Jennifer Bute
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COVID-19 Birth Stories
In this year-long project, Professor Bute and her research partner, Professor Maria Brann, first conducted focus groups with women across the country who had given birth during a time when their state or local governments had issued stay-at-home orders because of the COVID pandemic. Then, they followed up a year later by interviewing the same women individually to learn more about raising a newborn during a pandemic.
The researchers found that the isolation of stay-at-home orders and changes in health care policies, such as limitations on hospital visitors and in-person appointments, had a profound effect on women. Women discussed in detail the mental health challenges they faced, such as postpartum depression and anxiety, that they felt were heightened because of the pandemic. Women also discussed the challenges of navigating who had access to visit or hold their newborn, which involved keeping their babies safe while contending with family expectations about seeing the baby. The women who participated in the study were grateful for the opportunity to connect with other women with similar experiences to know that they are not alone. They provided recommendations for helping pregnant women and new moms who are navigating motherhood in an unprecedented time, and even spoke to the media about this project so that other women would feel supported.
Professor Bute's translation of research into supportive groups for new mothers is another excellent example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.
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Item Expectancy violations and boundary management when giving birth during a pandemic: implications for supporting women(Taylor & Francis, 2024) Bute, Jennifer J.; Brann, Maria; Scott, Susanna; Johnson, Nicole; Communication Studies, School of Liberal ArtsBackground: Few life events are as profound as the birth of a child. Yet for those who gave birth during the COVID-19 pandemic, the birth experience and the care of their newborn child were altered in significant ways. Method: In this study, we examined the stories of women who gave birth during the COVID-19 pandemic using expectations violations theory and communication privacy management theory. Results: Based on focus group interviews with 65 women from 19 states across the U.S., we found that policies imposed by institutions and visitation rules negotiated by women were prominent in women’s birth stories. Policies that affect territorial access to mothers and babies shaped communication to manage health and safety, resulted in intense emotional responses, and affected relationships with women’s partners and families. Conclusions: Our findings offer practical implications for both health care systems and health care providers. Systems must communicate proactively to offer compassionate patient care, and physicians should offer guidance to help new parents manage visitors.Item Jennifer Bute and Maria Brann Research Introduction(Center for Translating Research Into Practice, IU Indianapolis, 2021-09-24) Brann, Maria; Bute, JenniferProfessors Jennifer Bute and Maria Brann briefly discuss their translational research that deals with COVID-19 Birth Stories.Item “There's no time limit on grief:” Women's perspectives on a novel reproductive grief screening tool(Elsevier, 2023-12-04) Bute, Jennifer J.; Brann, Maria; Buskmiller, Cara; Fredenburg, Michaelene; Communication Studies, School of Liberal ArtsObjective: Women who have experienced reproductive loss (i.e., miscarriage, stillbirth, abortion) evaluated the usefulness of a novel screening tool, Reproductive Grief Screen (RGS), to identify patients struggling with ongoing, complicated grief. Methods: This mixed-methods study involved U.S. women who had experienced reproductive loss. Online data collection resulted in 27 interviews and 282 surveys completed. Perceptions of and preferences about RGS were thematically analyzed. Chi square analyses assessed relationships between demographics and tool preferences. Results: RGS validated women's experiences with grief after reproductive loss. Women noted their providers may be unaware of their loss(es). Participants requested periodic screening using RGS beginning shortly after a loss (or during new patient intake) and occurring regularly (e.g., annually). Overall, women preferred completing RGS online before an appointment, though preferences varied by demographics (i.e., age, time since loss). Participants want providers to compassionately discuss RGS results with them and offer appropriate resources. Conclusion: The RGS can help identify largely ignored grief after reproductive loss. Innovation: Findings from group and individual interviews and a survey of women who have coped with reproductive loss suggest that use of a brief RGS tool could reshape clinical practice to aid women who might be facing complicated grief. Moreover, women expressed clear preferences for how to implement use of the RGS in clinical contexts.Item The association of news media with anxiety in food allergic children and their parents(Wiley, 2022-01) Bute, Jennifer J.; Martins, Nicole; Communication Studies, School of Liberal ArtsItem ‘Had I gone into the office, they would have caught it a little bit sooner’: Narrative problematics in U.S. pandemic birth stories(T&F, 2022) Scott, Susanna Foxworthy; Johnson, Nicole L.; Brann, Maria; Bute, Jennifer J.; Communication Studies, School of Liberal ArtsIndividuals who gave birth during the COVID-19 pandemic experienced an increased risk for premature births, stillbirths, depression, and lower access to care. Their stories provide valuable information that can inform clinical care, particularly due to loss of in-person support resulting from visitor restrictions in hospitals. Grounded in a theory of narrative problematics, we explored how elicited birth narratives were affected by COVID-19 and how stories can be used as material evidence to inform healthcare systems. We facilitated seven focus group discussions with 65 women from 19 states who had given birth between March and July 2020. Three themes emerged from our qualitative thematic analysis: (1) navigating disrupted access to healthcare; (2) experiencing loss of co-construction of birth experience; and (3) recognizing fissures in the mask-wearing master narrative. Practical implications for improving healthcare include developing spaces for individuals to process birth stories for cathartic benefit due to significant disruption, improving hospital policies about in-person support to avoid loss of co-construction of experience, and centering hospitals and the providers that work within them as audiences for interventions around preventive measures during a disease outbreak.Item Breaking Bad News: A Randomized Trial Assessing