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Korkmaz Aslan G, Kılınç İşleyen E, Kartal A, Koştu N. The relation between eHealth literacy and healthy lifestyle behaviours in pregnant women. Health Promot Int 2024; 39:daae022. [PMID: 38501310 DOI: 10.1093/heapro/daae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
The aim of this study was to determine the relationship between eHealth literacy and healthy lifestyle behaviours among pregnant women. This cross-sectional study was conducted in five family health centres in a city in the western part of Turkey. The study sample consisted of 201 pregnant women who were admitted to the five family health centres between September and December 2022. A socio-demographic questionnaire, the eHealth Literacy Scale and the Healthy Lifestyle Behaviours in Pregnancy Scale were used to collect data. Multiple linear regression analysis was used to explore predictors of health-promoting behaviours. The mean score of the eHealth Literacy Scale was 29.37 ± 6.20. The mean score of the Healthy Lifestyle Behaviours Scale was 119.69 ± 13.58. Multiple linear regression showed that predictors of healthy lifestyle behaviours among pregnant women were eHealth literacy, using internet to access health information and gestational age. eHealth literacy was found to be an important factor affecting the healthy lifestyle behaviours of pregnant women. This study highlights the importance of considering pregnant women's eHealth literacy in interventions aimed at improving healthy lifestyle behaviours.
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Affiliation(s)
- Gülbahar Korkmaz Aslan
- Faculty of Health Sciences, Public Health Nursing Department, Pamukkale University, Kınıklı Campus, Pamukkale, Denizli, Türkiye
| | - Eda Kılınç İşleyen
- Faculty of Health Sciences, Public Health Nursing Department, Uşak University, 1 Eylül Campus, Uşak, Türkiye
| | - Asiye Kartal
- Faculty of Health Sciences, Public Health Nursing Department, Pamukkale University, Kınıklı Campus, Pamukkale, Denizli, Türkiye
| | - Nazan Koştu
- Faculty of Health Sciences, Public Health Nursing Department, Pamukkale University, Kınıklı Campus, Pamukkale, Denizli, Türkiye
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Jin YJ, Kim HW. Influence of folic acid knowledge on effective folic acid intake in Chinese pregnant women: a cross-sectional study. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2023; 29:291-301. [PMID: 38204389 PMCID: PMC10788392 DOI: 10.4069/kjwhn.2023.11.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE This study aimed to investigate the current status of effective folic acid intake and the level of folic acid knowledge of Chinese pregnant women and to analyze the relationship between effective folic acid intake and folic acid knowledge. METHODS From November 2021 to May 2022, 140 pregnant women at Yantai Yuhuangding Hospital in the Chinese province of Shandong, answered questions about their general characteristics, folic acid intake, and folic acid knowledge. The data were analyzed using the t-test, chi-square test, and logistic regression analysis, and were presented with frequency with percentage or mean±standard deviation. RESULTS Only 16.4% of the pregnant women (n=23) took folic acid effectively, using the following four criteria. Of all pregnant women who took folic acid, 72.2% took folic acid starting 1 month before pregnancy, 70.8% took folic acid up to 3 months after pregnancy, 36.8% took 400 μg every time, and 78.6% took folic acid more than 24 days every month. The score for folic acid knowledge was relatively high (5.61±2.18 on a scale of 0-9). A higher folic acid knowledge score correlated with more effective folic acid intake (t=4.10, p<.001). CONCLUSION Our study shows that the current recommendations to prevent neural tube defects through effective folic acid intake supplementation are not being fully implemented in China. Furthermore, folic acid knowledge was positively correlated with the effectiveness of its intake. Future education related to effective folic acid intake should emphasize the four methods of effective folic acid intake, especially regarding the recommended dose of 400 μg every time.
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Affiliation(s)
- You Jing Jin
- College of Nursing, Seoul National University, Seoul, Korea
| | - Hae Won Kim
- College of Nursing, Seoul National University, Seoul, Korea
- The Research Institute of Nursing Science Seoul National University, Seoul, Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University, Seoul, Korea
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Ferber M, Chrusciel T, Cantwell S, Salas J, Christopher KM. Pre-pregnancy weight loss associations with prenatal and postpartum mental health conditions: A retrospective cohort study. RESEARCH SQUARE 2023:rs.3.rs-3232490. [PMID: 37720051 PMCID: PMC10503832 DOI: 10.21203/rs.3.rs-3232490/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Background Obesity is a risk factor for adverse outcomes during and following pregnancy. Most women are advised to lose weight prior to becoming pregnant, to help alleviate complications including prenatal and postpartum depression and anxiety. Yet, no studies have examined how the process of losing weight prior to pregnancy interacts with the development of prenatal and postpartum mental health disorders.The objective of the study was to determine if women with pre-pregnancy weight loss (≥10%) vs. those who do not, in the two years prior to pregnancy, have a lower risk for new onset prenatal and postpartum mental health conditions. Methods This retrospective cohort study used data from the Virtual Data Warehouse of a large Midwestern, U.S. based hospital system. The final sample consisted of 6,085 female patients of reproductive age that had given birth between 10/1/2011-6/30/2020 and had two recorded weights in the year prior to conception. Univariate analysis between weight loss and outcome variables (pre-natal and post-partum depression and anxiety) and multivariate analysis using logistic regression was conducted for variable significant on univariate analysis. Results On univariate analysis, women with pre-pregnancy weight loss had increased odds of post-partum depression (OR=1.47, 95%CI=1.03-2.10), though decreased odds of prenatal anxiety (OR=0.59, 95% CI 0.33-0.90). After controlling for confounders in the multivariate analysis, there was not a significant difference in the odds of post-partum depression; however, women who lost weight had approximately half the odds of having prenatal anxiety than those who did not lose weight (OR=0.54, 95%CI=0.33-0.90). Discussion The experience of achieving weight loss prior to pregnancy may foster a sense of agency within pregnant women, helping them to reduce their experience of pre-natal anxiety. Providers could engage in patient conversations around weight loss and mental health management in a strengths-based framework to continue to foster this sense of agency. Conclusion Anxiety and depression were uniquely related to pre-pregnancy weight loss. Pre-pregnancy weight loss was associated with lower odds of prenatal anxiety and higher odds of postpartum depression. These results highlight the need for real world examination of pre-conception treatment recommendations and their association with non-physical health-based outcomes.
