Ann C Celi, Emma M Anghel, Skylar N Smith, Sharlay K Butler, Saba H Berhie, Giselle Chiprez Ramirez, Jill C Doyle, Michelle C Lara, Margot Stone-Condry, Raquel M Vargas-Vila, Barbara E Wilkinson, Chloe A Zera
The "My Health Beyond Pregnancy" educational discussion guide was perceived as highly acceptable, appropriate, and feasible among a diverse population of postpartum patients with HDP. By addressing key behavioral determinants and remaining useful across patient populations, the guide shows promise as a scalable tool to support equitable postpartum engagement and cardiovascular risk prevention. Future research should assess its impact on long-term health behaviors, care engagement, and clinical outcomes.
INTRODUCTION: Hypertensive disorders of pregnancy (HDPs) are a leading contributor to preventable maternal morbidity and mortality and are associated with increased risk of cardiovascular disease. The postpartum period represents a critical opportunity to improve engagement in follow-up care and support cardiovascular disease prevention after HDP; however, few patient-facing, postpartum educational tools about HDP have been studied. We sought to develop and evaluate a patient educational discussion guide to support postpartum recovery and promote heart-healthy behavior after a hypertensive pregnancy.
METHODS: We developed an updated three-page educational discussion guide, "My Health Beyond Pregnancy," in collaboration with national professional societies and patient advocacy organizations. The guide was designed at a sixth-grade reading level and in English and Spanish. Postpartum patients with HDP were recruited from an urban academic medical center and affiliated community health centers. Participants reviewed the guide and completed an anonymous survey assessing acceptability, appropriateness, and feasibility using validated measures (AIM, IAM, FIM, respectively) and open-ended qualitative feedback. Quantitative data were analyzed using non-parametric tests and qualitative responses were analyzed within the COM-B framework to determine how the educational tool may impact behavior change.
RESULTS: A total of 100 postpartum patients with HDP participated. The cohort was racially and ethnically diverse, with the majority publicly insured and nearly half having less than a college education. Participants agreed or strongly agreed that the guide was acceptable (95%), appropriate (96%), and feasible (97%). Perceptions did not differ by race, ethnicity, language, education, or insurance type. Qualitative analysis of free-response questions demonstrated that the guide enhanced behavioral determinants, including psychological capability and reflective motivation by improving understanding of postpartum hypertension and supporting self-advocacy.
CONCLUSION: The "My Health Beyond Pregnancy" educational discussion guide was perceived as highly acceptable, appropriate, and feasible among a diverse population of postpartum patients with HDP. By addressing key behavioral determinants and remaining useful across patient populations, the guide shows promise as a scalable tool to support equitable postpartum engagement and cardiovascular risk prevention. Future research should assess its impact on long-term health behaviors, care engagement, and clinical outcomes.