Date of Award

5-1-2022

Language

English

Document Type

Dissertation

Degree Name

Doctor of Public Health (DrPH)

College/School/Department

Department of Health Policy, Management and Behavior

Content Description

1 online resource (vii, 137 pages) : illustrations (some color)

Dissertation/Thesis Chair

Jennifer Manganello

Committee Members

Rukhsana Ahmed, Marilyn Kacica, Rachel de Long

Keywords

Black Maternal Health, eHealth Literacy, Health Literacy, Instagram, Prenatal Care Quality, Social Media, Pregnant women, Women, Black, African American women, Prenatal care, Social media in medicine

Subject Categories

African American Studies | Communication | Public Health

Abstract

Pregnancy-related maternal morbidity and mortality disproportionately affect Black women more than their White counterparts. Black pregnant women are more likely to omit or engage in prenatal care late than White women. Social media is an essential source of pregnancy-related information and shows it effectively improves pregnancy knowledge. Greater than 80% of Black women own a mobile device, and some data demonstrate that Black women use social media for pregnancy-related information. However, little is known about social media use during pregnancy for this population. Several gaps exist about what maternal health content is available on social media, how Black women use social media during pregnancy, and what factors influence their social media use behaviors. It is vital to explore how this tool can be utilized to address knowledge gaps and promote equitable maternal health among Black women. This dissertation sought to fill these gaps by conducting a content analysis of maternal health Instagram posts from three popular parenting accounts (Aim 1) and doing a cross-sectional survey of Black women who were pregnant or gave birth within a year to (1) assess whether health literacy or eHealth literacy influenced their social media to use patterns (Aim 2) and (2) examine whether prenatal care quality (precisely the quality of guidance and support and respect) impacted how they use social media (Aim 3). Aim 1 results suggest that maternal health and Black maternal health topics are rarely posted on popular parenting Instagram accounts. Aim 2 analyses indicate that Black women use social media and share pregnancy information and obtain support. Black birthing women with low health literacy used social media more and obtained support from social media. Women with higher health literacy reported sharing information found online with others more. Those with higher eHealth literacy were more likely to use social media, share pregnancy information found on social media with others, and use social media for support. Aim 3 found that the quality of guidance and the quality of support and respect delivered during prenatal care were scored as good. Black women who reported getting more prenatal care guidance from their provider reported more social media use and more use of social media for giving and getting support. Also, Black women who reported getting more prenatal care support and respect from their provider reported more social media use and more use of social media for giving and getting support. Findings across all three aims highlight possible opportunities to improve pregnancy knowledge, share high-quality pregnancy information and resources, and improve patient-provider relationships. Results also suggest the importance of continued evaluations of the impact of social media use by Black women during pregnancy and the potential implications social media use can have for Black women with respect to maternal health. Social media can be a viable and innovative solution to help promote maternal health equity. Results from all three studies can advance research, identify strategies for information dissemination, provide ideas for future social media interventions, and inform practice for pregnancy care providers and organizations that support pregnant women.

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