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Lang AY, Harrison CL, Boyle JA. Australian women's information-seeking preferences and needs in preparation for pregnancy. Health Promot J Austr 2023; 34:123-128. [PMID: 35596655 PMCID: PMC10087491 DOI: 10.1002/hpja.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/10/2022] [Accepted: 05/18/2022] [Indexed: 01/28/2023] Open
Abstract
ISSUE ADDRESSED The preconception period provides opportunities for health behaviour optimisation for improved maternal and child well-being. However, preconception information sources women engage with are not well-known. METHODS To address this gap, the current cross-sectional study retrospectively explored (1) preconception information or advice accessed on recommended preconception health topics and (2) preferred sources of preconception information amongst pregnant women receiving care through Australian public and private maternity settings. RESULTS Overall, 78% of women reported accessing any preconception health information, predominantly concerning achieving/maintaining a healthy weight, diet, folic acid and multivitamin supplementation. Preferred information sources included health professionals, e.g. general practitioners (74%) and the internet (66%), although source engagement varied. CONCLUSIONS Whilst women predominantly prefer seeking preconception health information from health professionals and the internet, multi-modal resources are needed to reach women and enhance engagement with evidence-based information and healthcare in preparation for pregnancy. SO WHAT?: Evaluation of preconception health resources for women and health professionals is warranted, appraising their adequacy in supporting engagement with key preconception health messages. In particular, assessment of the quality, readability and evidence-base of online resources is needed. Our findings highlight the need for public health experts to take action to raise awareness amongst women of the importance of preconception health, encourage health professional engagement for preconception care and direct women to more appropriate evidence-based online resources.
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Affiliation(s)
- Adina Y Lang
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Channon S, Coulman E, Cannings-John R, Henley J, Lau M, Lugg-Widger F, Strange H, Davies F, Sanders J, Scherf C, Couzens Z, Morantz L. Acceptability and feasibility of a planned preconception weight loss intervention in women with long-acting reversible contraception: the Plan-it mixed-methods study. Health Technol Assess 2023; 27:1-224. [PMID: 36688498 PMCID: PMC9885302 DOI: 10.3310/nkix8285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Women with overweight (a body mass index of ≥ 25 kg/m2) or obesity (a body mass index of ≥ 30 kg/m2) are at greater risk of experiencing complications during pregnancy and labour than women with a healthy weight. Women who remove their long-acting reversible contraception (i.e. coils or implants) are one of the few groups of people who contact services as part of their preparation for conception, creating an opportunity to offer a weight loss intervention. OBJECTIVES The objectives were to understand if routine NHS data captured the pathway from long-acting reversible contraception removal to pregnancy and included body mass index; to identify the suitable components of a preconception weight loss intervention; and to engage with key stakeholders to determine the acceptability and feasibility of asking women with overweight/obesity to delay the removal of their long-acting reversible contraception in order to take part in a preconception weight loss intervention. DESIGN This was a preparatory mixed-methods study, assessing the acceptability and feasibility of a potential intervention, using routine NHS data and purposefully collected qualitative data. PARTICIPANTS The NHS routine data included all women with a long-acting reversible contraception code. There were three groups of participants in the surveys and interviews: health-care practitioners who remove long-acting reversible contraception; weight management consultants; and women of reproductive age with experience of overweight/obesity and of using long-acting reversible contraception. SETTING UK-based health-care practitioners recruited at professional meetings; and weight management consultants and contraceptive users recruited via social media. DATA SOURCES Anonymised routine data from UK sexual health clinics and the Clinical Practice Research Datalink, including the Pregnancy Register; and online surveys and qualitative interviews with stakeholders. RESULTS The records of 2,632,871 women aged 16-48 years showed that 318,040 had at least one long-acting reversible contraception event, with 62% of records including a body mass index. Given the identified limitations of the routine NHS data sets, it would not be feasible to reliably identify women with overweight/obesity who request a long-acting reversible contraception removal with an intention to become pregnant. Online surveys were completed by 100 health-care practitioners, four weight management consultants and 243 contraceptive users. Ten health-care practitioners and 20 long-acting reversible contraception users completed qualitative interviews. A realist-informed approach generated a hypothesised programme theory. The combination of weight discussions and the delay of long-acting reversible contraception removal was unacceptable as an intervention to contraceptive users for ethical and practical reasons. However, a preconception health intervention incorporating weight loss could be acceptable, and one potential programme is outlined. LIMITATIONS There was very limited engagement with weight management consultants, and the sample of participating stakeholders may not be representative. CONCLUSIONS An intervention that asks women to delay long-acting reversible contraception removal to participate in a preconception weight loss intervention would be neither feasible nor acceptable. A preconception health programme, including weight management, would be welcomed but requires risk communication training of health-care practitioners. FUTURE WORK Work to improve routine data sets, increase awareness of the importance of preconception health and overcome health-care practitioner barriers to discussing weight as part of preconception care is a priority. TRIAL REGISTRATION This trial is registered as ISRCTN14733020. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 1.
