Author ORCID Identifier


Date of Award

Spring 5-10-2024

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Ashli Owen-Smith

Second Advisor

Virginia Tester


INTRODUCTION: Refugee/ immigrant/ and migrant (RIM) women are at particularly high risk of pregnancy-related health disparities in the United States. One strategy for addressing these health disparities and improving pregnancy- and childbirth-related outcomes is to provide RIM women with education about sexual and reproductive health (SRH) and maternal and child health (MCH) topics so that they are better able to effectively communicate with their health care provider. To this end, Embrace Refugee Birth Support provides a culturally tailored educational program, Healthy Moms, that provides expectant refugee women with information about SRH while emphasizing their health care right to make informed health decisions.

METHODS: An outcome evaluation of the Healthy Moms educational class series was conducted to evaluate the impact of the program. Using a pre-post evaluation design, participants (n=18) were evaluated on patient communication self-efficacy and sexual and maternal health knowledge acquisition. Data was collected separately between participants that were native to Afghanistan or African countries. Data was analyzed using descriptive statistics and paired sample t-tests (n=8).

RESULTS: Baseline SRH and MCH knowledge acquisition was measured among 18 participants. A one-way ANOVA revealed that there was a statistically significant difference in knowledge base between Afghanistan and African participants [F(1, 15) = [11.833], p=0.004)]. A paired samples t-test showed that the participant’s level of knowledge increased from baseline (Mean=9.75, SD=1.98) to follow-up (Mean=11.38, SD=2.67; t(7)=-1.72, p=0.129), though results were not statistically significant. A paired samples t-test showed that the participants’ level of communication self-efficacy with providers increased from baseline (Mean=36.57, SD=8.73) to follow-up (Mean=46.00, SD=2.77; t(6)=-2.92, p=0.027). Participants reported a high level of program satisfaction (Mean=11.38, SD=0.74).

DISCUSSION: Across participants, the results indicated a significant increase in patient communication self-efficacy over the course of the program. This evaluation did not find significant increases in knowledge acquisition. Most notably, however, at program entry, the results revealed topic areas in which participants were relatively knowledgeable or demonstrated deficits. This finding may have important implications for the Healthy Moms curriculum development.


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Available for download on Saturday, October 26, 2024