi-country study showed for example that many obstetric procedures were performed without the adequate informed consent of women, including caesarean section (among 10.8% of women), episiotomy (56.1%), induction of labour (26.9%) and vaginal examinations (58.9%) [4, 192]. This lack of consent could be greatly reduced by improved interpersonal communication. More generally, better interpersonal communication could lower the occurrence of mistreatment, and has been emphasized in global guidelines as a way to improve quality of care [2, 18, 193, 194] and respectful maternity care [16, 195–198].

The importance of an enabling environment, however, needs to be recognized. The health care setting at all levels (micro, meso and macro) impacts the ability of individual health workers to effectively communicate [199]. Enabling factors can include a non-excessive workload (and thus time to communicate), availability of adequate space and resources, [183, 200] and a work atmosphere where team work and good communication are the norm [199]. The enabling environment should also include the consideration of culture, which can impact understandings and expectations of what ‘good communication’ is between the health worker and women and partners [201].

This review highlights the importance of interpersonal communication between health workers and women and partners. There are other aspects of communication within MNC that can be possible anchors of quality improvement as well. These include interprofessional communication between health workers, which can be improved by simulation training [202] or ‘time outs’, deliberate interprofessional communication moments during labour [203]. Similarly, other quality improvement strategies have aimed to increase the frequency of contact moments between health workers and women, often through mobile-health [204–214]. Improved information provision by health workers can also occur without an interpersonal component, for example through an information video [215] or leaflets [216]. Finally, in addition to the targeted communication improvement strategies within the scope of this review, several successful multi-component or complex interventions have been reported, that take a comprehensive approach and target various interpersonal communication aspects simultaneously. An example is the multi-component strategy of Abuya et al. [217] which covered many respectful maternity care elements including interpersonal communication between health workers and women [217]. If, how, and in what way these intervention packages work (better), is relevant to include in future studies. Because of the complex interactions between strategies and local contexts, this requires implementation research with a learning agenda on how to design to make these interventions more context specific, and what the underlying mechanisms of action are.

Strengths, limitations and future considerations

Our broad domain and systematic search enabled us to capture a large number of intervention studies and thereby to incorporate a broader perspective of effective interpersonal communication in different domains of SRH and MNH. Due to the large number of included studies, we may not have done full justice to complexities and nuances because we were only able to summarize limited information from each intervention. Language limitations may have resulted in the exclusion of relevant studies or reduced the diversity of study settings (six non-English articles were excluded). Exclusion of grey literature prevented review of potentially relevant reports from (non-governmental) organizations and other projects.

Although our search deliberately included databases that indexed journals from LMICs, the vast majority of studies were conducted in high-income settings. More research and better documentation of strategies to improve interpersonal communication in LMICs is therefore necessary, given both the need to develop culturally-tailored strategies in general and the greater health system constraints in these settings [218, 219]. Contextualized strategies appear especially relevant when targeting communication goals such as ‘building a relationship’, and ‘inclusion of patients in decision making or shared decision making’. Importantly, we believe communication strategies should always be adapted to local settings irrespective of their high- or low-income status. Because of the broad domain and inclusion of many studies from diverse settings, we believe our classification could serve well as a basis for designing strategies, measurement tools and implementation studies that can be further shaped and tailored to local settings.

Finally, our review also points towards the need to develop guidance for the reporting of communication interventions’ implementation and evaluation. We observed often a lack of detail on the exact design of a communication intervention and heterogeneity in reported outcomes, which reduces the opportunities for others to learn and adapt these strategies elsewhere. Such reporting guidance would ideally reflect the value of mixed methods designs to ensure evaluation studies report both what has been done, its effectiveness and an understanding of how the strategies worked, and whether they are sustainable over time. Existing tools [220, 221] can be used to start documenting these processes.

Conclusion

This scoping review provides a classification of strategies to improve interpersonal communication between health workers and women and partners. This classification can be used as the foundation to inform the design and further tailoring of strategies to improve interpersonal communication, measurement tools and evaluation studies at local settings. While most communication strategies focus on the facilitation of information exchange, incorporation of the other goals of communication (creating a good interpersonal relationship, and including women and families in decision making) are essential to ensure optimal improvement of patient-centred communication in MNC. A learning agenda on how to do this especially in low-resource settings could provide concrete and actionable guidance for settings where the burden of maternal and newborn mortality is highest, and quality of care improvements are urgent.

Supporting information

S1 Checklist. PRISMA 2009 checklist.

https://doi.org/10.1371/journal.pgph.0002449.s001

(DOC)

S1 Appendix. Complete search strategy for different databases.

https://doi.org/10.1371/journal.pgph.0002449.s002

(DOCX)

S2 Appendix. Communication goals.

https://doi.org/10.1371/journal.pgph.0002449.s003

(XLSX)

Acknowledgments

We would like to acknowledge the contributions of Sasha Kruger to the development of the protocol, the support of Pauline Wiersma and Janneke Staaks in developing the search strategy, and Giulia Ensing and Gina Melis in references management. We thank Rio Withall for the framework visualization design. Furthermore, we would like to extend our appreciation to Action on Preeclampsia Ghana (APECGH), and especially APECGH’s CEO Mrs Koiwah-Koi Larbi Ofosuapea, for feedback on the protocol and reflections on the role of communication in care for women with hypertensive disorders of pregnancy in Ghana. Finally, we thank Linda McPhee and Steve Russell for providing input in editing this manuscript.

