The Effect of a Culturally Sensitive Educational Intervention on Acceptance of Neuraxial Anesthesia

Completed · Not applicable

Conditions studied: Labor Pain

In brief

The purpose of this study is to see if an educational intervention provided to pregnant women in early labor has an effect on their decision to use epidural anesthesia for relief of labor pain. The study will also investigate differences between Hispanic and non-Hispanic white women in their attitudes and beliefs regarding epidurals in labor. Previous studies have shown that Hispanic women receive epidural anesthesia in labor much less frequently than their non-Hispanic white counterparts. The investigators hypothesize that the rate of epidural use will be higher in subjects who receive the educational intervention than in those who do not. Women who have been admitted to the OHSU labor and delivery unit will be screened for study eligibility. In order to minimize the influence of socioeconomic factors, only women receiving Medicaid will be enrolled. Other inclusion criteria include age of at least 18 years, having a fetus of at least 24 weeks gestational age, and being categorized as American Society of Anesthesiologist category 1 to 3. Exclusion criteria include any condition that either excludes or mandates neuraxial anesthesia. Midwife patients are also excluded from this study. Those who meet study criteria will be approached by a member of the study team and informed consent will be obtained. Subjects will be randomly assigned to receive an educational intervention about epidurals or no educational intervention. Hispanic and non-Hispanic subjects will be randomized separately, yielding four study groups (Hispanic - intervention; Hispanic - control; non-Hispanic - intervention, non-Hispanic - control). The investigators expect to enroll approximately 176 women, 44 in each group. All subjects will complete a survey in early labor and again 1 to 2 days postpartum that asks about common beliefs and misconceptions regarding epidurals. Subjects in the intervention group will receive an educational pamphlet and watch a video in their native language (spanish or english) about epidurals, and have an opportunity to ask questions. Study staff will collect limited information about the subject's labor and delivery from the electronic medical record.

Key facts

Study ID

NCT02672397

Run by

Oregon Health and Science University

People needed

200

Starts

2015-02-10

Expected to finish

2017-12-31

Last updated by the study team

2020-03-04

Who can join

Age: 18 and older. Sex: female. Healthy volunteers: not accepted.

You may qualify if…

• Age > 18 years
• Pregnant with a fetus > 24 weeks gestation
• Medicaid insurance
• ASA class 1 to 3
• Arriving at OHSU in spontaneous labor, requiring induction, or receiving augmentation of labor

You may not qualify if…

• Patients having scheduled cesarean sections
• Patients with conditions that are contraindications for epidural labor analgesia
• Patients in whom epidural analgesia is mandated by the medical team
• Patients delivering with a midwife

Where it is running

• OHSU Labor and Delivery; Oregon Health and Science University Hospital — Portland, Oregon, United States

Full record on ClinicalTrials.gov

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