# Effect of virtual group counseling based on health literacy on the empowerment and self-care of pregnant women: A randomized controlled trial

## TL;DR

Virtual group counseling based on health literacy significantly improved empowerment and self-care in pregnant women compared to standard care.

## Contribution

This study demonstrates the effectiveness of virtual group counseling focused on health literacy in improving maternal outcomes.

## Key findings

- The intervention group showed significant improvements in empowerment, self-care, and health literacy scores.
- Between-group differences were statistically significant, highlighting the intervention's effectiveness.
- The study supports virtual group counseling as a recommended strategy for maternal health programs.

## Abstract

Pregnancy presents a valuable opportunity for education and counseling aimed at enhancing the health outcomes of both mothers and newborns. This study was conducted to assess the effectiveness of virtual group counseling based on health literacy in promoting empowerment and self-care among pregnant women.

This open label, randomized controlled trial was conducted in 2024-2025 involved 84 pregnant women. Participants who met the inclusion criteria were randomly allocated to either the intervention or control group through a block randomization method. In addition to receiving routine prenatal care, the intervention group participated in weekly virtual group counseling sessions focused on health literacy. Standardized questionnaires were used to assess empowerment and self-care as primary outcomes, and health literacy as a secondary outcome. These assessments were conducted both before the intervention and four weeks after its completion. The statistical analysis followed the intention-to-treat principle. To compare the changes in outcomes over time between the two groups, the generalized estimating equations model was employed.

The mean differences in empowerment, self-care, and health literacy scores before and after the intervention in the intervention group were as follows: 16.68 (95% confidence interval: 14.39, 18.95), 29.78 (95% confidence interval: 24.24, 35.19), and 19.37 (95% confidence interval: 16.71, 22.32), respectively (P<0.001). While the changes in the scores of these three outcomes in the control group were 1.93 (95% confidence interval: 1.12, 2.80), 2.52 (95% confidence interval: 1.23, 4), and 1.85 (95% confidence interval: 1.60, 3.25), respectively. These between-group differences were statistically significant (P<0.001), highlighting the intervention’s effectiveness.

The virtual group counseling intervention based on health literacy significantly improved empowerment, self-care, and health literacy scores among pregnant women. This approach is recommended to health program planners as an effective strategy for empowering pregnant women and promoting better maternal health outcomes.

This trial was registered at the Iranian Registry of Clinical Trials with the identifier IRCT20221109056451N1.