References

  1. 1. Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384(9940):347–70. pmid:24853604
  2. 2. World Health Organization. Standards for Improving Quality of Maternal and Newborn Care in Health Facilities. World Heal Organ. 2016;6(11):e1140–1.
  3. 3. Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review. PLoS Med. 2015;12(6):1–32. pmid:26126110
  4. 4. Bohren MA, Mehrtash H, Fawole B, Maung TM, Balde MD, Maya E, et al. How women are treated during facility-based childbirth in four countries: a cross-sectional study with labour observations and community-based surveys. 2019;6736(19):1–14.
  5. 5. Frank JR, Snell L, Sherbino J E. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.
    • 6. Cometto G, Assegid S, Abiyu G, Kifle M, Tunçalp Ö, Syed S, et al. Health workforce governance for compassionate and respectful care: a framework for research, policy and practice. BMJ Glob Heal. 2022 Mar 31;7(3):e008007.
    • 7. Ha JF, Longnecker N. Doctor-patient communication: A review. Ochsner J. 2010;10(1):38–43. pmid:21603354
    • 8. Ong LML, de Haes JCJM, Hoos AM, Lammes FB. Doctor-patient communication: A review of the literature. Soc Sci Med. 1995;40(7):903–18. pmid:7792630
    • 9. Khosla R, Zampas C, Vogel JP, Bohren MA, Roseman M, Erdman JN. International human rights and the mistreatment of women during childbirth. Health Hum Rights. 2016;18(2):131–43. pmid:28559681
    • 10. Stewart MA. Effective physician-patient communication and health outcomes: A review. Cmaj. 1995;152(9):1423–33. pmid:7728691
    • 11. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295–301.
    • 12. Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: A meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121–34. pmid:26878223
    • 13. Sudhinaraset M, Landrian A, Golub GM, Cotter SY, Afulani PA. Person-centered maternity care and postnatal health: associations with maternal and newborn health outcomes. AJOG Glob Reports. 2021;1(1):100005. pmid:33889853
    • 14. Feldman-Stewart D, Brundage MD. A conceptual framework for patient-provider communication: A tool in the PRO research tool box. Qual Life Res. 2009;18(1):109–14. pmid:19043804
    • 15. Brundage MD, Feldman-Stewart D, Tishelman C. How do interventions designed to improve provider-patient communication work? Illustrative applications of a framework for communication. Acta Oncol (Madr). 2010;49(2):136–43. pmid:20100151
    • 16. World Health Organization. Intrapartum care for a positive childbirth experience. 2018. 212 p.
    • 17. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. WHO library. 2016.
      • 18. World Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience. 2022.
      • 19. Chang YS, Coxon K, Portela AG, Furuta M, Bick D. Interventions to support effective communication between maternity care staff and women in labour: A mixed-methods systematic review. Midwifery. 2018;59(December 2017):4–16. pmid:29351865
      • 20. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73. pmid:30178033
      • 21. Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022) [Internet]. Cochrane. 2022. Available from: Available from www.training.cochrane.org/handbook
      • 22. World Health Organization. Optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting. World Heal Organ. 2012;1–98.
        • 23. Lockwood C, dos Santos KB, Pap R. Practical Guidance for Knowledge Synthesis: Scoping Review Methods. Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(5):287–94. pmid:31756513
        • 24. The World Bank. World Bank Country and Lending Groups. World Bank Gr (cited May 04th 2022).
          • 25. Macdonell K, Omrin D, Pytlik K, Pezzullo S, Bracht M, Diambomba Y. An Effective Communication Initiative: Using parents’ experiences to improve the delivery of difficult news in the NICU. J Neonatal Nurs. 2015 Aug 1;21(4):142–9.
          • 26. Figueroa EM, Nitti K, Sladek SM. Lowering Gestational Diabetes Risk by Prenatal Weight Gain Counseling. J Am Board Fam Med. 2020;33(2):189–97. pmid:32179602
          • 27. Nobili MP, Piergrossi S, Brusati V, Moja EA. The effect of patient-centered contraceptive counseling in women who undergo a voluntary termination of pregnancy. Patient Educ Couns. 2007;65(3):361–8. pmid:17125957
          • 28. Posner G, Nakajima A. Assessing residents’ communication skills: disclosure of an adverse event to a standardized patient. J Obstet Gynaecol Canada JOGC. 2011;33(3):262–8. pmid:21453567
          • 29. Posner G, Naik V, Bidlake E, Nakajima A, Sohmer B, Arab A, et al. Assessing Residents’ Disclosure of Adverse Events: Traditional Objective Structured Clinical Examinations Versus Mixed Reality. J Obstet Gynaecol Canada. 2012;34(4):367–73. pmid:22472338
          • 30. Weis J, Zoffmann V, Egerod I. Improved nurse-parent communication in neonatal intensive care unit: Evaluation and adjustment of an implementation strategy. J Clin Nurs. 2014;23(23–24):3478–89. pmid:24698260
          • 31. Calderón SH, Gilbert P, Jackson R, Kohn MA, Gerbert B. Cueing Prenatal Providers. Effects on Discussions of Intimate Partner Violence. Am J Prev Med. 2008;34(2):134–7.
          • 32. Kim YM, Kols A, Martin A, Silva D, Rinehart W, Prammawat S, et al. Promoting Informed Choice: EvaluatingA Decision-Making Tool for Family Planning ClientsAnd Providers in Mexico. Int Fam Plan Perspect. 2005;31(4):162–71. pmid:16439343
          • 33. Moore GP, Lemyre B, Daboval T, Ding S, Dunn S, Akiki S, et al. Field testing of decision coaching with a decision aid for parents facing extreme prematurity. J Perinatol. 2017 Jun 1;37(6):728–34. pmid:28358384
          • 34. Voos KC, Ross G, Ward MJ, Yohay AL, Osorio SN, Perlman JM. Effects of implementing family-centered rounds (FCRs) in a neonatal intensive care unit (NICU). J Matern Neonatal Med. 2011;24(11):1403–6.
          • 35. Kim YM, Davila C, Tellez C, Kols A. Evaluation of the World Health Organization’s family planning decision-making tool: Improving health communication in Nicaragua. Patient Educ Couns. 2007;66(2):235–42. pmid:17250989
          • 36. Jennings L, Yebadokpo AS, Affo J, Agbogbe M. Antenatal counseling in maternal and newborn care: Use of job aids to improve health worker performance and maternal understanding in Benin. BMC Pregnancy Childbirth. 2010 Nov 22;10. pmid:21092183
          • 37. Jennings L, Yebadokpo A, Affo J, Agbogbe M. Use of Job Aids to Improve Facility-Based Postnatal Counseling and Care in Rural Benin. Matern Child Health J. 2015 Mar 1;19(3):557–65. pmid:24916207
          • 38. Setubal MSV, Goncalves AV, Rocha SR, Amaral EM. Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It? Rev Bras Ginecol e Obstet. 2017;39(10):552–9.
          • 39. Baird K, Creedy DK, Saito AS, Eustace J. Longitudinal evaluation of a training program to promote routine antenatal enquiry for domestic violence by midwives. Women Birth J Aust Coll Midwives. 2018;31(5):398–406. pmid:29352725
          • 40. Boss RD, Urban A, Barnett MD, Arnold RM. Neonatal Critical Care Communication (NC3): Training NICU physicians and nurse practitioners. J Perinatol. 2013 Aug;33(8):642–6. pmid:23448940