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Affiliation(s)
- Susan Channon
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Elinor Coulman
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Josie Henley
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Mandy Lau
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Freya Davies
- The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Caroline Scherf
- Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
| | - Zoë Couzens
- Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
| | - Leah Morantz
- 1Centre for Trials Research, Cardiff University, Cardiff, UK
- 2The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
- 3School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- 4Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
- 5Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
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Dennis CL, Birken CS, Brennenstuhl S, Wrottesley S, Marini F, Bell RC, Tremblay MS, Prioreschi A. Describing 24-hour movement behaviours among preconception and recently pregnant Canadian parents: who do we need to target? Behav Med 2023; 49:83-95. [PMID: 34809524 DOI: 10.1080/08964289.2021.1987854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study aimed to describe adherence to 24-hour movement guidelines and determine factors associated with meeting guidelines in pregnancy planning and recently postpartum parents. A survey of preconception care attitudes and beliefs was conducted in Canadian adults who were pregnancy planning or ≤5 years postpartum. The Global Physical Activity Questionnaire was used to evaluate physical activity and sedentary time. Respondents reported the number of hours spent sleeping and using a screen per day. Multiple logistic regressions were run to determine factors (sociodemographic and health related) associated with meeting each individual movement guideline and number of guidelines met. 1080 females and 224 males provided survey data. 54.0% (n = 654) of the sample met the physical activity guideline, with no difference between females and males. More than 78.4% (n = 909) met the sedentary behavior guideline, 56.4% (n = 679) met the sleep guideline, and 15.4% (n = 187) met the screen time guideline. Only 5.0% (n = 60) of the sample met all four guidelines. Higher odds of meeting more guidelines were associated with parity and perceived health. Lower odds of meeting more guidelines were associated with obesity and overweight; and with depression. Most parents and parents-to-be are not meeting 24-hour movement guidelines. Interventions should focus on optimizing movement behaviors in the peri-partum period, while focusing on mental health, obesity, and general wellbeing.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Catherine S Birken
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Stephanie Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Rezaee R, Ravangard R, Amani F, Dehghani Tafti A, Shokrpour N, Bahrami MA. Healthy lifestyle during pregnancy: Uncovering the role of online health information seeking experience. PLoS One 2022; 17:e0271989. [PMID: 35913949 PMCID: PMC9342740 DOI: 10.1371/journal.pone.0271989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
In the new era, many people seek their health-related information through the Internet due to the increasing access to this technology. Searching online health information can affect the health behavior. This study aimed to investigate the correlation between online health information-seeking behavior and a healthy lifestyle during pregnancy in a sample of Iranian pregnant women. This cross-sectional study was conducted among pregnant women admitted to health centers of Eghlid city, Fars province, Iran in 2019. A total of 193 women participated in the study. The required data were gathered using two validated questionnaires to measure the online health information-seeking behavior and the healthy lifestyle practices of the participants. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 22. Online health information experience and its subscales showed no statistical correlation with a healthy lifestyle. Age and education did not correlate with online health information-seeking behavior. Age had a statistical correlation with a healthy lifestyle, but education had the same correlation only with some subscales of a healthy lifestyle. The findings were surprising, suggesting that online health information-seeking behavior does not affect the lifestyle of pregnant women. These finding and probable explanations are discussed, but due to the limited literature on the subject, further studies are recommended to be conducted.
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Affiliation(s)
- Rita Rezaee
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Ramin Ravangard
- Healthcare Management Department, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Fahime Amani
- Healthcare Management Department, Shahid Sadoughi University of Medical Sciences, Yazd, Yazd, Iran
| | - Arefeh Dehghani Tafti
- Biostatistics Department, Kerman University of Medical Sciences, Kerman, Kerman, Iran
| | - Nasrin Shokrpour
- English Department, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Mohammad Amin Bahrami
- Healthcare Management Department, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
- * E-mail:
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Planning is not equivalent to preparing, how Dutch women perceive their pregnancy planning in relation to preconceptional lifestyle behaviour change - a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:577. [PMID: 35854217 PMCID: PMC9295368 DOI: 10.1186/s12884-022-04843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Unhealthy prenatal lifestyle behaviours are associated with adverse pregnancy outcomes, but little is known about what motivates women to comply with preconceptional lifestyle recommendations or consciously plan their pregnancy. Therefore, the objective of this study is to explore the associations between preconceptional lifestyle behaviours, health beliefs and pregnancy planning among Dutch pregnant women. Methods In this cross-sectional study based on the data of the APROPOS-II study, 1,077 low-risk pregnant women were eligible for inclusion. Preconception lifestyle behaviours and actively preparing for pregnancy were assessed in relation to planned pregnancies (based on the London Measure of Unplanned Pregnancies) and health beliefs (14 statements). The following preconceptional lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester of pregnancy: fruit intake, vegetable intake, caffeine intake, (second-hand)smoking, alcohol intake, folic acid supplement use and exercise. Data were analysed using multivariate logistic regression analyses. Results A total of 921 (85.5%) women in our cohort had a planned pregnancy. However, of these women, 640 (69.5%) adequately used folic acid supplements and 465 (50.5%) women consumed alcohol at any point during pregnancy. Of the women considering themselves ‘healthy enough and not needing preconception care’, 48 (9.1%) women had an adequate vegetable intake, 294 (55.6%) women consumed alcohol at any point during pregnancy and 161 (30.4%) women were either over-or underweight. Conclusion Despite consciously planning their pregnancy, most women did not adhere to preconceptional lifestyle behaviour recommendations. Women’s health beliefs and overestimation of their health status seem to interfere with actively planning and preparing for pregnancy. Findings from our study may encourage the development of prospective health-promoting interventions that focus on health beliefs and actively preparing for pregnancy, to improve preconceptional lifestyle behaviours, thereby optimizing the health of future generations. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04843-4.
