Including individuals with memory impairment in the research process: the importance of scales and response categories used in surveys

Several ethical considerations emerge when conducting research with memory-impaired individuals, including the individuals' ability to comprehend and accurately respond to survey questions. However, little empirical research exists on how to format surveys to decrease cognitive demands, thereby allowing researchers to more accurately survey this population. The current study presents data from structured interviews with 125 community-residing, memory-impaired older adults about their illness experience. The interview contained 14 scales varying in subjectivity, directionality, and response choice content. While objectivity did not affect participants' ability to use the full range of responses, participants with greater cognitive impairment tended to use simpler, dichotomous response categories, especially when questions had bidirectional response choices. Results suggest that memory-impaired individuals can participate in survey research, that such surveys should contain unidirectional frequency/amount items when possible, and that not all memory-impaired individuals will have difficulty completing surveys.     

Cathodal current-induced vasodilation to single application and the amplified response to repeated application in humans rely on aspirin-sensitive mechanisms.

Assumed to rely on an axon reflex, the current-induced vasodilation (CIV) interferes with the microvascular response to iontophoretic drug delivery. Mechanisms resulting in CIV are likely different at the anode and at the cathode. While studies have been conducted to understand anodal CIV, little information is available on cathodal CIV. The present study investigates CIV observed following 0.1-mA cathodal applications on forearms of healthy volunteers and the possible mechanisms involved. Results are expressed in percentage of the cutaneous heat-induced maximal vascular conductance [%MVC (means +/- SE)]. 1) The amplitude of CIV was proportional to the duration of cathodal currents for periods of <1 min: r = 0.99. 2) Two current applications of 10 s, with 10-min interstimulation interval, induced a higher peak value of CIV (79.1 +/- 8.6% MVC) than the one obtained with all-at-once 20-s current application (39.5 +/- 4.3% MVC, P < 0.05). This amplified vascular response due to segmental application was observed for all tested interstimulation intervals (up to 40 min). 3) Two hours and 3 days following pretreatment with 1-g oral aspirin, the CIV observed following cathodal application, as well as the difference of cathodal CIV amplitude between all-at-once and segmented applications, were reduced. These findings suggest a role of prostaglandins, not only released from endothelial or smooth muscle cells, as direct vasodilator and/or as a sensitizer. Thus aspirin pretreatment could be used to decrease CIV resulting from all-at-once and repeated cathodal application and facilitate the study of the specific vascular effect induced by the drug delivered.     

A comparison of structural and contextual features of middle school children's playful and aggressive fighting

This study compared structural and contextual features of playful [rough-and tumble play (r/t)] and aggressive fighting based on direct playground observations of two classes of 8 and two classes of 11 year old children. Most bouts of r/t and aggressive fighting were dyadic, but significantly more bouts of the former involved three or more participants than the latter. Rough-and-tumble play was found to contain more individual action patterns than aggressive fighting, but the latter was more varied in form than some earlier studies had shown. Both wrestling and chasing were seen more in r/t than aggressive fighting, but restraint in bouts of chasing was not more common in playful chasing than aggressive chasing. Positive and neutral facial expressions were more characteristic of r/t, and negative facial expressions were more characteristic of aggressive fighting. Rough-and-tumble initiations were more likely to receive an r/t response and less likely to receive an aggressive response than were aggressive initiations. Participants in r/t were more likely to have been together than to have been apart prior to the encounter, but this tendency was strongly mediated by sex. In three out of the four classes, children were more likely to have been together prior to same sex r/t interactions and to have been apart prior to mixed sex r/t interactions. Participants in r/t were not significantly more likely to have been together beforehand than participants in aggressive fighting. Finally, while most bouts of r/t led to the participants remaining together, the proportion that did so was not significantly greater than was the case for bouts of aggressive fighting. Possible reasons why r/t and aggressive fighting did or did not differ in these ways are discussed.     

The influence of feeding on predatory tactics in a water bug

Abstract. The tropical belostomatid Diplonychus indicus Venk. & Rao (Heter-optera: Belostomatidae) forages both actively and from ambush, changing frequently from one predatory mode to the other. Analyses presented here of the influence of feeding and of developmental stage on several locomotory and predatory parameters show that the fact that a bug was eating did not prevent it from reacting to and from seizing prey items, but it did influence the mode of predatory attempts. Feeding bugs were less active and they foraged actively less frequently, but feeding did not affect the frequency of predatory attempts from ambush. No important variations during development were found and first stadium larvae behaved similarly to adults. Capture success rates were higher at all developmental stages during a meal than when a bug was not eating and rejection rates were lower during a meal. These results suggest that, when eating, Diplonychus indicus bugs aim more successfully at prey items they are more likely to capture and to eat.     