Resident Performance After Novel Video Instruction(Cureus, 2021-06-05) Shanks, Anthony L.; Brann, Maria; Bute, Jennifer J.; Borse, Vyvian; Tonismae, Tiffany; Scott, Nikki; Obstetrics and Gynecology, School of MedicineIntroduction; Delivering bad news to patients is an essential skill for physicians, which is often developed through patient encounters. Residents in our program participate in objective structured clinical examinations (OSCEs) on an annual basis to evaluate their skills in these scenarios. Our objectives were to develop an educational video and determine if an educational video provided to residents prior to OSCEs would improve performance. Methods: Previous OSCEs were reviewed to identify best practices and to create a four-minute video highlighting the "do's and don'ts" of delivering bad news. Residents in two post-graduate year (PGY) classes were randomized to watch the video prior to or after a standardized patient encounter. Three masked reviewers assessed resident empathy, attention, and understanding on 10 five-point Likert scales and assigned a total score (scale: 0-50). Hedges' g was used to assess mean scores and effect size. Results: A total of 17 residents participated in the evaluation: nine in the pre-OSCE video group and eight in the control group. Residents randomized to the video prior to the patient encounter had a mean score of 37.01 (SD=3.6). Residents randomized to the control group had a mean score of 35.38 (SD=4.85). Hedges' g was 0.37 (95% CI: -0.59 to 1.33). Conclusion: Residents randomized to the video group had a small increase in OSCE performance, which was not statistically significant. The novel video was helpful and addresses the need for a quick pre-assessment educational tool, though interns and graduating medical students may be a more appropriate target audience for instruction.Item Communicating to promote informed decisions in the context of early pregnancy loss(Elsevier, 2017) Brann, Maria; Bute, Jennifer J.; Communication Studies, School of Liberal ArtsObjective. To evaluate residents’ ability to engage standardized patients in informed decision making during a pregnancy loss scenario. Methods. Forty patient encounters between interns and standardized patients were coded to assess informed decision-making practices, exploration of unexpressed concerns, and support provision. Results. Interns engaged in minimum informed decision making but did not address all of the communicative elements necessary for informed decisions, and most elements were only partially addressed. Patients in this study did not receive information about all management options, their concerns were not addressed, and there was limited support communicated for their decision. Conclusion. This study offers an initial assessment of a communicative approach to evaluate and improve decision making during early pregnancy loss. A comprehensive approach to making informed decisions must include discussion of all management options, exploration of patient preferences and concerns, and support for the patient’s decision. Practice Implications. Healthcare providers could benefit from communication skills training to communicate more effectively with patients to help them make more informed decisions.Item The Influence of Everyday Interpersonal Communication on the Medical Encounter: An Extension of Street’s Ecological Model(Taylor & Francis, 2018-06-03) Head, Katharine J.; Bute, Jennifer J.; Communication Studies, School of Liberal ArtsStreet’s ecological model has shaped the research-examining communication during medical encounters for over a decade. Although the model accounts for the variety of contexts that shape the conversations in which patients and health-care providers engage, the model does not adequately address the way that everyday conversations about health carry over into patient–provider interactions. In this essay, we propose an extension of Street’s model that adds the context of everyday communication about health as a contributing factor in the medical encounter. We support the need for this extension by discussing research that points to the ways these conversations with our social network influence communication during the medical encounter and propose new areas for research based on this extension.Item Parents’ Communication Work in the Management of Food Allergies(Taylor & Francis, 2021-02-02) Bute, Jennifer J.; Bowers, Clarissa; Park, Daniel; Communication Studies, School of Liberal ArtsThe National Academies of Sciences, Engineering, and Medicine (NASEM) has identified food allergies as a critical public health issue that significantly affects quality of life for patients and their families. Despite the crisis-level status of food allergies, especially in children, there are currently no curative treatments. As a result, impacted families must learn how to carry the burden of disease management. Using an expanded application of the concept of communication work, this study features data from interviews with 26 parents of food allergic children and explores how parents navigate the nuances of food allergy maintenance while negotiating and preserving valued relationships and identities through everyday talk. Results revealed that parents used communication to legitimate food allergy, balance potential face-threats with identity and relational goals, and coordinate care with spouses. Due to the lack of therapeutic treatment options, we found that parents utilize communication work, which is both demanding and effortful, as a form of disease management.Item Qualitative Assessment of Bad News Delivery Practices during Miscarriage Diagnosis(SAGE, 2020) Brann, Maria; Bute, Jennifer J.; Foxworthy Scott, Susanna; Communication Studies, School of Liberal ArtsMiscarriage is one of the most common pregnancy complications health care providers discuss with patients. Previous research suggests that women’s distress is compounded by ineffective communication with providers, who are usually not trained to deliver bad news using patient-centered dialogue. The purpose of this study was to use a patient-centered approach to examine women’s experiences with and perspectives of communication during a miscarriage to assist in the development of communication training tools for health care providers. During focus groups, 22 women who had experienced miscarriage discussed video-recorded standardized patient-provider interactions and recalled communication during their own miscarriages. Results of a pragmatic iterative analysis of the transcripts suggest training techniques and communication behaviors that should guide education for providers to deliver the diagnosis of and treatment options for early pregnancy loss, such as demonstrating empathy, creating space for processing, checking for understanding, and avoiding medical jargon and emotionally charged language.