The urban community as the client in preterm birth prevention: Evaluation of a program component

Education of communities about preterm birth is essential because preterm birth is a major perinatal health problem, contributing 60-80% of the perinatal mortality in the United States. Preterm birth impacts on the health of the community through the increased morbidity and mortality of the affected children, which leads to higher health care costs and compromised future productivity. The role of early enrollment into prenatal care in the improvement of perinatal outcomes has been established by many investigators. A health education strategy using a communication in the form of a videotaped program was designed in order to increase community awareness about this serious health problem and about the importance of early prenatal care. The purpose of this investigation was to evaluate that strategy by: determining the validity of the communication; analyzing its impact on related behavioral intentions of Community Board members; and assessing the association between behavioral intentions and reported behaviors in those Community Board members. A panel of experts in the fields of prenatal care/preterm birth or health education/communication was used to evaluate the face validity of the communication, using the Communication Rating Scale, an instrument developed by James Malfetti, Ed.D. The Fishbein Linear Regression Model was utilized in ascertaining attitudes and social normative factors predictive of behavioral intentions. A nonequivalent control group design was used to measure the impact of the communication on the behavioral intentions of 10 Community Boards in the Bronx, New York. The findings included high ratings by the expert panel; a positive significant difference behavioral intentions of Community Board members before and after viewing the communication; and significant correlation between behavioral intentions and reported behaviors. Since attitudes were found to be the best predictor of behavioral intention, this investigation concluded that a short potent communication can have a significant impact on attitudes of Community Board members. This evaluation of a community education program suggests that health educators can utilize this strategy in urban areas with poor health outcomes in order to impact on behavioral intentions of community leaders.