Lukas Kötting

• Patient safety, as a topic that has been under constant development for several decades with the aim of increasing it, is associated with an understudied target behaviour: safe communication behaviour of pregnant women. Study one refers to N= 424 cross-sectional self-administered data. The evaluation was carried out via path modelling. In the second study (N=367), the effectiveness of two forms of intervention developed in the project for improving safe communication was tested using repeated measures analyses of covariance (ANCOVAs) for a before-and-after comparison, whereby the online live seminar and control group followed an RCT design. In the third study (N=1187), psychological predictors of safe communication as well as sociodemographic characteristics were identified using hierarchical regression. Risk factors associated with early drop out within the web app were identified using logistic regression. Results from Study 1 show that an adapted HAPA fitted the data best, whereby two sequential mediations emerged. Regarding Study 2 results indicate that women participating in the digital live seminar improved their safe communication behaviour and perceived patient more compared to women using the web app. Study 3 identified that younger women are at risk for early dropout in the web app. Action planning revealed as a core finding in predicting safe communication behaviour over the course of the web app. Psychological mechanisms and their social-cognitive determinants in the motivational phase of pregnant women's intention to communicate safely are mediated by coping-specific as well as planning-specific volitional determinants and could be identified and explained. Younger age is a risk factor for early discontinuation in the web-app. This thesis shows how digital applications could be built, developed and implemented from a psychological perspective in the future and is addressed to pregnant women, to health care providers and to researchers.