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Corrales-Gutierrez I, Baena-Antequera F, Gomez-Baya D, Leon-Larios F, Mendoza R. Relationship between Eating Habits, Physical Activity and Tobacco and Alcohol Use in Pregnant Women: Sociodemographic Inequalities. Nutrients 2022; 14:nu14030557. [PMID: 35276912 PMCID: PMC8839613 DOI: 10.3390/nu14030557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Pregnant women must maintain or acquire healthy habits during pregnancy to protect both their own health and their child's. Such habits include an adequate eating pattern along with good adherence to the intake of certain supplements, practice of moderate physical activity and avoiding the consumption of toxic products such as tobacco and alcohol. The objective of this study is to assess the interrelation between such habits and their association with sociodemographic variables. To such end, a cross-sectional study was conducted with a representative sample of pregnant women who attended the scheduled morphology echography consultation at the 20th gestational week in their reference public hospital in the city of Seville (Spain). Results: Younger pregnant women and with lower educational levels are the ones that present the worst eating habits and the highest smoking rate. Pregnant women with lower educational levels are the least active. Non-smoking pregnant women present better eating habits than those who smoke. Pregnant women with lower educational levels are those who accumulate more unhealthy habits during pregnancy. This should be taken into account when planning the health care provided to pregnant women and in public health intersectoral policies.
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Affiliation(s)
- Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, University of Seville, 41009 Seville, Spain
| | - Francisca Baena-Antequera
- Obstetric Unit, University Hospital Virgen de Valme, 41014 Seville, Spain
- Nursing Department, Osuna’s University School, 41640 Osuna, Spain
- Correspondence: ; Tel.: +34-615-51-95-65
| | - Diego Gomez-Baya
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Ramon Mendoza
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
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Linda I, Santoso H, Lubis Z, Siregar MFG. Empowering Village Health Workers to Influence Preconception Behavior and Increase Utilization of Preconception Health Services in the Deli Serdang Regency. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Preconception health care are critical in addressing modifiable risk factors to prevent maternal death, neonatal death, unplanned pregnancies, birth defects, premature birth and retardation of fetal growth in the womb.
AIM: The aim of this study was to determine the impact of preconception health cadres empowerment on changed in preconception health behaviors of brides and grooms-to-be, as well as improved utilization of preconception health services at eight community health centers in the Deli Serdang district.
METHODS: This research is part of a dissertation study entitled Preconception Period Service Strategy on Brides and Grooms-to-Be through Empowerment of Preconception Health Cadres in Deli Serdang Regency. The effect of the empowerment of preconception health cadres in preconception health behaviors performed by Wilcoxon Signed Rank Test with the statistical significance test with CI 95% and significant difference value p<0,05. The Normalized Gain (N-gain score) test is used to assess the effectiveness of the intervention.
RESULTS. There is a significant influence of preconception health cadres empowerment interventions on the knowledge, attitudes, and actions of brides and grooms-to-be in preconception health with the same probability value of p=0.001. Most brides and grooms-to-be (80%) take advantage of preconception health services at health centers after following the intervention of empowerment of preconception health cadres.
CONCLUSIONS. Interventions empowering preconception health cadres significantly affect the behavior of the brides and grooms-to-be and quite effective in increasing knowledge and actions of brides and grooms-to-be in preconception health.
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Ojifinni OO, Ibisomi L. Health Care Providers Perceptions About Preconception Care in Ibadan, Southwest Nigeria: A Qualitative Study. Matern Child Health J 2022; 26:587-600. [PMID: 34982335 DOI: 10.1007/s10995-021-03305-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. PCC services are minimally available and not fully integrated into maternal health services in Nigeria. This study explored perceptions about PCC services among health care providers in Ibadan, Nigeria. METHODS Using a qualitative case study design the perspectives of 26 health care providers-16 specialist physicians and nine nurses covering 10 specialties at the primary, secondary and tertiary health care levels was explored. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis. RESULTS Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed between lower and higher levels. Participants stated that although all people of reproductive age would benefit from PCC, those who had medical problems like hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice. They identified potential benefits of PCC including opportunity to prepare for pregnancy to ensure positive pregnancy outcomes. CONCLUSIONS FOR PRACTICE Preconception care is perceived as important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will require establishment of guidelines and uptake will depend on acceptability to community members who will benefit from the service.