Human Preferences for Conformation Attributes and Head-And-Neck Positions in Horses

Human preferences for certain morphological attributes among domestic animals may be entirely individual or, more generally, may reflect evolutionary pressures that favor certain conformation. Artificial selection for attributes, such as short heads and crested necks of horses, may have functional and welfare implications because there is evidence from other species that skull shape co-varies with behaviour. Crested necks can be accentuated by flexion of the neck, a quality that is often manipulated in photographs vendors use when selling horses. Equine head-and-neck positions acquired through rein tension can compromise welfare. Our investigation was designed to identify conformations and postures that people are attracted to when choosing their ‘ideal’ horse. Participants of an internet survey were asked to rate their preference for horse silhouettes that illustrated three gradations of five variables: facial shape, crest height, ear length, ear position and head-and-neck carriage. There were 1,234 usable responses. The results show that overall preferences are for the intermediate, rather than extreme, morphological choices (p=<0.001). They also indicate that males are 2.5 times less likely to prefer thicker necks rather than the intermediate shape, and 4 times more likely to prefer the thinner neck shape. When compared to the novice participants, experienced participants were 1.9 times more likely to prefer a thicker neck shape than the intermediate neck shape and 2.8 times less likely to prefer a thinner neck shape than the intermediate neck shape. There was overall preference of 93% (n=939) for the category of head carriage ‘In front of the vertical’. However, novice participants were 1.8 times more likely to choose ‘behind the vertical’ than ‘in front of the vertical’. Our results suggest that people prefer a natural head carriage, concave facial profile (dished face), larger ears and thicker necks. From these survey data, it seems that some innate preferences may run counter to horse health and welfare.     

Food sharing in lion tamarins: Tests of three hypotheses

Infant marmosets and tamarins (Callitrichidae) frequently receive food from older group members. Three possible functions of food sharing in lion tamarins were examined experimentally. The first hypothesis, that food sharing ensures that infants receive sufficient food even if it is difficult for them to acquire it themselves, was tested by varying the ease with which infants could reach a food source. When access to food was restricted, infants fed themselves less, received more food from others, and had a higher success rate in begging attempts. The second hypothesis, that food sharing helps teach infants an appropriate diet, was tested by presenting fruits that were novel to infants. Although infants fed themselves less under these conditions, adults were less likely to share novel foods than familiar foods. The final experiment compared food sharing when food was abundant with behavior when food items were presented singly. Infants fed themselves less and received more food from others when food items were rare. These results suggest that food sharing in lion tamarins helps to ensure that infants receive adequate amounts of food which is difficult to locate or acquire, but that it is not involved in teaching infants which foods they should eat. © 1993 Wiley-Liss, Inc.     

Adult-infant food transfer in common marmosets: an experimental study

Infant marmosets and tamarins obtain solid food items from adults during and after the time of weaning. In addition to providing nutrients, food transfers may provide infants with the opportunity to learn about diet. The aim of this study was to investigate patterns of begging and food transfer in captive groups of common marmosets during tests with 1) palatable novel food, 2) unpalatable novel food, and 3) familiar food. Infants may gain an opportunity to learn about diet breadth by preferentially begging for novel rather than familiar items, while adults may facilitate infant learning by differing in their willingness to transfer food depending upon the food's novelty or palatability. In this study, infants exhibited more interest and begging with novel food items than with familiar ones. However, food transfers were not more likely to occur with novel foods than with familiar ones, and in fact adults were more likely to refuse infant begging attempts with novel foods. The palatability of the food also did not influence the rates of refusal and transfer: adults transferred palatable and unpalatable novel foods with similar frequencies. These results suggest that infant marmosets gain an opportunity to learn about diet breadth by begging for novel foods, but adults do not preferentially transfer novel or palatable food items.     