          • 41. Boss RD, Donohue PK, Roter DL, Larson SM, Arnold RM. “This is a decision you have to make”: using simulation to study prenatal counseling. Simul Healthc J Soc Med Simul. 2012;7(4):207–12. pmid:22569285
          • 42. Chor J, Young D, Quinn MT, Gilliam M. A Novel Lay Health Worker Training to Help Women Engage in Postabortion Contraception and Well-Woman Care. Health Promot Pract. 2020;21(2):172–4. pmid:31559886
          • 43. Guillén Ú, Suh S, Munson D, Posencheg M, Truitt E, Zupancic JA, et al. Development and pretesting of a decision-aid to use when counseling parents facing imminent extreme premature delivery. J Pediatr. 2012;160(3):382–7. pmid:22048056
          • 44. Dehlendorf C, Reed R, Fitzpatrick J, Kuppermann M, Steinauer J, Kimport K. A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making. Contraception. 2019;100(5):420–3. pmid:31404538
          • 45. Dehlendorf C, Fitzpatrick J, Steinauer J, Swiader L, Grumbach K, Hall C, et al. Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling. Patient Educ Couns. 2017 Jul 1;100(7):1374–81. pmid:28237522
          • 46. de Jersey SJ, Tyler J, Guthrie T, New K. Supporting healthy weight gain and management in pregnancy: Does a mandatory training education session improve knowledge and confidence of midwives? Midwifery. 2018 Oct;65:1–7. pmid:30005316
          • 47. Dormandy E, Reid E, Tsianakas V, O’Neil B, Gill E, Marteau TM. Offering antenatal sickle cell and thalassaemia screening in primary care: A pre-post evaluation of a brief type of communication skills training. Patient Educ Couns. 2012;89(1):129–33. pmid:22742984
          • 48. Farnworth A, Robson SC, Thomson RG, Watson DB, Murtagh MJ. Decision support for women choosing mode of delivery after a previous caesarean section: a developmental study. Patient Educ Couns. 2008;71(1):116–24. pmid:18255248
          • 49. Fatima P, Antora AH, Dewan F, Nash S, Sethi M. Impact of contraceptive counselling training among counsellors participating in the FIGO postpartum intrauterine device initiative in Bangladesh. Int J Gynecol Obstet. 2018;143:49–55. pmid:30225871
          • 50. Gamazina K, Mogilevkina I, Parkhomenko Z, Bishop A, Coffey PS, Brazg T. Improving quality of prevention of mother-to-child HIV transmission services in Ukraine: a focus on provider communication skills and linkages to community-based non-governmental organizations. Cent Eur J Public Health. 2009;17(1):20–4. pmid:19418715
          • 51. Jennings L, Yebadokpo AS, Affo J, Agbogbe M, Tankoano A. Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin. Implement Sci. 2011;6:2.
          • 52. Kakkilaya V, Groome LJ, Platt D, Kurepa D, Pramanik A, Caldito G, et al. Use of a visual aid to improve counseling at the threshold of viability. Pediatrics. 2011;128(6). pmid:22106080
          • 53. Lemani C, Tang JH, Kopp D, Phiri B, Kumvula C, Chikosi L, et al. Contraceptive uptake after training community health workers in couples counseling: A cluster randomized trial. PLoS ONE [Electronic Resour]. 2017;12(4). pmid:28448502
          • 54. Lindberg SM, Anderson CK. Improving gestational weight gain counseling through meaningful use of an electronic medical record. Matern Child Health J. 2014;18(9):2188–94. pmid:24627233
          • 55. Lobatch E, Wise S. Effect of Hourly Rounds Implementation on Women’s Perceptions of Nursing Care. Nurs Womens Health. 2019;23(2):114–23. pmid:30851237
          • 56. Margolis B, Blinderman C, de Meritens AB, Chatterjee-Paer S, Ratan RB, Prigerson HG, et al. Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents. Am J Hosp Palliat Med. 2018;35(4):724–30. pmid:28950726
          • 57. Maurer M, Carman KL, Yang M, Firminger K, Hibbard J. Increasing the Use of Comparative Quality Information in Maternity Care: Results From a Randomized Controlled Trial. Med Care Res Rev. 2019;76(2):208–28. pmid:29148346
          • 58. Mazza D, Watson CJ, Taft A, Lucke J, McGeechan K, Haas M, et al. Increasing long-acting reversible contraceptives: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomized trial. Am J Obstet Gynecol. 2020;222(4). pmid:31837291
          • 59. Morony S, Weir K, Duncan G, Biggs J, Nutbeam D, McCaffery KJ. Enhancing communication skills for telehealth: Development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia. BMC Health Serv Res. 2018 Mar;18(1):162. pmid:29514642
          • 60. Nagle C, Gunn J, Bell R, Lewis S, Meiser B, Metcalfe S, et al. Use of a decision aid for prenatal testing of fetal abnormalities to improve women’s informed decision making: A cluster randomised controlled trial [ISRCTN22532458]. BJOG An Int J Obstet Gynaecol. 2008;115(3):339–47. pmid:18190370
          • 61. Olaiya O, Sharma AJ, Tong VT, Dee D, Quinn C, Agaku IT, et al. Impact of the 5As brief counseling on smoking cessation among pregnant clients of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics in Ohio. Prev Med (Baltim). 2015;81:438–43. pmid:26529063
          • 62. Omer K, Mhatre S, Ansari N, Laucirica J, Andersson N. Evidence-based training of frontline health workers for door-to-door health promotion: a pilot randomized controlled cluster trial with Lady Health Workers in Sindh Province, Pakistan. Patient Educ Couns. 2008;72(2):178–85. pmid:18395396
          • 63. Pelto GH, Santos I, Goncalves H, Victora C, Martines J, Habicht JP. Nutrition counseling training changes physician behavior and improves caregiver knowledge acquisition. J Nutr. 2004;134(2):357–62. pmid:14747672
          • 64. Peremans L, Rethans JJ, Verhoeven V, Coenen S, Debaene L, Meulemans H, et al. Empowering patients or general practitioners? A randomised clinical trial to improve quality in reproductive health care in Belgium. Eur J Contracept Reprod Heal Care. 2010;15(4):280–9. pmid:20528680
          • 65. Purcell-Jones JMA, Haasbroek M, Van der Westhuizen JL, Dyer RA, Lombard CJ, Duys RA. Overcoming Language Barriers Using an Information Video on Spinal Anesthesia for Cesarean Delivery: Implementation and Impact on Maternal Anxiety. Anesth Analg. 2019;129(4):1137–43. pmid:31219915
          • 66. Quinn GP, Bowman Curci M, Reich RR, Gwede CK, Meade CD, Vadaparampil ST. Impact of a web-based reproductive health training program: ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare). Psychooncology. 2019;28(5):1096–101. pmid:30882960
          • 67. Sabnis A, Hagen E, Tarn DM, Zeltzer L. Increasing Timely Family Meetings in Neonatal Intensive Care: A Quality Improvement Project. Hosp Pediatr. 2018;8(11):679–85. pmid:30309897
          • 68. Sawyer T, Fu B, Gray M, Umoren R. Medical improvisation training to enhance the antenatal counseling skills of neonatologists and neonatal fellows: a pilot study. J Matern Neonatal Med. 2017 Aug;30(15):1865–9. pmid:27549009
          • 69. Chin-Quee DS, Janowitz B, Otterness C. Counseling tools alone do not improve method continuation: further evidence from the decision-making tool for family planning clients and providers in Nicaragua. Contraception. 2007;76(5):377–82. pmid:17963863