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Affiliation(s)
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Nigerian Institute of Medical Research, Lagos, Nigeria
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Bagherzadeh R, Gharibi T, Safavi B, Mohammadi SZ, Karami F, Keshavarz S. Pregnancy; an opportunity to return to a healthy lifestyle: a qualitative study. BMC Pregnancy Childbirth 2021; 21:751. [PMID: 34740317 PMCID: PMC8569967 DOI: 10.1186/s12884-021-04213-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
Background The lifestyle of the mother during pregnancy can affectthe health of their baby. Since lifestyle change is a sociocultural act and the motivations associated with lifestyle patterns during pregnancy cannot be explained in quantitative studies, a comprehensive study of the lifestyle during pregnancy and factors influencing its patterns was needed to investigate it from different aspects. Thus, the present study aimed to explore ‘mothers’ perceptions and experiences about lifestyle patterns during and after pregnancy and the reasons for adopting these lifestyles. Methods The present study, conducted on 20 pregnant or postpartum women living in Bushehr, Iran, has used a conventional content analysis approach. The purposeful sampling method was used with maximum diversity and continued until data saturation. data were collected through face-to-face, in-depth, semi-structured interviews. Informed consent was obtained from all participants, and assuringthe confidentiality of their information. MAXQDA 10 software was used to analyze the data. Results Four main themes were defined after data analysis; "Being a mother as motivation for adopting a new healthy lifestyle"; "Access to information from media and supports from physicians as facilitators of adopting healthy lifestyle"; "Aspects of lifestyle modifications" and "Durability of healthy lifestyles". When women become pregnant, they feel a responsibility tohave a healthy pregnancy. They care about their fetuses more than themselves, which motivated them to look for the best lifestyle. In this way, access information from mass media and recommendations from professionals (physicians, midwives, and other health care providers) were helpful factors to have a healthy lifestyle, leading to modifying physical, mental, and religious aspects of lifestyle. However, despite reminding the advantages of a healthy lifestyle, these changesshift to a pre-pregnancy lifestyle due to the cessation of support and care provided during pregnancy. Conclusion The study results showed that pregnant women should be motivated to modify their lifestyle andadopt healthy lifestyles. Pregnant women seek to modify their lifestyle because of motherhood responsibility and and having a healthy baby. Access to information and supports from various sources promote a mother’s inner decision to change, leading to modifying different aspects of life. However, these modifications often shift to the pre-pregnancy lifestyle due to cessation of supports and care, despite reminding the benefits of the lifestyle change. Health care providers should consider supportive measures during pregnancy and postpartum.
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Affiliation(s)
- Razieh Bagherzadeh
- Department of Midwifery, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Tayebeh Gharibi
- Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bahare Safavi
- School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Fatemeh Karami
- Baqiyatallah Azam Hospital, Maternity Ward, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sedigheh Keshavarz
- Department of Midwifery, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.
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Pirotta S, Joham AE, Moran LJ, Skouteris H, Lim SS. Informing a PCOS Lifestyle Program: Mapping Behavior Change Techniques to Barriers and Enablers to Behavior Change Using the Theoretical Domains Framework. Semin Reprod Med 2021; 39:143-152. [PMID: 34433214 DOI: 10.1055/s-0041-1735456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article aimed to identify the behavior change techniques (BCTs) based on facilitators and barriers to lifestyle management in women with polycystic ovary syndrome (PCOS) according to the behavior change wheel (BCW). This qualitative study design using inductive thematic analysis following semistructured interviews (n = 20) identified barriers and enablers to lifestyle management. These were then mapped to Capability, Opportunity, Motivation-Behavioral Model (COM-B) constructs and the corresponding Theoretical Domains Framework (TDF) domains. This study included women with PCOS residing in Australia. Main outcome measures include intervention functions, policy categories, and BCTs described in the BCW. Twenty-three BCTs were recognized to influence behavior change in women with PCOS. Factors were categorized into the subcomponents of the COM-B: psychological capability (e.g., lack of credible information), physical capability (e.g., managing multiple health conditions), physical opportunity (e.g., limited access to resources), social opportunity (e.g., adequate social support), reflective motivation (e.g., positive health expectancies following behavior change), and automatic motivation (e.g., emotional eating). Future research should use this work to guide PCOS lifestyle intervention development and then test intervention effectiveness through an experimental phase to provide empirical evidence for wider use and implementation of tailored, theory-informed PCOS lifestyle programs as part of evidence-based PCOS management.