Gaze in Visual Search Is Guided More Efficiently by Positive Cues than by Negative Cues

Visual search can be accelerated when properties of the target are known. Such knowledge allows the searcher to direct attention to items sharing these properties. Recent work indicates that information about properties of non-targets (i.e., negative cues) can also guide search. In the present study, we examine whether negative cues lead to different search behavior compared to positive cues. We asked observers to search for a target defined by a certain shape singleton (broken line among solid lines). Each line was embedded in a colored disk. In “positive cue” blocks, participants were informed about possible colors of the target item. In “negative cue” blocks, the participants were informed about colors that could not contain the target. Search displays were designed such that with both the positive and negative cues, the same number of items could potentially contain the broken line (“relevant items”). Thus, both cues were equally informative. We measured response times and eye movements. Participants exhibited longer response times when provided with negative cues compared to positive cues. Although negative cues did guide the eyes to relevant items, there were marked differences in eye movements. Negative cues resulted in smaller proportions of fixations on relevant items, longer duration of fixations and in higher rates of fixations per item as compared to positive cues. The effectiveness of both cue types, as measured by fixations on relevant items, increased over the course of each search. In sum, a negative color cue can guide attention to relevant items, but it is less efficient than a positive cue of the same informational value.     

Gender Differences in Perception of Romance in Chinese College Students

Women often complain that their partners are not romantic enough. This raises the question: how romance is recognized and evaluated in a love relationship? However, there has been essentially no empirical research bearing on this issue. The present set of studies examined possible gender differences in perceptions of romance and the associated neural mechanisms in Chinese college students. In Study 1, 303 participants (198 women, 105 men) were administrated a questionnaire consisting of 60 sentences and required to rate the romance level of each sentence. Results showed higher rating scores in males than females for low romance items, but not for high or medium romance items. In Study 2, 69 participants (37 women, 32 men) were recruited to judge the degree of romance in sentences presented on a computer screen one by one. Compared with females, males again showed higher scores and responded more slowly only to low romance items. In Study 3, 36 participants (18 women, 18 men) currently in love with someone were scanned with functional MRI while they did the romance judgment task from Study 2. Compared with females, greater brain activation was found for males in the frontal lobe, precentral gyrus, precuneus and parahippocampal gyrus for low romance items. The results provide the first piece of evidence for gender differences in romance perception, suggesting enhanced cognitive processing in males when evaluating the degree of romance in romantic scenes.     

Dual Sensory Impairment in Older Adults Increases the Risk of Mortality: A Population-Based Study

Although concurrent vision and hearing loss are common in older adults, population-based data on their relationship with mortality is limited. This cohort study investigated the association between objectively measured dual sensory impairment (DSI) with mortality risk over 10 years. 2812 Blue Mountains Eye Study participants aged 55 years and older at baseline were included for analyses. Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold greater than 25 dB HL (500–4000 Hz, better ear). Ten-year all-cause mortality was confirmed using the Australian National Death Index. After ten years, 64% and 11% of participants with DSI and no sensory loss, respectively, had died. After multivariable adjustment, participants with DSI (presenting visual impairment and hearing impairment) compared to those with no sensory impairment at baseline, had 62% increased risk of all-cause mortality, hazard ratio, HR, 1.62 (95% confidence intervals, CI, 1.16–2.26). This association was more marked in those with both moderate-severe hearing loss (>40 dB HL) and presenting visual impairment, HR 1.84 (95% CI 1.19–2.86). Participants with either presenting visual impairment only or hearing impairment only, did not have an increased risk of mortality, HR 1.05 (95% CI 0.61–1.80) and HR 1.24 (95% CI 0.99–1.54), respectively. Concurrent best-corrected visual impairment and moderate-severe hearing loss was more strongly associated with mortality 10 years later, HR 2.19 (95% CI 1.20–4.03). Objectively measured DSI was an independent predictor of total mortality in older adults. DSI was associated with a risk of death greater than that of either vision loss only or hearing loss alone.     

The influence of gender, athletic events, and athletic experience on the subjective dominant hand and the determination of the dominant hand based on the laterality quotient (LQ) and the validity of the LQ