          • 70. Langston AM, Rosario L, Westhoff CL. Structured contraceptive counseling—a randomized controlled trial. Patient Educ Couns. 2010;81(3):362–7. pmid:20869187
          • 71. Johnson SL, Kim YM, Church K. Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool. Patient Educ Couns. 2010;81(3):355–61. pmid:21093194
          • 72. Bullock L, Everett KD, Mullen PD, Geden E, Longo DR, Madsen R. Baby BEEP: A randomized controlled trial of nurses’ individualized social support for poor rural pregnant smokers. Matern Child Health J. 2009;13(3):395–406. pmid:18496746
          • 73. Farrell MH, Christopher SA, La Pean Kirschner A, Roedl SJ, O’Tool FO, Ahmad NY, et al. Improving the quality of physician communication with rapid-throughput analysis and report cards. Patient Educ Couns. 2014;97(2):248–55. pmid:25224315
          • 74. Ferguson YO. A process evaluation of nurses’ implementation of an infant feeding counseling protocol for HIV-infected mothers: the Breastfeeding, Antiretroviral and Nutrition (BAN) Study in Lilongwe, Malawi. 2006;193 p-193 p.
          • 75. Pimentel VM, Sun M, Bernstein PS, Ferzli M, Kim M, Goffman D. Whiteboard Use in Labor and Delivery: A Tool to Improve Patient Knowledge of the Name of the Delivery Provider and Satisfaction with Care. Matern Child Health J. 2018 Apr;22(4):565–70. pmid:29397495
          • 76. Kakkilaya V, Groome LJ, Platt D, Kurepa D, Arun P, Caldito G, et al. Improving counseling at the threshold of viability with visual aides. J Investig Med. 2010;58(2):435.
          • 77. Baird KM, Saito AS, Eustace J, Creedy DK. Effectiveness of training to promote routine enquiry for domestic violence by midwives and nurses: A pre-post evaluation study. Women Birth J Aust Coll Midwives. 2018;31(4):285–91. pmid:29102526
          • 78. Ahmadi S, Kazemi F, Masoumi SZ, Parsa P, Roshanaei G. Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial. Int Breastfeed J. 2016;11(30):(14 November 2016). pmid:27895700
          • 79. Piccinini-Vallis H, Vallis M. Curbing excess gestational weight gain in primary care: using a point-of-care tool based on behavior change theory. Int J Womens Health. 2018;10:609–15. pmid:30349404
          • 80. Vlemmix F, Rosman AN, Rijnders ME, Beuckens A, Opmeer BC, Mol BWJ, et al. Implementation of client versus care-provider strategies to improve external cephalic version rates: A cluster randomized controlled trial. Acta Obstet Gynecol Scand. 2015;94(5):518–26. pmid:25682778
          • 81. Mash R, Baldassini G, Mkhatshwa H, Sayeed I, Ndapeua S. Reflections on the training of counsellors in motivational interviewing for programmes for the prevention of mother to child transmission of HIV in sub-Saharan Africa. South African Fam Pract. 2008;50(2):53–9.
          • 82. Hajarian Abhari Z, Karimi FZ, Taghizdeh Z, Mazloum SR, Asghari Nekah SM. Effects of counseling based on Gamble’s approach on psychological birth trauma in primiparous women: a randomized clinical trial. J Matern Fetal Neonatal Med. 2020;1–9.
          • 83. Oka M, Horiuchi S, Shimpuku Y, Madeni F, Leshabari S. Effects of a job aid-supported intervention during antenatal care visit in rural Tanzania. Int J Africa Nurs Sci. 2019;10:31–7.
          • 84. Fenwick J, Toohill J, Slavin V, Creedy DK, Gamble J. Improving psychoeducation for women fearful of childbirth: Evaluation of a research translation project. Women Birth J Aust Coll Midwives. 2018;31(1):1–9. pmid:28684046
          • 85. Zethof S, Bakker W, Nansongole F, Kilowe K, Van Roosmalen J, Van Den Akker T. Pre-post implementation survey of a multicomponent intervention to improve informed consent for caesarean section in Southern Malawi. BMJ Open. 2020;10(1). pmid:31911511
          • 86. Maurer M, Carman KL, Yang M, Firminger K, Hibbard J. Increasing the Use of Comparative Quality Information in Maternity Care: Results From a Randomized Controlled Trial. Med Care Res Rev. 2019;76(2):208–28. pmid:29148346
          • 87. Shah SD, Prine L, Waltermaurer E, Rubin SE. Feasibility study of family planning services screening as clinical decision support at an urban Federally Qualified Health Center network. Contraception. 2019;99(1):27–31. pmid:30336133
          • 88. Munro S, Manski R, Donnelly KZ, Agusti D, Stevens G, Banach M, et al. Investigation of factors influencing the implementation of two shared decision-making interventions in contraceptive care: A qualitative interview study among clinical and administrative staff. Implement Sci. 2019;14(1).
          • 89. Stern J, Larsson M, Tyden T. Introducing the Reproductive Life Plan in midwifery counselling-a randomised controlled trial. Eur J Contracept Reprod Heal Care. 2013;18.
          • 90. Parham D, Reed D, Olicker A, Parrill F, Sharma J, Brunkhorst J, et al. Families as educators: a family-centered approach to teaching communication skills to neonatology fellows. J Perinatol. 2019;39(10):1392–8. pmid:31371832
          • 91. Janice-Woods Reed D, Sharma J. Delivering Difficult News and Improving Family Communication: Simulation for Neonatal-Perinatal Fellows. Mededportal Publ. 2016;12. pmid:31008245
          • 92. Wu WJ, Tiwari A, Choudhury N, Basnett I, Bhatt R, Citrin D, et al. Community-based postpartum contraceptive counselling in rural Nepal: a mixed-methods evaluation. Sex Reprod Heal Matters. 2020;28(2).
          • 93. Smithbattle L, Lorenz R, Leander S. Listening with care: using narrative methods to cultivate nurses’ responsive relationships in a home visiting intervention with teen mothers. Nurs Inq. 2013;20(3):188–98. pmid:22713121
          • 94. Glavin K, Smith L, Sørum R, Ellefsen B. Supportive counselling by public health nurses for women with postpartum depression. J Adv Nurs. 2010;66(6):1317–27. pmid:20384641
          • 95. Arimori N. Randomized controlled trial of decision aids for women considering prenatal testing: The effect of the Ottawa Personal Decision Guide on decisional conflict. Japan J Nurs Sci. 2006;3(2):119–30.
          • 96. Farrokh-Eslamlou H, Aghlmand S, Eslami M, Homer CSE. Impact of the World Health Organization’s Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran. J Fam Plan Reprod Heal Care. 2014;40(2):89–95. pmid:23946327
          • 97. Guillén Ú, Mackley A, Laventhal N, Kukora S, Christ L, Derrick M, et al. Evaluating the Use of a Decision Aid for Parents Facing Extremely Premature Delivery: A Randomized Trial. J Pediatr. 2019;209:52. pmid:30952510
          • 98. Penticuff JH, Arheart KL. Effectiveness of an intervention to improve parent-professional collaboration in neonatal intensive care. J Perinat Neonatal Nurs. 2005;19(2):187–202. pmid:15923969
          • 99. Suryavanshi N, Kadam A, Gupte N, Hegde A, Kanade S, Sivalenka S, et al. A mobile health-facilitated behavioural intervention for community health workers improves exclusive breastfeeding and early infant HIV diagnosis in India: a cluster randomized trial. J Int AIDS Soc. 2020;23(7). pmid:32618115