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Affiliation(s)
- Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A E Joham
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Diabetes, Monash Health, Clayton, Victoria, Australia
| | - L J Moran
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Warwick Business School, Warwick University, Coventry, United Kingdom
| | - S S Lim
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Gonfa FT, Lemu YK, Koricha ZB. Predictors of Women's awareness of common non-communicable diseases screening during preconception period in Manna District, Southwest Ethiopia: implication for wellness check-up. BMC Health Serv Res 2021; 21:56. [PMID: 33435962 PMCID: PMC7802272 DOI: 10.1186/s12913-021-06067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/07/2021] [Indexed: 12/11/2022] Open
Abstract
Background Non-communicable diseases (NCDs) are the dominant cause of global morbidity and mortality, especially in developing countries. Tackling NCDs is central to advancing women’s and child health, and future generations. Many NCDs can be prevented with appropriate approaches across the maternal and child health life-cycle, throughout the years of reproductive age especially before conception and continuing through pregnancy. However, women’s awareness of NCDs screening during the preconception period was not well known in many countries including Ethiopia. Therefore, this study aimed to assess women’s awareness of common NCDs screening during the preconception period and associated factors in Manna District, Jimma Zone, Oromia Region, Ethiopia, 2019. Methods A community-based cross-sectional study was conducted from March 02 to April 10, 2019. The sample size was 636 pregnant women from eight randomly selected rural kebeles and a purposively taken urban kebele. The data were collected using a pre-tested structured questionnaire and entered into Epi data manager version 4.0.2 and exported to SPSS version 21. Descriptive, binary, and multivariable logistic regression analyses were carried out. Results Of the total of 623 respondents, 459 (73.7%) of them had good awareness of common NCDs screening during the preconception period. Women who had formal education [AOR = 1.95, 95% CI: (1.31–2.89)], those who had planned pregnancy [AOR = 2.17, 95% CI: (1.47–3.19)], on ANC follow up [AOR = 1.79, 95% CI: (1.16–2.74], and those who had media (radio and/or television) in their house [AOR = 1.55, 95% CI: (1.05–2.29)] had good awareness on common NCDs screening during the preconception period compared to their counterparts. Conclusions In this study, nearly three-quarters of respondents had a good awareness of common NCDs screening during the preconception period. Women’s educational status, pregnancy planning status, ANC visit, and having radio and/or television in the house were predictors of women’s good awareness of common NCDs screening during the preconception period. Therefore, all concerned bodies are recommended to work toward increasing women’s awareness using different approaches like awareness creation campaigns and counseling clients attending health facilities.
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Affiliation(s)
- Firanbon Teshome Gonfa
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
| | - Yohannes Kebede Lemu
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Zewdie Birhanu Koricha
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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15
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Benton MR, Tape N, Deussen AR, Turnbull D, Dodd JM. Barriers to and facilitators for addressing overweight and obesity before conception: A qualitative study. Women Birth 2020; 34:e493-e497. [PMID: 33077404 DOI: 10.1016/j.wombi.2020.09.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Obesity is a significant global health issue, especially for reproductive-aged women. Women who enter pregnancy overweight or obese are at increased risk of a range of adverse reproductive, maternal, and child health outcomes. The preconception period has been recognised as a critical time to intervene to improve health outcomes for women and their children. Despite this recognition, adequate information is significantly lacking in relation to women's health experiences, behaviours, and information preferences to inform the development of high-quality preconception intervention strategies. AIM This study aimed to examine women's perspectives of barriers, enablers, and strategies for addressing overweight and obesity before conception. METHOD Using a qualitative research design, twelve multiparous women, aged between 32 and 43 years, who considered themselves to be overweight or obese were interviewed. Data were analysed using thematic analysis. FINDINGS Three themes were identified in relation to barriers: lack of information and knowledge, time constraints, and affordability. The following four themes emerged with respect to enablers and strategies: knowledge provision, accountability and motivation, regular contact, and habit formation. CONCLUSION Key factors to incorporate in women-centred interventions for preconception weight loss include multi-faceted knowledge provision and practical affordable methods for supporting healthy behaviours. Interventions should integrate techniques for ensuring regular contact with support networks, to enhance accountability, motivation, and facilitate habit formation. Further research is now being conducted by our team to co-design interventions and strategies informed by these findings.
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Affiliation(s)
- Madeleine R Benton
- School of Psychology, The University of Adelaide, South Australia, Australia.
| | - Nicole Tape
- School of Psychology, The University of Adelaide, South Australia, Australia
| | - Andrea R Deussen
- The University of Adelaide, Discipline of Obstetrics and Gynaecology and Robinson Research Institute, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, The University of Adelaide, South Australia, Australia
| | - Jodie M Dodd
- The University of Adelaide, Discipline of Obstetrics and Gynaecology and Robinson Research Institute, South Australia, Australia; The Women's and Children's Hospital, Women's and Babies Division, Department of Perinatal Medicine, South Australia, Australia
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16
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Sijpkens MK, van Voorst SF, Rosman AN, de Jong-Potjer LC, Denktaş S, Koch BCP, Bertens LCM, Steegers EAP. Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study. Am J Health Promot 2020; 35:116-120. [PMID: 32431156 PMCID: PMC7747029 DOI: 10.1177/0890117120927287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose: To evaluate the effects of preconception care (PCC) consultations by change in lifestyle behaviors. Setting and Intervention: Women in deprived neighborhoods of 14 Dutch municipalities were encouraged to visit a general practitioner or midwife for PCC. Sample: The study included women aged 18 to 41 years who had a PCC consultation. Design: In this community-based prospective cohort study, we assessed initiation of folic acid supplementation, cessation of smoking, alcohol consumption, and illicit drug use. Measures: Self-reported and biomarker data on behavioral changes were obtained at baseline and 3 months later. Analysis: The changes in prevalence were assessed with the McNemar test. Results: Of the 259 included participants, paired analyses were available in 177 participants for self-reported outcomes and in 82 for biomarker outcomes. Baseline self-reported prevalence of no folic acid use was 36%, smoking 12%, weekly alcohol use 22%, and binge drinking 17%. Significant changes in prevalence toward better lifestyle during follow-up were seen for folic acid use (both self-reported, P < .001; and biomarker-confirmed, P = .008) and for self-reported binge drinking (P = .007). Conclusion: Our study suggests that PCC contributes to initiation of folic acid supplementation and cessation of binge drinking in women who intend to become pregnant. Although based on a small sample, the study adds to the limited body of evidence regarding the benefits of PCC in improving periconception health.
