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Elevating the voices of expectant parents during the COVID-19 pandemic

Illustration of a mother and a baby.
'Elevating the voices of expectant parents during the COVID-19 pandemic' a public engagement project developed and delivered by the Health Equity Action Lab, LSHTM.

The Public Engagement team followed up with Research Fellow, Amber Raja, partway through this project to find out their experiences of delivering a virtual public engagement project. 

Project Lead: Elizabeth Brickley, Faculty of Epidemiology and Population Health

Project Team: Tanaka Nyoni, Amber Raja, Leila Mendonca, Nuria Sanchez Clemente, Enny Cruz, Julia Pescarini and Niamh Murphy, Faculty of Epidemiology and Population Health

Overview and context

The coronavirus pandemic (COVID-19) presents unprecedented public health challenges. The rapid spread of the virus led to prompt changes in social and healthcare policies, and many vulnerable groups, including pregnant persons, have been impacted by changes to healthcare services.

Our diverse research team has a wealth of experience in maternal-child health, with a special focus on the impact and outcomes of infectious disease during pregnancy, having worked closely with families of children with Congenital Zika Syndrome. These projects have given us insights into the effects of emerging infectious diseases on the lives of expectant families and has demonstrated to us the importance of undertaking a COVID-19 public engagement project related to pregnancy. In this project, we consulted with focus groups of new parents and have used social media (@healthequityactionlab on Instagram) to engage with the public and promote an inclusive and respectful conversation around the impact of the COVID-19 pandemic on pregnancy, childbirth and new parenthood.

Aim

  • To promote an inclusive and respectful conversation around the impact of the coronavirus pandemic (COVID-19) on pregnancy, childbirth, and new parenthood.

The audience

Our target audience is new and expectant parents, and caregivers. To date, we have spoken with new and expectant mums by holding four virtual focus group sessions and five one-to-one calls. The focus groups were small with 3-4 mums per group, which allowed an opportunity for more in-depth discussion for each person. Participants for our initial focus group were reached through a contact of one of the researchers, and subsequent participants were reached using snowballing techniques.

The project

The virtual focus groups started with introductions and setting expectations to create a safe space (e.g., confidentiality, active listening, option to step away from their screens if they had a ‘baby emergency’). Each contributor was given time to introduce themselves and to kick off discussion we asked contributors to share their top three challenges during the pandemic. We wanted the session to be free flowing and guided by what the contributors were thinking, and turned to our pre-set questions if there were lulls in conversation. In each session we touched on 4-5 areas: delivery experiences, levels of permitted partner presence, access to routine appointments, adapted vaccination schedules for new-borns, through to where contributors currently were in their pregnancy and postpartum journey. Consent was obtained to record the sessions’ audio for note taking purposes, which made it easier to get direct quotes and enabled team members to participate fully in the session. The audio recordings were deleted once the session was transcribed. 


“All mothers are strong, but being a pandemic mother is on another level.”

First-time mum of a 3-month-old

We held the first focus group via Zoom in October 2020, and 4-5 months later we held a catch-up session with the some of the same contributors. Two additional virtual focus groups were held in early 2021, each with a new group of contributors. The project required some flexibility as a few contributors dropped out of the original focus group dates, so we held separate one-to-one calls with them to ensure we could still include their views. 

What worked?

Sharing tasks between the team: there were a lot of tasks, so being able to split task between the team was helpful. For example, we set up a rota for social media with each week assigned to a different pair who are responsible for sharing at least two posts in the week. 

Virtual format: with the online format our funding has lasted longer than it would normally. In addition, as location was not an issue, we were able to hold online focus groups with contributors located across the UK (e.g., Sheffield, Birmingham, London)

What did not work?

Reaching all our audience: the target audience was originally new and expectant parents and other carers to-be, however, we found that partners did not join the session despite encouraging mums to ask their partners to take part. To address this, we could have explored partner-only sessions, which may have helped them feel more at ease and willing to contribute. 

Project Outcomes

Our next steps include sharing the outputs of the virtual focus groups via our website and Instagram. We had an illustrator draw images of the contributors from photos they submitted, and we will be posting quotes from contributors to stimulate discussion with wider audiences via Instagram. We are using our website to provide links to resources including on topics, such as maternal well-being, COVID-19 vaccines for people who are pregnant or breastfeeding, and others. 

The public engagement project has directly informed three new grant applications for further epidemiological research on the impact of the pandemic on pregnancy, parents, and child development in Brazil and the UK. It has also encouraged us to strategise how we, as a team, can make public engagement a cornerstone of all our future research endeavours.  


“A lot of research can be far removed from the community it aims to serve. So it’s been really nice to speak to the members of the community we are trying to help and have their voices included in the conversation. It’s been eye-opening in many respects and we’ve learnt so much from them already.”

Amber Raja, Research Fellow, EPH

Future potential or plans

We plan to continue interacting with the original group of mums, perhaps in more of a supportive capacity with a focus on giving back to them. We are taking some time to consider what types of interaction would be most beneficial; ideas include interactive discussions with experts, which would alternate with social activities such as book groups and movie viewings. 

It was eye-opening and nice to interact with new and expectant mothers, and to have their voices included in the conversation, which is something the team wants to continue moving forward. Going forward we are exploring setting up an expert panel of parents and carers we could go to in the future to gauge their opinion for example, on research priorities, study design and opportunities for public/patient involvement. 

This project has impacted our team’s motivation to continue public engagement and for these interactions to be built into our future research projects, with a number of our most recent grant applications including a public engagement component. We believe that the views of our contributors are important, and we are exploring the possible expansion on this public engagement project into qualitative research. 

Advice for other researchers

  • Finding the intended target group/audience can be challenging, try to be innovative and explore many avenues on how you can find your target audience.
  • Continue to maintain interaction with your contributors (i.e., through social media, e-newsletters).
  • Build into your project a way to give back to your contributors. 
  • Be open to have your research be guided by the issues that are important to your contributors. 


This project was funded by the LSHTM Public Engagement Small Grants Scheme. Find out more about the other public engagement projects awarded funding in 2020.