          • 100. Muthusamy AD, Leuthner S, Gaebler-Uhing C, Hoffmann RG, Li SH, Basir MA. Supplemental written information improves prenatal counseling: A randomized trial. Pediatrics. 2012;129(5). pmid:22492766
          • 101. Sebastian MP, Khan ME, Kumari K, Idnani R. Increasing postpartum contraception in rural India: evaluation of a community-based behavior change communication intervention. Int Perspect Sex Reprod Heal. 2012;38(2):68–77. pmid:22832147
          • 102. Chinkam S, Ewan J, Koeniger-Donohue R, Hawkins JW, Shorten A. The Effect of Evidence-Based Scripted Midwifery Counseling on Women’s Choices About Mode of Birth After a Previous Cesarean. J Midwifery Womens Health. 2016;61(5):613–20. pmid:27428683
          • 103. Tsoh JY, Kohn MA, Gerbert B. Promoting smoking cessation in pregnancy with Video Doctor plus provider cueing: a randomized trial. Acta Obstet Gynecol Scand. 2010;89(4):515–23. pmid:20196678
          • 104. Everett-Murphy K, Steyn K, Mathews C, Petersen Z, Odendaal H, Gwebushe N, et al. The effectiveness of adapted, best practice guidelines for smoking cessation counseling with disadvantaged, pregnant smokers attending public sector antenatal clinics in Cape Town, South Africa. Acta Obstet Gynecol Scand. 2010;89(4):478–89. pmid:20302533
          • 105. Antoniou A, Marmai K, Cherry R, Singh S, Jones P. Educating anesthesia residents to obtain and document informed consent for epidural labour analgesia: Does simulation play a role? Can J Anesth. 2012;59.
          • 106. McLachlan HL, Forster DA, Collins R, Gunn J, Hegarty K. Identifying and supporting women with psychosocial issues during the postnatal period: evaluating an educational intervention for midwives using a before-and-after survey. Midwifery. 2011;27(5):723–30. pmid:20888094
          • 107. Phillippi JC, Holley SL, Schorn M, Lauderdale J, Roumie C, Bennett K. On the same page: A novel interprofessional model of patient-centered perinatal consultation visits. J Perinatol. 2016;36(11):932–8. pmid:27537857
          • 108. Miazga E, Reed C, Tunde-Byass M, Cipolla A, Shapiro J, Shore EM. Decreasing Cesarean Delivery Rates Using a Trial of Labour After Cesarean (TOLAC) Bundle. J Obstet Gynaecol Canada. 2020;42(9):1111–5. pmid:32389633
          • 109. Mansson C, Sivberg B, Selander B, Lundqvist P. The impact of an individualised neonatal parent support programme on parental stress: a quasi-experimental study. Scand J Caring Sci. 2019;33(3):677–87. pmid:30735266
          • 110. Hegarty K, Brown S, Gunn J, Forster D, Nagle C, Grant B, et al. Women’s views and outcomes of an educational intervention designed to enhance psychosocial support for women during pregnancy. Birth. 2007;34(2):155–63. pmid:17542820
          • 111. Rasoulzadeh Bidgoli M, Latifnejad Roudsari R. The effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization: A randomized controlled trial. Int J Women’s Heal Reprod Sci. 2018;6(1):47–54.
          • 112. Bowen R, Lally KM, Pingitore FR, Tucker R, McGowan EC, Lechner BE. A simulation based difficult conversations intervention for neonatal intensive care unit nurse practitioners: A randomized controlled trial. PLoS One. 2020;15(3). pmid:32150584
          • 113. Samandari G, Delamou A, Traore P, Diallo FG, Millimono S, Camara BS, et al. Integrating Intimate Partner Violence Screening and Counseling in a Family Planning Clinic: Evaluation of a Pilot Project in Conakry, Guinea. Afr J Reprod Health. 2016;20(2):86–93. pmid:29553167
          • 114. Setubal MSV, Antonio MÂRGM, Amaral EM, Boulet J. Improving Perinatology Residents’ Skills in Breaking Bad News: A Randomized Intervention Study. Rev Bras Ginecol e Obstet. 2018;40(3):137–46.
          • 115. Sorce G, Chamberlain J. Evaluation of an education session using standardized patients and role play during perinatal bereavement. J Neonatal Nurs. 2019;25(3):145–51.
          • 116. Bakker MJ, Mullen PD, de Vries H, van Breukelen G. Feasibility of implementation of a Dutch smoking cessation and relapse prevention protocol for pregnant women. Patient Educ Couns. 2003;49(1):35–43. pmid:12527151
          • 117. Stapleton H, Kirkham M, Thomas G. Qualitative study of evidence based leaflets in maternity care. Br Med J. 2002;324(7338):639–43. pmid:11895821
          • 118. Nejati B, Masoumi SZ, Parsa P, Karami M, Mortazavi A. Effect of counselling based on the plissit model on pregnant women’s sexual satisfaction: A randomised controlled trial. Fam Med Prim Care Rev. 2020;22(1):43–8.
          • 119. Andaroon N, Kordi M, Kimiaee SA, Esmaily H. Effect of individual counseling program by a midwife on anxiety during pregnancy in nulliparous women. Iran J Obstet Gynecol Infertil. 2018;20(12):Pe86–95.
          • 120. Ekström A, Kylberg E, Nissen E. A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study. Breastfeed Med Off J Acad Breastfeed Med. 2012;7(2):85–92. pmid:22168946
          • 121. Lindhardt CL, Rubak S, Mogensen O, Hansen HP, Lamont RF, Jorgensen JS. Training in motivational interviewing in obstetrics: a quantitative analytical tool. Acta Obstet Gynecol Scand. 2014;93(7):698–704. pmid:24773133
          • 122. Van Dulmen AM, Van Weert JC. Effects of gynaecological education on interpersonal communication skills. Br J Obstet Gynaecol. 2001;108(5):485–91. pmid:11368134
          • 123. Bekker HL, Hewison J, Thornton JG. Applying decision analysis to facilitate informed decision making about prenatal diagnosis for Down syndrome: A randomised controlled trial. Prenat Diagn. 2004 Apr;24(4):265–75. pmid:15065100
          • 124. Drago MJ, Guillén Ú, Schiaratura M, Batza J, Zygmunt A, Mowes A, et al. Constructing a Culturally Informed Spanish Decision-Aid to Counsel Latino Parents Facing Imminent Extreme Premature Delivery. Matern Child Health J. 2018 Jul 1;22(7):950–7. pmid:29520727
          • 125. Gerancher JC, Grice SC, Dewan DM, Eisenach J. An evaluation of informed consent prior to epidural analgesia for labor and delivery. Int J Obstet Anesth. 2000;9(3):168–73. pmid:15321088
          • 126. Guillén Ú, Suh S, Wang E, Stickelman V, Kirpalani H. Development of a video decision aid to inform parents on potential outcomes of extreme prematurity. J Perinatol. 2016 Nov 1;36(11):939–43. pmid:27537856
          • 127. Brasington A, Abdelmegeid A, Dwivedi V, Kols A, Kim Y-M, Khadka N, et al. Promoting Healthy Behaviors among Egyptian Mothers: A Quasi-Experimental Study of a Health Communication Package Delivered by Community Organizations. PLoS One. 2016;11(3). pmid:26989898
          • 128. Leshabari S, Koniz-Booher P, Burkhalter B, Hoffman M, Jennings L. Testing a PMTCT Infant-feeding Counseling Program in Tanzania. Operations Research Results. Published for the U.S. Agency for International Development (USAID) by QAP. 2007.
            • 129. Lemmon ME, Donohue PK, Williams EP, Brandon D, Ubel PA, Boss RD. No question too small: Development of a question prompt list for parents of critically ill infants. J Perinatol. 2018 Apr 1;38(4):386–91. pmid:29472708