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Affiliation(s)
- Meertien K Sijpkens
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sabine F van Voorst
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ageeth N Rosman
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Lieke C de Jong-Potjer
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Semiha Denktaş
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Psychology, Education and Child Studies, 6993Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Birgit C P Koch
- Department of Hospital Pharmacy, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Loes C M Bertens
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, 6993Erasmus University Medical Center, Rotterdam, the Netherlands
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17
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Ebadi T, Narjes Sadat B, Bayrami R, Mehrbakhsh Z. Preconception Care Patterns and Some Related Factors in Pregnant Women in Gorgan in 2017. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2019. [DOI: 10.29252/jgbfnm.16.2.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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18
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Preconception Health Attitudes and Behaviours of Women: A Qualitative Investigation. Nutrients 2019; 11:nu11071490. [PMID: 31261954 PMCID: PMC6682867 DOI: 10.3390/nu11071490] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 12/11/2022] Open
Abstract
The preconception period is a critical window in which maternal health can profoundly affect both individual and intergenerational health. Despite its importance, little information about women’s preconception health attitudes, behaviours and information preferences exists, yet these details are vital to inform targeted health communication. Semi-structured interviews were conducted to explore women’s attitudes to preconception health (areas of importance, support sources, enablers and barriers), behaviours (information seeking and health actions taken) and information preferences. Interviews were transcribed, coded and thematically analysed. Fifteen women participated (n = 7 preconception, n = 7 pregnant and n = 1 postpartum). Women perceived optimising lifestyle behaviours including a healthy diet, regular physical activity, reducing alcohol intake and pre-pregnancy vitamin supplementation as important preconception health actions to adopt. Few women acknowledged the importance of formal preconception health checks and screening with health professionals. Barriers to achieving health behaviour change included anxiety, stress and challenges obtaining reputable information. Participants reported a lack of preconception information about supplementation requirements, safe foods and exercise recommendations. Information preferences included the internet or their general practitioner. Whilst women predominantly prioritised optimising diet and physical activity prior to pregnancy, there appeared to be limited awareness of preconception health checks and screening, highlighting a need for broader awareness of overall preconception health and wellbeing.
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19
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Allan HT, Mounce G, Crespo E, Shawe J. Preconception care for infertile couples: Nurses' and midwives' roles in promoting better maternal and birth outcomes. J Clin Nurs 2018; 27:4411-4418. [PMID: 29943889 DOI: 10.1111/jocn.14586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/18/2018] [Accepted: 06/16/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Preconception care promotes better maternal outcomes, may assist in preventing birth defects and improves fertility awareness among healthy childbearing couples. Yet, the significance of preconception care for infertile couples is undeveloped area of practice in Europe. AIMS AND OBJECTIVES To discuss the importance of nurses and midwives in providing preconception care to infertile couples in the United Kingdom and Spain. DESIGN Discursive paper. METHOD A comparison of different midwifery and nursing approaches to preconception care for infertile couples in two European countries. FINDINGS At present, infertile couples' needs for preconception care are not routinely identified or understood. There is an opportunity for these needs to be considered and identified by nurses at the time of investigation for infertility or when planning pregnancy with assisted conception. CONCLUSIONS We argue that, by providing preconception care, nurses and midwives have an opportunity to deliver important advice to infertile couples in both primary care and specialist infertility services.
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Affiliation(s)
| | - Ginny Mounce
- University of Oxford/Oxford Fertility, Oxford, UK
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20
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Goossens J, De Roose M, Van Hecke A, Goemaes R, Verhaeghe S, Beeckman D. Barriers and facilitators to the provision of preconception care by healthcare providers: A systematic review. Int J Nurs Stud 2018; 87:113-130. [PMID: 30096578 DOI: 10.1016/j.ijnurstu.2018.06.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Healthcare providers play an important role in providing preconception care to women and men of childbearing age. Yet, the provision of preconception care by healthcare providers remains low. OBJECTIVES To provide an overview of barriers and facilitators at multiple levels that influence the provision of preconception care by healthcare providers. DESIGN A mixed-methods systematic review. DATA SOURCES PubMed, Web of Science, CINAHL, The Cochrane Library, and EMBASE were systematically searched up to April 27, 2017. The search strategy contained MeSH terms and key words related to preconception care and healthcare providers. Reference lists of included studies and systematic reviews on preconception care were screened. REVIEW METHODS Publications were eligible if they reported on barriers and facilitators influencing the provision of preconception care by healthcare providers. Data were extracted by two independent reviewers using a data extraction form. Barriers and facilitators were organized based on the social ecological model. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme Qualitative checklist for qualitative studies, the Quality Assessment Tool for quantitative studies, and the Mixed Methods Appraisal Tool for mixed methods studies. RESULTS Thirty-one articles were included. Barriers were more reported than facilitators. These were situated at provider level (unfavourable attitude and lack of knowledge of preconception care, not working in the field of obstetrics and gynaecology, lack of clarity on the responsibility for providing preconception care) and client level (not contacting a healthcare provider in the preconception stage, negative attitude, and lack of knowledge of preconception care). Limited resources (lack of time, tools, guidelines, and reimbursement) were frequently reported at the organizational and societal level. CONCLUSIONS Healthcare providers reported more barriers than facilitators to provide preconception care, which might explain why the provision of preconception care is low. To overcome the different client, provider, organizational, and societal barriers, it is necessary to develop and implement multilevel interventions.
