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Table 3 Pre and post-test scores within each sub-domain for each country

From: Midwives’ experiences of cultural competency training and providing perinatal care for migrant women a mixed methods study: Operational Refugee and Migrant Maternal Approach (ORAMMA) project

  Greece (N = 23) Netherlands (N = 7) UK (N = 5) Overall pre-post
Pre Post) p value Pre Post p value Pre Post p value P value
Knowledge on: (Median [IQR]) a
 Medical aspects (max score 12) 6.5 [5–8.25] 9.0 [7–10] 0.007** 9 [6–11] 10 [10–11] 0.041* 8 [4–10] 11 [10–11.5] 0.068 0.000***
 Interpretation services (max score 5) 1.5 [1–2] 2 [1–2.5] 0.454 1 [1–2] 2 [1–2] 0.157 2.5 [1.3–4.5] 2.5 [2–3] 0.854 0.404
 National legislation (max score 3) 2 [2–3] 2 [2–3] 0.480 2 [2–3] 2 [2–3] 0.564 2 [2–3] 3 [2.5–3] 0.157 0.405
 Ethnic minority patients (max score 8) 7 [6–7] 7 [6–7] 0.435 7 [6–8] 7 [7–8] 0.157 8 [7–8] 7 [6–8] 0.180 0.569
Attitude - (Yes %) b
 I respect her choice to become pregnant 52.2% 65.2% 0.250 42.9% 57.1% 1.000 40.0% 100% 0.250 0.016*
 I understand why scheduled appointments are hard 56.5% 73.9% 0.125 85.7% 71.4% 1.000 40.0% 100% 0.250 0.070
 I feel irritated when she fails to attend twice c 4.3% 4.3% 1.000 71.4% 28.6% 0.250 0% 0% 0.250
 I cannot understand why she would bring a child into the world in her situation c 0% 0% 14.3% 14.3% 1.000 0% 0% 1.000
 I feel empathy for her 4.3% 8.7% 1.000 42.9% 57.1% 1.000 60.0% 100% 0.500 0.219
 I’m worried about her 73.9% 82.6% 0.625 100% 100% 80.0% 100% 1.000 0.375
 I’m worried about her child 56.5% 52.2% 1.000 100% 85.7% 1.000 80.0% 100% 1.000 1.000
 I feel desperate as I have no idea how to help c 4.3% 4.3% 1.000 28.6% 0% 0.500 0% 0% 0.625
 I’m glad I will be able to help her 56.5% 52.2% 1.000 28.6% 85.7% 0.123 80.0% 100% 1.000 0.344
 I’m considering informing child protection c 39.1% 47.8% 0.625 0% 0% 20.0% 20.0% 1.000 0.625
 I feel I need to consult more experienced colleagues 69.6% 43.5% 0.031* 42.9% 42.9% 1.000 60.0% 60.0% 1.000 0.109
Skills (Yes - %) b
 I will end my care as usual in my country c 8.7% 8.7% 1.000 57.1% 42.9% 1.000 20.0% 20.0% 1.000 1.000
 I will approach different organisations for support 78.3% 73.9% 1.000 57.1% 85.7% 0.500 20.0% 60.0% 0.500 0.453
 Discuss pros and cons of government accommodation 43.5% 47.8% 1.000 57.1% 71.4% 1.000 60.0% 60.0% 1.000 0.754
 Write to the government requesting stay in current shelter until postnatal visits complete 26.1% 21.7% 1.000 0% 14.3% 1.000 20.0% 20.0% 1.000 1.000
 Concerns over victim of sexual violence 52.2% 56.5% 1.000 42.9% 57.1% 1.000 20.0% 60.0% 0.500 0.289
 Inform General Practitioner (GP) and health visitor over medical and mental health risk concerns 56.5% 69.6% 0.453 71.4% 100% 0.500 80.0% 100% 1.000 0.109
 Concerns over Female Genital Mutilation (FGM) 13% 30.4% 0.125 42.9% 42.9% 1.000 0% 40% 0.500 0.031*
 No partner so contraception not discussed c 4.3% 4.3% 1.000 14.3% 14.3% 1.000 0% 0% 1.000
 Inform of relevant social and other care 82.6% 87.0% 1.000 57.1% 100% 0.250 60% 100% 0.500 0.070
SPCC (each sub-domain scored from 1 to 5) (Median [IQR]) a
I feel capable of providing adequate care in relation to: Communication with a language barrier 3 [2.75–3] 4 [3–4] 0.090 3 [3–4] 4 [3–4] 0.157 4 [4–4.5] 4 [4–5] 0.317 0.025*
 handling cultural differences 4 [3–5] 4 [3–5] 0.180 3 [3–4] 4 [3–4] 0.046* 4 [3–4] 4 [4–4] 0.157 0.007**
 discuss (sexual) violence 3 [2.5–4] 3 [3–4] 0.351 3 [2–4] 4 [3–4] 0.046* 4 [3–4] 3 [3–4] 0.564 0.788
 ask about FGM 3 [2–4] 3 [2–4] 0.412 4 [3–4] 4 [3.5–4] 0.414 4 [4–5] 4 [4–4] 0.157 0.446
 manage consequences of FGM 3 [2–4] 3.5 [2–4] 0.414 4 [3–4] 4 [3–4] 1.000 4 [3–4] 4 [4–4] 0.157 0.276
 provide health promotion to migrants 4 [3–5] 4 [3.75–5] 0.102 3 [2–4] 3 [3–4] 0.480 4 [3.5–4] 4 [4–4.5] 0.157 0.046*
 legal and procedural aspects around migration status 2 [1–3] 3 [2–3] 0.013* 1 [1–2] 2 [1–3] 0.096 2 [1.5–2.5] 4 [3–4] 0.038* 0.000***
 refer to social care 4 [3–4] 4 [4–5] 0.019* 3 [3–5] 4 [4–4] 0.317 4 [4–4.5] 4 [4–5] 0.317 0.007**
  1. a - domains negatively scoring - so a decrease in score is desired
  2. b - McNemar Test used for dichotomous variables to test for differences between pre- and post-test proportions within each country and overall
  3. c - Differences between median pre- and post-score within each country and overall tested using Wilcoxon signed-rank test
  4. IQR Interquartile range
  5. * p < 0.05, ** p < 0.01, ***p < 0.001