            • 130. Teshome M, Wolde Z, Gedefaw A, Asefa A. Improving surgical informed consent in obstetric and gynaecologic surgeries in a teaching hospital in Ethiopia: A before and after study. BMJ Open. 2019 Jan 1;9(1).
            • 131. Andaroon N, Kordi M, Kimiaee SA, Esmaeili H. The effect of individual counseling on attitudes and decisional conflict in the choice of delivery among nulliparous women. J Educ Health Promot. 2020;9:35. pmid:32318603
            • 132. Biasini A, Fantini F, Neri E, Stella M, Arcangeli T. Communication in the neonatal intensive care unit: A continuous challenge. J Matern Neonatal Med. 2012 Oct;25(10):2126–9. pmid:22191692
            • 133. Zethof S, Bakker W, Nansongole F, Kilowe K, van Roosmalen J, van den Akker T. Pre-post implementation survey of a multicomponent intervention to improve informed consent for caesarean section in Southern Malawi. BMJ Open. 2020;10:1–10.
            • 134. Clarke-Pounder JP, Boss RD, Roter DL, Hutton N, Larson S, Donohue PK. Communication intervention in the neonatal intensive care unit: can it backfire? J Palliat Med. 2015;18(2):157–61. pmid:24983892
            • 135. Leon FR, Rios A, Zumaran A, de la Cruz M, Brambila C. Enhancing Quality for Clients: The Balanced Counseling Strategy. Frontiers Program Brief no. 3. Washington, DC: Population Council. 2003.
              • 136. Nassar N, Roberts CL, Raynes-Greenow CH, Barratt A, Peat B. Evaluation of a decision aid for women with breech presentation at term: A randomised controlled trial [ISRCTN14570598]. BJOG An Int J Obstet Gynaecol. 2007 Mar;114(3):325–33. pmid:17217360
              • 137. Roter DL, Erby LH, Rimal RN, Smith KC, Larson S, Bennett IM, et al. Empowering Women’s Prenatal Communication: Does Literacy Matter? J Health Commun. 2015 Oct 9;20:60–8. pmid:26513032
              • 138. Weis J, Zoffmann V, Greisen G, Egerod I. The effect of person-centred communication on parental stress in a NICU: A randomized clinical trial. Acta Paediatr Int J Paediatr. 2013;102(12):1130–6.
              • 139. Weis J, Zoffmann V, Egerod I. Enhancing person-centred communication in NICU: A comparative thematic analysis. Nurs Crit Care. 2015;20(6):287–98. pmid:24237931
              • 140. Toivonen M, Lehtonen L, Ahlqvist-Björkroth S, Axelin A. Key factors supporting implementation of a training program for neonatal family- centered care—A qualitative study. BMC Health Serv Res. 2019 Jun 19;19(1). pmid:31217007
              • 141. Toivonen M, Lehtonen L, Löyttyniemi E, Ahlqvist-Björkroth S, Axelin A. Close Collaboration with Parents intervention improves family-centered care in different neonatal unit contexts: a pre–post study. Pediatr Res. 2020;88(3):421–8. pmid:32380505
              • 142. Bashour HN, Kanaan M, Kharouf MH, Abdulsalam AA, Tabbaa MA, Cheikha SA. The effect of training doctors in communication skills on women’s satisfaction with doctor-woman relationship during labour and delivery: a stepped wedge cluster randomised trial in Damascus. BMJ Open. 2013;3(8):14.
              • 143. Bry K, Bry M, Hentz E, Karlsson HL, Kyllönen H, Lundkvist M, et al. Communication skills training enhances nurses’ ability to respond with empathy to parents’ emotions in a neonatal intensive care unit. Acta Paediatr Int J Paediatr. 2016;105(4):397–406.
              • 144. Fenwick J, Gamble J, Creedy D, Barclay L, Buist A, Ryding EL. Women’s perceptions of emotional support following childbirth: A qualitative investigation. Midwifery. 2013;29(3):217–24. pmid:23149239
              • 145. García D, Bautista O, Venereo L, Coll O, Vassena R, Vernaeve V. Training in empathic skills improves the patient-physician relationship during the first consultation in a fertility clinic. Fertil Steril. 2013;99(5).
              • 146. Gunn J, Hegarty K, Nagle C, Forster D, Brown S, Lumley J. Putting woman-centered care into practice: a new (ANEW) approach to psychosocial risk assessment during pregnancy. Birth. 2006;33(1):46–55. pmid:16499531
              • 147. Hall SL, Famuyide ME, Saxton SN, Moore TA, Mosher S, Sorrells K, et al. Improving Staff Knowledge and Attitudes Toward Providing Psychosocial Support to NICU Parents Through an Online Education Course. Adv Neonatal Care. 2019;19(6):490–9. pmid:31306236
              • 148. Henrikson NB, Opel DJ, Grothaus L, Nelson J, Scrol A, Dunn J, et al. Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial. Pediatrics. 2015;136(1):70–9. pmid:26034240
              • 149. Kasat K, Stoffels G, Ellington M. Improving parent communication: Neonatal intensive care unit empathy workshop. Pediatr Conf Natl Conf Educ. 2018;144(2).
              • 150. La Rosa M, Spencer N, Abdelwahab M, Zambrano G, Saoud F, Jelliffe K, et al. The Effect of Wearing White Coats on Patients’ Appreciation of Physician Communication during Postpartum Rounds: A Randomized Controlled Trial. Am J Perinatol. 2018;36(1):62–6. pmid:29883984
              • 151. Lechner BE, Shields R, Tucker R, Bender GJ. Seeking the best training model for difficult conversations in neonatology. J Perinat Med. 2016;44(4):461–7. pmid:26115488
              • 152. Moudi Z, Talebi B, Faramarzi M, Ansari H. Studying the effect of a supportive communication techniques program on the quality gap among women who gave birth in local childbirth outposts, south-east Iran. J Public Heal. 2020 Apr;28(2):147–54.
              • 153. Shao YN, Sun HM, Huang JW, Li ML, Huang RR, Li N. Simulation-Based Empathy Training Improves the Communication Skills of Neonatal Nurses. Clin Simul Nurs. 2018;22:32–42.
              • 154. Tektaş P, Çam O. The Effects of Nursing Care Based on Watson’s Theory of Human Caring on the Mental Health of Pregnant Women After a Pregnancy Loss. Arch Psychiatr Nurs. 2017;31(5):440–6. pmid:28927506
              • 155. Verhaeghe C, Gicquel M, Bouet PE, Corroenne R, Descamps P, Legendre G. Positive impact of simulation training of residents on the patients’ psychological experience following pregnancy loss. J Gynecol Obstet Hum Reprod. 2020;49(3):101650. pmid:31760179
              • 156. Waisblat V, Langholz B, Bernard FJ, Arnould M, Benassi A, Ginsbourger F, et al. Impact of a Hypnotically-Based Intervention on Pain and Fear in Women Undergoing Labor. Int J Clin Exp Hypn. 2017;65(1):64–85.
              • 157. Young OM, Parviainen K. Training obstetrics and gynecology residents to be effective communicators in the era of the 80-hour workweek: A pilot study. BMC Res Notes. 2014;7(1):455. pmid:25030271
              • 158. Zazulak J, Sanaee M, Frolic A, Knibb N, Tesluk E, Hughes E, et al. The art of medicine: Arts-based training in observation and mindfulness for fostering the empathic response in medical residents. Med Humanit. 2017;43(3):192–8. pmid:28450412
              • 159. Meyer EC, Brodsky D, Hansen AR, Lamiani G, Sellers DE, Browning DM. An interdisciplinary, family-focused approach to relational learning in neonatal intensive care. J Perinatol. 2011 Mar;31(3):212–9. pmid:20706191