This study aimed to reveal the influence of gender, athletic events and athletic experience on the subjective dominant hand and the dominant hand based on the laterality quotient (LQ). It also aimed to examine the validity of the Edinburgh Inventory (Oldfield, 1971). Males and females (n=3,726) living in 7 prefectures in Japan (age: 16-45 yrs) participated in this survey. Analysis was performed on 3,557 separate datasets with high reliability. The reliability of the survey was examined using a test-retest method consisting of 100 people selected randomly from all participants. All participants provided the same answers for each question. The influence of gender, event and experience was examined for the subjective and LQ-based dominant hands. In addition, concordance rates of the subjective dominant hand and the LQ-based dominant hand and both dominant hands were examined. Differences of concordance rates between hands used in the 10 movement questions of the Inventory and the subjective dominant hand were tested using the chi(2) test. The frequency differences among items were tested using Ryan's method (multiple comparisons). Significant gender differences were found between rates of the LQ-based dominant hand (males: 94.4%; females: 96.6%) and the subjective dominant hand (males: 91.6%; females: 94.0%), but the degree was only 2.0-4.0%. Insignificant differences were found among athletic events, two groups of different athletic experience, and gender according to each athletic event. The subjective dominant hand almost always agreed with the LQ-based dominant hand (complete concordance rate=0.96, kappa=0.67). Of the 10 question items, inexperienced answers were found only in the item "Knife (without fork)". The "Toothbrush", "Broom (upper hand)", and "Opening box (lid)" items had significantly lower correspondence with the subjective dominant hand (79.7-87.0%) than the other items (92.1-95.7%).In conclusion, athletic experience appears to have little influence on handedness, although there is a slight gender difference. The subjective dominant hand almost always agrees with the dominant hand based on the Inventory. A more efficient handedness inventory may be constructed by excluding the above 4 items.     

Validation of the Fibromyalgia Survey Questionnaire within a cross-sectional survey

The Fibromyalgia Survey Questionnaire (FSQ) assesses the key symptoms of fibromyalgia syndrome. The FSQ can be administrated in survey research and settings where the use of interviews to evaluate the number of pain sites and extent of somatic symptom intensity and tender point examination would be difficult. We validated the FSQ in a cross-sectional survey with FMS patients. In a cross-sectional survey, participants with physician diagnosis of FMS were recruited by FMS-self help organisations and nine clinical institutions of different levels of care. Participants answered the FSQ (composed by the Widespread Pain Index [WPI] and the Somatic Severity Score [SSS]) assessing the Fibromyalgia Survey Diagnostic Criteria (FSDC) and the Patient Health Questionnaire PHQ 4. American College of Rheumatology 1990 classification criteria were assessed in a subgroup of participants. 1,651 persons diagnosed with FMS were included into analysis. The acceptance of the FSQ-items ranged between 78.9 to 98.1% completed items. The internal consistency of the items of the SSS ranged between 0.75-0.82. 85.5% of the study participants met the FSDC. The concordance rate of the FSDC and ACR 1990 criteria was 72.7% in a subsample of 128 patients. The Pearson correlation of the SSS with the PHQ 4 depression score was 0.52 (p<0.0001) and with the PHQ anxiety score was 0.51 (p<0.0001) (convergent validity). 64/202 (31.7%) of the participants not meeting the FSDC criteria and 152/1283 (11.8%) of the participants meeting the FSDC criteria reported an improvement (slightly too very much better) in their health status since FMS-diagnosis (Chi(2)?=?55, p<0.0001) (discriminant validity). The study demonstrated the feasibility of the FSQ in a cross-sectional survey with FMS-patients. The reliability, convergent and discriminant validity of the FSQ were good. Further validation studies of the FSQ in clinical and general population settings are necessary.     

Assessing the role of color cues and people's beliefs about color-flavor associations on the discrimination of the flavor of sugar-coated chocolates

We report 2 experiments designed to investigate the effect of people's prior beliefs concerning specific color-flavor associations on their ability to discriminate the flavor of colored sugar-coated chocolate sweets. The participants in our study judged whether pairs of Smarties had the same flavor or not. In our first experiment, the participants either performed the task with their eyes open or else while wearing a blindfold to eliminate any visual cues. We used pairs of Smarties that either did or did not differ in flavor. In making a sighted comparison between red and green Smarties, the participants were more likely to judge them as tasting the same if they believed all non-orange Smarties to be identical in flavor and as different in flavor if they did not hold such a belief. The ability of our participants to discriminate orange Smarties from the red and green Smarties was unaffected by their prior belief that orange Smarties taste different. In a second experiment, participants' ratings of their certainty of there being a difference in flavor between a red and an orange Smartie that either tasted the same or different were affected by their prior beliefs-those participants who expected a difference were more likely to report a difference than those without any such prior expectation. Taken together, these results demonstrate that people's expectations concerning color-flavor associations can modulate their flavor discrimination responses, even for a familiar food product such as Smarties.     

Diabetes knowledge: Are resident physicians and Nurses adequately prepared to manage diabetes?

