Can a Question-Prompt Tool Improve Communication about Hypertensive Disorders of Pregnancy (HDP): Qualitative Interviews with Women and Clinicians

Women and clinicians said that a question prompt tool (QPT) about hypertensive disorders of pregnancy (HDP) could improve awareness of premature cardiovascular disease (CVD) risk. In this study, we explored views about the design of a draft QPT for HDP. We interviewed 21 clinicians including 7 midwives, 6 nurse practitioners and 8 physicians of differing specialty, and 21 ethno-culturally diverse women; and identified themes using content analysis. Women and clinicians suggested elaborating instructions, eliminating medical jargon, adding space for answers and graphic elements, and offering both print and electronic versions. Women also recommended links to additional information and an eye-catching title. Clinicians said the QPT should be endorsed and shared by professional societies. Women said to share the QPT in clinics, on a web site and through community agencies. Clinicians thought they should introduce the QPT, and decide which questions to address and when to avoid overwhelming pregnant women or new mothers. In contrast, women recommended providing the QPT as early as possible, even during pregnancy, to raise women’s awareness and confidence to ask clinicians questions in a credible manner. Still, women expressed concern about negative clinician reactions if women introduced the QPT. We refined QPT design in advance of a multi-centre pilot-test of QPT impact on women’s CVD prevention knowledge and behaviour. If found to be effective and widely disseminated by our partners, the QPT could raise awareness and communication about this issue, and may reduce CVD risk in thousands of Canadian women annually.