              • 160. Chuffo Siewert R, Cline M, Segre LS. Implementation of an innovative nurse-delivered depression intervention for mothers of NICU infants. Adv Neonatal Care. 2015;15(2):104–11. pmid:25607637
              • 161. Afulani PA, Aborigo RA, Walker D, Moyer CA, Cohen S, Williams J. Can an integrated obstetric emergency simulation training improve respectful maternity care? Results from a pilot study in Ghana. Birth. 2019;46(3):523–32.
              • 162. Alder J, Christen R, Zemp E, Bitzer J. Communication skills training in obstetrics and gynaecology: whom should we train? A randomized controlled trial. Arch Gynecol Obstet. 2007;276(6):605–12. pmid:17576587
              • 163. Segre LS, Brock RL, O’Hara MW. Depression treatment for impoverished mothers by point-of-care providers: A randomized controlled trial. J Consult Clin Psychol. 2015;83(2):314–24. pmid:25486371
              • 164. Skene C, Gerrish K, Price F, Pilling E, Bayliss P, Gillespie S. Developing family-centred care in a neonatal intensive care unit: An action research study. Intensive Crit Care Nurs. 2019 Feb 1;50:54–62. pmid:29937077
              • 165. Axelin A, Ahlqvist-Björkroth S, Kauppila W, Boukydis Z, Lehtonen L. Nurses’ perspectives on the close collaboration with parents training program in the NICU. MCN Am J Matern Nurs. 2014;39(4):260–8. pmid:24978006
              • 166. Baijens SWE, Huppelschoten AG, Van Dillen J, Aarts JWM. Improving shared decision-making in a clinical obstetric ward by using the three questions intervention, a pilot study. BMC Pregnancy Childbirth. 2018;18(1).
              • 167. Whitford HM, Entwistle VA, van Teijlingen E, Aitchison PE, Davidson TCM, Humphrey T, et al. Use of a birth plan within woman-held maternity records: a qualitative study with women and staff in northeast Scotland. Birth. 2014;41(3):283–9. pmid:24750377
              • 168. Fay M, Grande SW, Donnelly K, Elwyn G. Using Option Grids: Steps toward shared decision-making for neonatal circumcision. Patient Educ Couns. 2016 Feb 1;99(2):236–42. pmid:26324111
              • 169. O’Cathain A, Walters SJ, Nicholl JP, Thomas KJ, Kirkham M. Use of evidence based leaflets to promote informed choice in maternity care: Randomised controlled trial in everyday practice. Br Med J. 2002;324:643–6. pmid:11895822
              • 170. Johnson SL, Kim YM, Church K. Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool. Patient Educ Couns. 2010;81(3):355–61. pmid:21093194
              • 171. Umbeli T, Murwan I, Kunna A, Ismail S, Sulman M, Elmahgoub A. Impact of Health Care Provider’s Training on Patients’ Communication During Labor at Omdurman Maternity Hospital, Sudan 2011. Sudan J Med Sci. 2015;9(4):211–6.
              • 172. Weiss S, Goldlust E, Vaucher YE. Improving parent satisfaction: An intervention to increase neonatal parent-provider communication. J Perinatol. 2010 Jun;30(6):425–30. pmid:19847189
              • 173. Weiss S, Goldlust E, Vaucher YE. Improving parent satisfaction: An intervention to increase neonatal parent-provider communication. J Perinatol. 2010;30(6):425–30. pmid:19847189
              • 174. O’Cathain A, Walters SJ, Nicholl JP, Thomas J, Kirkham M. Papers Use of evidence based leaflets to promote informed choice in maternity care: randomised controlled trial in everyday practice. BMJ. 2002;324:1–5.
              • 175. Baijens SWE, Huppelschoten AG, Van Dillen J, Aarts JWM. Improving shared decision-making in a clinical obstetric ward by using the three questions intervention, a pilot study. BMC Pregnancy Childbirth. 2018;18(1):1–8.
              • 176. Sheikh K, Gilson L, Aguepong IA, Hanson K, Ssengooba F, Bennett S. Building the Field of Health Policy and Systems Research: Framing the Questions. PLoS Med. 2011;8(8). pmid:21857809
              • 177. Rowe RE, Garcia J, Macfarlane AJ, Davidson LL. Improving communication between health professionals and women in maternity care: A structured review. Heal Expect. 2002;5(1):63–83. pmid:11906542
              • 178. Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796–804. pmid:11032203
              • 179. Horton R, Astudillo O. The power of midwifery. Lancet. 2014;384(9948):1075–6. pmid:24965820
              • 180. Srivastava A, Avan BI, Rajbangshi P, Bhattacharyya S. Determinants of women’s satisfaction with maternal health care: A review of literature from developing countries. BMC Pregnancy Childbirth. 2015;15(1):1–12. pmid:25928085
              • 181. Peremans L, Rethans JJ, Verhoeven V, Coenen S, Debaene L, Meulemans H, et al. Empowering patients or general practitioners? A randomised clinical trial to improve quality in reproductive health care in Belgium. Eur J Contracept Reprod Heal Care. 2010;15(4):280–9. pmid:20528680
              • 182. Muthusamy AD, Leuthner S, Gaebler-Uhing C, Hoffmann RG, Li SH, Basir MA. Supplemental written information improves prenatal counseling: A randomized trial. Pediatrics. 2012;129(5):e1269–74. pmid:22492766
              • 183. Diouf NT, Charif AB, Adisso L, Adekpedjou R, Zomahoun HTV, Agbadjé TT, et al. Shared decision making in West Africa: The forgotten area. Z Evid Fortbild Qual Gesundhwes. 2017 Jun;123–124:7–11. pmid:28527636
              • 184. Bohren MA, Vazquez Corona M, Odiase OJ, Wilson AN, Sudhinaraset M, Diamond-Smith N, et al. Strategies to reduce stigma and discrimination in sexual and reproductive healthcare settings: A mixed-methods systematic review. PLOS Glob Public Health. 2022; 2(6). pmid:36962453
              • 185. Durand MA, Carpenter L, Dolan H, Bravo P, Mann M, Bunn F, et al. Do interventions designed to support shared decision- making reduce health inequalities? A systematic review and meta-analysis. PLoS One. 2014;9(4). pmid:24736389
              • 186. Schaaf M, Jaffe M, Tunçalp Ö, Freedman L. A critical interpretive synthesis of power and mistreatment of women in maternity care. PLOS Glob Public Health. 2023; 3(1). pmid:36962936
              • 187. The White Ribbon Alliance for Safe Motherhood. Respectful maternity care: The universal rights of childbearing women. White Ribb Alliance Safe Mother. 2011;1–6.
              • 188. McMahon SA, George AS, Chebet JJ, Mosha IH, Mpembeni RN, Winch PJ. Experiences of and responses to disrespectful maternity care and abuse during childbirth; a qualitative study with women and men in Morogoro Region, Tanzania. BMC Pregnancy Childbirth. 2014;14(1):1–13. pmid:25112432
              • 189. Chadwick RJ, Cooper D, Harries J. Narratives of distress about birth in South African public maternity settings: A qualitative study. Midwifery. 2014;30(7):862–8. pmid:24456659
              • 190. D’Ambruoso L, Abbey M, Hussein J. Please understand when I cry out in pain: Women’s accounts of maternity services during labour and delivery in Ghana. BMC Public Health. 2005;5:1–11.
              • 191. Janevic T, Sripad P, Bradley E, Dimitrievska V. “There’s no kind of respect here” A qualitative study of racism and access to maternal health care among Romani women in the Balkans. Int J Equity Health. 2011;10(1):53. pmid:22094115