ObjectiveTo assess and compare the diabetes knowledge of nurses and residents in surgery, internal medicine, and family practice.MethodsA 21-question survey based on current diabetes standards of care was developed and administered. The results were stratified by type of participant and analyzed statistically.ResultsA total of 52 internal medicine residents (IMR), 21 family practice residents (FPR), 42 surgery residents (SR), and 48 registered nurses (RN) participated. The survey had good overall internal consistency (Cronbach α of 0.78) and test-retest reliability (Pearson correlation coefficient of 0.71). The total mean percent correct for all participants was 61%. The total scores of IMR, FPR, and RN groups were similar (69%, 64%, and 66%) and significantly greater (P < 0.001) than the SR score (44%). Collectively, all survey participants averaged less than 50% correct on several items. The IMR scored higher than the SR and FPR on several items. The nurses outscored the physicians on items regarding insulin preparations, treatment of hypoglycemia, and perioperative insulin management. A subgroup of 13 RN with additional diabetes training earned the highest total score (82%).ConclusionOur novel survey was shown to be a statistically valid tool for assessment of diabetes knowledge. IMR, FPR, and inpatient RN have similar but insufficient levels of knowledge about diabetes. SR may have a more profound deficit of diabetes knowledge. Previous additional diabetes training among nurses was associated with greater diabetes knowledge. Most nurses and residents require additional education in order to provide optimal care to patients with diabetes. (Endocr Pract. 2007;13: 17-21)     

A novel parallel distributor for dispensing of IRORItrade mark RF-encoded tags to microkans in 96-well format

A novel parallel radio-frequency (RF) tag distributor has been developed which allows for distribution of RF tags into Irori microkans in 96-well format. The distributor has a holding capacity of approximately 1000 RF tags and distributes RF tags in groups of 12. Using the distributor, a block of 96 microkans can be filled with RF tags in less than 30 sec resulting in significant time savings over one-at-a-time manual RF tag distribution. The distributor may also be of utility as a solid-phase synthesis tool for dispensing resin enclosed in capsules (which have the same shape as RF tags). Copyright 1998 John Wiley & Sons, Inc.     

Circadian-rhythm differences among emergency department patients with chronic obstructive pulmonary disease exacerbation

The purpose of the study was determine whether patients with chronic obstructive pulmonary disease (COPD) exacerbation who present to the emergency department (ED) during the night (00:00 to 07:59 h) vs. other times of the day have more severe COPD exacerbation, require more intensive treatment, and have worse clinical outcomes. A multicenter cohort study was completed involving 29 EDs in the United States and Canada. Using a standard protocol, consecutive ED patients with COPD exacerbation were interviewed, and their charts were reviewed. Of 582 patients enrolled, 52% were women, and the median age was 71 yrs (interquartile range, 64-77 yrs). Nighttime patients (15% of cohort) did not differ from patients presenting at other times except that they were less likely to have private insurance, more likely to have a history of corticosteroid use, and have a shorter duration of symptoms exacerbation. Except for a few features indicative of more severe COPD exacerbation (such as higher respiratory rate at ED presentation, greater likelihood of receiving noninvasive positive pressure ventilation, and increased risk of endotracheal intubation), nighttime patients did not differ from other patients with respect to ED management. Nighttime patients were approximately three-fold more likely to be intubated in the ED (odds ratio, 3.46; 95% confidence interval, 1.10-10.9). There were no day-night differences regarding ED disposition and post-ED relapse. Except for some features indicating more severe exacerbation, nighttime ED patients had similar chronic COPD characteristics, received similar treatments in the ED, and had similar clinical outcomes compared with patients presenting to the ED at other times of the day.     

Age at first birth and family size: Evidence from a longitudinal study

Abstract

This paper examines the correlates of the relationship of age at first birth to completed parity, using data from a fifteen‐year longitudinal study. Particular emphasis is given to measures of orientation toward family roles which have been singled out in previous studies as a likely causal factor not yet examined. Women who had an early first birth went on to have larger families than women who postponed childbearing longer. Demographic factors, including premarital pregnancies, unwanted births, and fecundity differentials, did not appear to account for the observed relationship. The hypothesis that early socialization toward traditional female roles might account for the higher fertility of women who began childbearing early was not confirmed. Women with a first birth at a young age were not characterized by more traditional sex‐role behavior or attitudes nor did they express higher initial fertility preferences. They did more often increase their fertility preferences over the inter‐survey period.     