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Affiliation(s)
- Joline Goossens
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 5K3, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Marjon De Roose
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 5K3, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Ann Van Hecke
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 5K3, De Pintelaan 185, B-9000 Ghent, Belgium; Nursing Science, University Hospital Ghent, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Régine Goemaes
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 5K3, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Sofie Verhaeghe
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 5K3, De Pintelaan 185, B-9000 Ghent, Belgium; VIVES University College, Department Health Care, Wilgenstraat 32, B-8800 Roeselare, Belgium
| | - Dimitri Beeckman
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 5K3, De Pintelaan 185, B-9000 Ghent, Belgium; School of Health Sciences, Faculty of Health & Medical Sciences, Duke of Kent Building, University of Surrey Guildford Surrey, GU2 7XH, United Kingdom.
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M'hamdi HI, Sijpkens MK, de Beaufort I, Rosman AN, Steegers EA. Perceptions of pregnancy preparation in women with a low to intermediate educational attainment: A qualitative study. Midwifery 2018; 59:62-67. [PMID: 29396381 DOI: 10.1016/j.midw.2018.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 12/07/2017] [Accepted: 01/03/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE in the promotion of periconceptional health, appropriate attention has to be given to the perceptions of those who are most vulnerable, such as women with a relatively low socioeconomic status based on their educational attainment. The aim of this study was to explore these women's perceptions of pregnancy preparation and the role they attribute to healthcare professionals. DESIGN we conducted semi-structured interviews with women with a low to intermediate educational attainment and with a desire to conceive, of which a subgroup had experience with preconception care. Thematic content analysis was applied on the interview transcripts. FINDINGS the final sample consisted of 28 women. We identified four themes of pregnancy preparation perceptions: (i)"How to prepare for pregnancy?", which included health promotion and seeking healthcare; (ii) "Why prepare for pregnancy?", which mostly related to fertility and health concerns; (iii) "Barriers and facilitators regarding pregnancy preparation", such as having limited control over becoming pregnant as well as the health of the unborn; (iv) "The added value of preconception care", reported by women who had visited a consultation, which consisted mainly of reassurance and receiving information. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE the attained insights into the perceptions of women with a low to intermediate education are valuable for adapting the provision of preconception care to their views. We recommend the proactive offering of preconception care, including information on fertility, to stimulate adequate preparation for pregnancy and contribute to improving perinatal health among women who are socioeconomically more vulnerable.
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Affiliation(s)
- Hafez Ismaili M'hamdi
- Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Meertien K Sijpkens
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Inez de Beaufort
- Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Ageeth N Rosman
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Eric Ap Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Goossens J, Beeckman D, Van Hecke A, Delbaere I, Verhaeghe S. Preconception lifestyle changes in women with planned pregnancies. Midwifery 2017; 56:112-120. [PMID: 29096279 DOI: 10.1016/j.midw.2017.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 09/05/2017] [Accepted: 10/09/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVES (1) to study preconception lifestyle changes and associated factors in women with planned pregnancies; (2) to assess the prevalence of risk factors for adverse pregnancy outcomes in women not reporting any preconception lifestyle changes; and (3) to explore the need for and use of preconception-related advice. DESIGN secondary data analysis of a cross-sectional study about pregnancy planning. SETTING six Flemish Hospitals (Belgium). PARTICIPANTS four hundred and thirty women with a planned pregnancy ending in birth. MEASUREMENTS preconception lifestyle changes were measured during the first 5 days postpartum using the validated London Measure of Unplanned Pregnancy. The following changes were assessed: folic acid or multivitamin intake, smoking reduction or cessation, alcohol reduction or cessation, caffeine reduction or cessation, eating more healthily, achieving a healthier weight, obtaining medical or health advice, or another self-reported preconception lifestyle change. FINDINGS most women (83%) that planned their pregnancy reported ≥1 lifestyle change in preparation for pregnancy. Overall, nulliparous women (OR 2.18, 95% CI 1.23-3.87) and women with a previous miscarriage (OR 2.44, 95% CI 1.14-5.21) were more likely to prepare for pregnancy, while experiencing financial difficulties (OR 0.20, 95% CI 0.04-0.97) or having a lower educational level (OR 0.56, 95% CI 0.32-0.99) decreased the likelihood of preparing for pregnancy. Half of the women (48%) obtained advice about preconception health, and 86% of these women received their advice from a professional caregiver. Three-quarters (77%) of the women who did not improve their lifestyle before conceiving reported one or more risk factors for adverse pregnancy outcomes. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE multiparous women and women of lower socio-economic status were less likely to change their lifestyle before conception. Strategies to promote preconception health in these women need to be tailored to their needs and characteristics to overcome barriers to change. It may be advantageous to reach these women through non-medical channels, such as schools or other community organizations.
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Affiliation(s)
- Joline Goossens
- University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Dimitri Beeckman
- University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Ann Van Hecke
- University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium; Nursing Science, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Ilse Delbaere
- VIVES University College, Doorniksesteenweg 145, 8500 Kortrijk, Belgium.
| | - Sofie Verhaeghe
- University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
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