              • 192. Adu-Bonsaffoh K, Mehrtash H, Guure C, Maya E, Vogel JP, Irinyenikan TA, et al. Vaginal examinations and mistreatment of women during facility-based childbirth in health facilities: Secondary analysis of labour observations in Ghana, Guinea and Nigeria. BMJ Glob Heal. 2021;5.
              • 193. Tunçalp Ö, Were WM, Maclennan C, Oladapo OT, Gülmezoglu AM, Bahl R, et al. Quality of care for pregnant women and newborns—The WHO vision. BJOG An Int J Obstet Gynaecol. 2015;122(8):1045–9. pmid:25929823
              • 194. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva; 2016.
                • 195. Shakibazadeh E, Namadian M, Bohren MA, Vogel JP, Rashidian A, Nogueira Pileggi V, et al. Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG: An International Journal of Obstetrics and Gynaecology. 2018.
                • 196. Butler MM, Fullerton J, Aman C. Competencies for respectful maternity care: Identifying those most important to midwives worldwide. 2020;(September 2019):1–11.
                • 197. Rosen HE, Lynam PF, Carr C, Reis V, Ricca J, Bazant ES, et al. Direct observation of respectful maternity care in five countries: a cross-sectional study of health facilities in East and Southern Africa. BMC Pregnancy Childbirth. 2015;1–11.
                • 198. International Federation of Gynecology and Obstetrics, International Confederation of Midwives, White Ribbon Alliance, International Pediatric Association, World Health Organization. Mother−baby friendly birthing facilities ☆. Int J Gynaecol Obstet. 2015;128:95–9.
                • 199. Reddy B, Thomas S, Karachiwala B, Sadhu R, Iyer A, Sen G, et al. A scoping review of the impact of organisational factors on providers and related interventions in LMICs: Implications for respectful maternity care. PLOS Glob Public Health. 2022; 2(10). pmid:36962616
                • 200. Jardien-Baboo S, van Rooyen D, Ricks E, Jordan P. Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay. Heal SA Gesondheid. 2016;21:397–405.
                • 201. Mole TB, Begum H, Cooper-Moss N, Wheelhouse R, Mackeith P, Sanders T, et al. Limits of “patient-centredness”: Valuing contextually specific communication patterns. Med Educ. 2016;50(3):359–69. pmid:26896021
                • 202. Osman H, Campbell OMR, Nassar AH. Using emergency obstetric drills in maternity units as a performance improvement tool. Birth. 2009;36(1):43–50. pmid:19278382
                • 203. Wood J, Stevenson E. USING HOURLY TIME-OUTS and a STANDARDIZED TOOL to Promote Team Communication, Medical Record Documentation, and Patient Satisfaction during Second-Stage Labo. MCN Am J Matern Nurs. 2018;43(4):195–200.
                • 204. Blackwell TM, Dill LCJ, Hoepner LA, Geer LA. Using text messaging to improve access to prenatal health information in urban african American and afro-caribbean immigrant pregnant women: Mixed methods analysis of text4baby usage. JMIR mHealth uHealth. 2020;8(2). pmid:32053117
                • 205. Demirci J, Kotzias V, Bogen DL, Ray KN, Uscher-Pines L. Telelactation via Mobile App: Perspectives of Rural Mothers, Their Care Providers, and Lactation Consultants. Telemed e-Health. 2019;25(9):853–8. pmid:30212280
                • 206. Rothstein JD, Jennings L, Moorthy A, Yang F, Gee L, Romano K, et al. Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana. Int J Telemed Appl. 2016;2016.
                • 207. Sibley LM, Tesfaye S, Fekadu Desta B, Hailemichael Frew A, Kebede A, Mohammed H, et al. Improving maternal and newborn health care delivery in rural Amhara and Oromiya regions of Ethiopia through the maternal and newborn health in Ethiopia partnership. J Midwifery Women’s Heal. 2014;59:S6–20. pmid:24588917
                • 208. Odetola TD, Okanlawon FA. Effects of a nursing intervention using a mobile phone application on uptake of antenatal care, tetanus toxoids and malaria prevention among pregnant women in Nigeria. J Int Soc Telemed eHealth. 2016;4(January):1–7.
                • 209. Van Zutphen M, Milder IE, Bemelmans WJ. Integrating an ehealth program for pregnant women in midwifery care: A feasibility study among midwives and program users. J Med Internet Res. 2009;11(1):1–12.
                • 210. Unger JA, Ronen K, Perrier T, DeRenzi B, Slyker J, Drake AL, et al. Short message service communication improves exclusive breastfeeding and early postpartum contraception in a low- to middle-income country setting: a randomised trial. BJOG An Int J Obstet Gynaecol. 2018;125(12):1620–9.
                • 211. Danbjørg DB, Wagner L, Kristensen BR, Clemensen J. Intervention among new parents followed up by an interview study exploring their experiences of telemedicine after early postnatal discharge. Midwifery. 2015;31(6):574–81. pmid:25765743
                • 212. Huq NL, Azmi AJ, Quaiyum MA, Hossain S. Toll free mobile communication: Overcoming barriers in maternal and neonatal emergencies in Rural Bangladesh. Reprod Health. 2014;11(1):1–12.
                • 213. Gund A, Sjöqvist BA, Wigert H, Hentz E, Lindecrantz K, Bry K. A randomized controlled study about the use of eHealth in the home health care of premature infants. BMC Med Inform Decis Mak. 2013;13(1). pmid:23394465
                • 214. Drozd F, Haga SM, Lisøy C, Slinning K. Evaluation of the implementation of an internet intervention in well-baby clinics: A pilot study. Internet Interv. 2018;13(March):1–7. pmid:30206512
                • 215. Adam M, Tomlinson M, Le Roux I, Lefevre AE, McMahon SA, Johnston J, et al. The Philani MOVIE study: A cluster-randomized controlled trial of a mobile video entertainment-education intervention to promote exclusive breastfeeding in South Africa. BMC Health Serv Res. 2019;19(1):1–14.
                • 216. O’Cathain A, Walters SJ, Nicholl JP, Thomas KJ, Kirkham M. Use of evidence based leaflets to promote informed choice in maternity care: Randomised controlled trial in everyday practice. Br Med J. 2002;324:643–6. pmid:11895822
                • 217. Abuya T, Ndwiga C, Ritter J, Kanya L, Bellows B, Binkin N, et al. The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2015;15(1). pmid:26394616
                • 218. Housseine N, Punt MC, Browne JL, Meguid T, Klipstein-Grobusch K, Kwast BE, et al. Strategies for intrapartum foetal surveillance in low-and middle-income countries: A systematic review. PLoS One. 2018;13(10):1–17. pmid:30365564
                • 219. Maaløe N, Meguid T, Housseine N, Tersbøl BP, Nielsen KK, Bygbjerg IC, et al. Local adaption of intrapartum clinical guidelines, United Republic of Tanzania. Bull World Health Organ. 2019;97(5):365–70. pmid:31551633
                • 220. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348. pmid:24609605
                • 221. Kågesten AE, Tunçalp Ö, Portela A, Ali M, Tran N, Gülmezoglu AM. Programme Reporting Standards (PRS) for improving the reporting of sexual, reproductive, maternal, newborn, child and adolescent health programmes. BMC Med Res Methodol. 2017;17(1):1–16.