Special features of health services and register based trials – experiences from a randomized trial of childbirth classes
2008

Using Routine Data in Childbirth Classes Trial

Sample size: 1601 publication Evidence: moderate

Author Information

Author(s): Elina Hemminki, Kaija Heikkilä, Tiina Sevón, Päivikki Koponen

Primary Institution: National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland

Hypothesis

Can a trial relying solely on routinely collected register data effectively evaluate the impact of childbirth education on caesarean section rates?

Conclusion

The trial showed that using register data for outcomes is feasible, but changing health service provider behavior is challenging.

Supporting Evidence

  • The trial used routine data to evaluate outcomes, which is a cost-effective method.
  • Changing the behavior of health service providers is a significant challenge in implementing interventions.

Takeaway

This study looked at how using existing health data can help understand if childbirth classes can lower caesarean section rates, but it found that getting nurses to change their behavior is hard.

Methodology

The study used a matched-pair design with 20 maternity health centers, where 10 pairs were randomly assigned to intervention and control groups, analyzing outcomes from register data.

Potential Biases

Potential bias due to the lack of randomization in the intervention's implementation and varying levels of engagement from public health nurses.

Limitations

The intervention did not succeed well, and the study faced challenges in changing health service provider behavior.

Participant Demographics

The study included 1601 mothers, with a mean age of 30.6 years, and a mix of marital statuses and social classes.

Digital Object Identifier (DOI)

10.1186/1472-6963-8-126

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