Career and parenting satisfaction among medical students,residents and physician teachers at a Canadian medical school

BACKGROUND: Studies of career and parenting satisfaction have focused separately on medical students, residents and practising physicians. The objective of this study was to compare satisfaction across a spectrum of stages of medical career. METHODS: A survey of incoming medical students, current medical students, residents and physician teachers at the University of Saskatchewan was conducted in the spring of 1997. Response rates were 77% (43/56), 81% (177/218), 65% (134/206) and 39% (215/554) respectively. Factors assessed in the stepwise regression analysis were the effect of sex, parenting and level of training on the likelihood of recommending parenting to medical students or residents, and on parenting dissatisfaction, job dissatisfaction, career dissatisfaction and the importance of flexibility within the college program to accommodate family obligations. RESULTS: More male than female physician teachers had partners (92% v. 81%, p < 0.01) and were parents (94% v. 72%, p < 0.01). Female physician teachers spent equal hours per week at work compared with their male counterparts (mean 52 and 58 hours respectively) and more than double the weekly time on family and household work (36 v. 14 hours, p < 0.01). Physician teachers were the most likely respondents to recommend parenting to residents and their peers. Residents were the most dissatisfied with their parenting time. At all career stages women were less likely than men to recommend parenting, were more dissatisfied with the amount of time spent as parents and were more likely to regard flexibility within the college program as beneficial. There were no sex-related differences in job dissatisfaction and career dissatisfaction. However, married women were more dissatisfied with their jobs than were married men. Job dissatisfaction was greatest among medical students, and career dissatisfaction was greatest among residents. INTERPRETATION: The optimal timing of parenthood appears to be upon completion of medical training. Women were less likely to recommend parenting, less satisfied with the time available for parenting and more likely to value flexibility within the college program to accommodate family needs. These differences did not translate into women experiencing more job or career dissatisfaction.     

Chefs' Opinions About Reducing the Calorie Content of Menu Items in Restaurants

Modifying the energy content of foods, particularly foods eaten away from home, is important in addressing the obesity epidemic. Chefs in the restaurant industry are uniquely placed to influence the provision of reduced‐calorie foods, but little is known about their opinions on this issue. A survey was conducted among chefs attending US culinary meetings about strategies for creating reduced‐calorie foods and opportunities for introducing such items on restaurant menus. The 432 respondents were from a wide variety of employment positions and the majority had been in the restaurant industry for ≥20 years. Nearly all chefs (93%) thought that the calories in menu items could be reduced by 10–25% without customers noticing. To decrease the calories in two specific foods, respondents were more likely to select strategies for reducing energy density than for reducing portion size (P < 0.004). Low consumer demand was identified as the greatest barrier to including reduced‐calorie items on the menu by 38% of chefs, followed by the need for staff skills and training (24%), and high ingredient cost (18%). The majority of respondents (71%) ranked taste as the most influential factor in the success of reduced‐calorie items (P < 0.0001). The results of this survey indicate that opportunities exist for reducing the energy content of restaurant items. Ongoing collaboration is needed between chefs and public health professionals to ensure that appealing reduced‐calorie menu items are more widely available in restaurants and that research is directed toward effective ways to develop and promote these items.     

Development and First Phase Evaluation of a Maternity Leave Educational Tool for Pregnant,Working Women in California

Background

Despite the provision of maternity leave offered to mothers, many American women fail to take leave.

Methods

We developed an evidence-based maternity leave educational tool for working women in California using participatory design. We tested its short-term efficacy with a randomized controlled trial of pregnant English-speakers (n=155).

Results

Among intervention participants exposed to the tool, 65% reported that they learned something new; 38% were motivated to seek more information; and 49% said it helped them plan their maternity leave. Among participants who delivered at ≥ 37 weeks gestation and said the tool helped them plan their leave, 89% took more than one week of prenatal leave, a significantly higher proportion than among controls who did not receive the tool (64%, p=0.049). Other findings favored trial participants, but were not statistically significant in this small sample. More intervention participants took some prenatal leave (80%) vs. controls (74%, p=0.44). Among participants who had returned to work when surveyed (n=50), mean postnatal leave uptake was on average 1 week longer for intervention participants vs. controls (13.3 vs. 12.2 weeks, p=0.54).

Conclusions

The first-phase evaluation of this tool shows that it successfully informed women about maternity leave options, clarified complex regulations, encouraged women to seek further information and helped plan maternity leave. Compared to controls, trial participants who used the tool to plan their leave were far more likely to take prenatal leave close to term. Future evaluation of the tool when mediated by a health provider or employer is warranted.