title: Use of evidence based leaflets to promote informed choice in maternity care: randomised controlled trial in everyday practice.
abstract: OBJECTIVE
  To assess the effect of leaflets on promoting informed choice in women using maternity services.
  
  
  METHODS
  Cluster trial, with maternity units randomised to use leaflets (intervention units) or offer usual care (control units). Data collected through postal questionnaires.
  
  
  METHODS
  13 maternity units in Wales.
  
  
  METHODS
  Four separate samples of women using maternity services. Antenatal samples: women reaching 28 weeks' gestation before (n=1386) and after (n=1778) the intervention. Postnatal samples: women at eight weeks after delivery before (n=1741) and after (n=1547) the intervention.
  
  
  METHODS
  Provision of 10 pairs of Informed Choice leaflets for service users and midwives and a training session for staff in their use.
  
  
  METHODS
  Change in the proportion of women who reported exercising informed choice.
  
  
  RESULTS
  changes in women's knowledge; satisfaction with information, choice, and discussion; and possible consequences of informed choice.
  
  
  RESULTS
  There was no change in the proportion of women who reported that they exercised informed choice in the intervention units compared with the control units for either antenatal or postnatal women. There was a small increase in satisfaction with information in the antenatal samples in the intervention units compared with the control units (odds ratio 1.40, 95% confidence interval 1.05 to 1.88). Only three quarters of women in the intervention units reported being given at least one of the leaflets, indicating problems with the implementation of the intervention.
  
  
  CONCLUSIONS
  In everyday practice, evidence based leaflets were not effective in promoting informed choice in women using maternity services.
authors.affiliation: School of Health and Related Research, University of Sheffield, Regent Court, Sheffield S1 4DA. a.ocathain@sheffield.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: O'Cathain
authors.forename: S J
authors.initials: SJ
authors.lastname: Walters
authors.forename: J P
authors.initials: JP
authors.lastname: Nicholl
authors.forename: K J
authors.initials: KJ
authors.lastname: Thomas
authors.forename: M
authors.initials: M
authors.lastname: Kirkham
mesh_terms: D001294:Attitude to Health; D002755:Choice Behavior; D019317:Evidence-Based Medicine; D005260:Female; D006293:Health Promotion; D006801:Humans; D007258:Informed Consent; D010174:Pamphlets; D010353:Patient Education as Topic / Q000592:standards*; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000592:standards*; D011379:Prognosis; D014852:Wales