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Nagpal TS, Angrish K, Bonisteel E, Puhl RM, Ferraro ZM, Malkani NM, LeJour C, Adamo KB. 'It's not me, it's them' - a report describing the weight-related attitudes towards obesity in pregnancy among maternal healthcare providers. BMC Pregnancy Childbirth 2024; 24:404. [PMID: 38831416 PMCID: PMC11149224 DOI: 10.1186/s12884-024-06591-z] [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: 12/05/2023] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Occurrences of weight stigma have been documented in prenatal clinical settings from the perspective of pregnant patients, however little is known from the viewpoint of healthcare providers themselves. Reported experiences of weight stigma caused by maternal healthcare providers may be due to negative attitudes towards obesity in pregnancy and a lack of obesity specific education. The objective of this study was to assess weight-related attitudes and assumptions towards obesity in pregnancy among maternal healthcare providers in order to inform future interventions to mitigate weight stigma in prenatal clinical settings. METHODS A cross-sectional survey was administered online for maternal healthcare providers in Canada that assessed weight-related attitudes and assumptions towards lifestyle behaviours in pregnancy for patients who have obesity. Participants indicated their level of agreement on a 5-point likert scale, and mean scores were calculated with higher scores indicating poorer attitudes. Participants reported whether they had observed weight stigma occur in clinical settings. Finally, participants were asked whether or not they had received obesity-specific training, and attitude scores were compared between the two groups. RESULTS Seventy-two maternal healthcare providers (midwives, OBGYNs, residents, perinatal nurses, and family physicians) completed the survey, and 79.2% indicated that they had observed pregnant patients with obesity experience weight stigma in a clinical setting. Those who had obesity training perceived that their peers had poorer attitudes (3.7 ± 0.9) than those without training (3.1 ± 0.7; t(70) = 2.23, p = 0.029, Cohen's d = 0.86). CONCLUSIONS Weight stigma occurs in prenatal clinical environments, and this was confirmed by maternal healthcare providers themselves. These findings support advocacy efforts to integrate weight stigma related content and mitigation strategies in medical education for health professionals, including maternal healthcare providers. Future work should include prospective examination of weight related attitudes among maternal healthcare providers and implications of obesity specific education, including strategies on mitigating weight stigma in the delivery of prenatal care.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 2R3, Canada.
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada.
| | - Kirina Angrish
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Emily Bonisteel
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Niyati M Malkani
- Department of Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Salazar N, Ortiz F, Edie A, Miller A. Clinicians Address Gestational Weight Gain and Nutrition Using the International Federation of Gynecology and Obstetrics (FIGO) Nutrition Checklist. J Midwifery Womens Health 2024; 69:422-426. [PMID: 38766896 DOI: 10.1111/jmwh.13646] [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] [Revised: 04/19/2024] [Indexed: 05/22/2024]
Abstract
The negative effects of excessive gestational weight gain (GWG) and obesity during pregnancy are well documented in the literature. However, lack of time, education, comfort, and confidence among health care providers often make it difficult to provide proper nutrition and weight gain guidance for pregnant persons. In response, the International Federation of Gynecology and Obstetrics (FIGO) has developed a nutrition checklist that can standardize recommendations for GWG, facilitate discussions with pregnant persons, and aid providers with nutrition education. The checklist is an innovative tool that can help reduce complications associated with excessive GWG. This article discusses the benefits of FIGO Nutrition Checklist and its implementation at a midwifery clinic that primarily serves Native American women. By using this quick, simple, guided, time-efficient tool, clinics can be successful in facilitating important conversations and education about nutrition and GWG during pregnancy.
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Affiliation(s)
| | - Felina Ortiz
- University of New Mexico School of Nursing, Albuquerque, New Mexico
| | - Alison Edie
- Duke University School of Nursing, Durham, North Carolina
| | - Anne Miller
- San Juan Regional Medical Center, Farmington, New Mexico
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Kilpatrick ML, Venn AJ, Barnden KR, Newett K, Harrison CL, Skouteris H, Hills AP, Hill B, Lim SS, Jose KA. Health System and Individual Barriers to Supporting Healthy Gestational Weight Gain and Nutrition: A Qualitative Study of the Experiences of Midwives and Obstetricians in Publicly Funded Antenatal Care in Tasmania, Australia. Nutrients 2024; 16:1251. [PMID: 38732498 PMCID: PMC11085055 DOI: 10.3390/nu16091251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Individual and health system barriers can impede clinicians from supporting weight-related behaviour change for pregnant women, particularly in publicly funded antenatal care accessed by women from diverse socioeconomic backgrounds. The aim was to understand clinicians' experiences of supporting healthy gestational weight gain for pregnant women in a publicly funded antenatal setting. The work was undertaken to guide the implementation of systems changes, resource development, and workforce capacity building related to nutrition, physical activity, and gestational weight gain in the service. The qualitative descriptive study used purposive sampling and semi-structured interviews conducted between October 2019 and February 2020. Nine midwives and five obstetricians from a publicly funded hospital antenatal service in Tasmania, Australia participated. Interview transcripts were analysed using inductive thematic analysis. The three dominant themes were prioritising immediate needs, continuity of care support weight-related conversations, and limited service capacity for weight- and nutrition-related support. The subthemes were different practices for women according to weight and the need for appropriately tailored resources. Improving access to continuity of care and clinician training, and providing resources that appropriately consider women's socioeconomic circumstances and health literacy would enhance the ability and opportunities for clinicians to better support all women.
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Affiliation(s)
- Michelle L. Kilpatrick
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
- Centre for Mental Health Service Innovation, Advocate House, Hobart, TAS 7000, Australia
| | - Alison J. Venn
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
| | | | - Kristy Newett
- Royal Hobart Hospital, Hobart, TAS 7000, Australia; (K.R.B.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3168, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (H.S.); (B.H.)
- Warwick Business School, University of Warwick, Coventry CV4 7AL, UK
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia;
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (H.S.); (B.H.)
| | - Siew S. Lim
- Eastern Health Clinical School, Monash University, Melbourne, VIC 3128, Australia;
| | - Kim A. Jose
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
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Hoch M, Meloncelli N, de Jersey S. Examining Enhanced Implementation of Routine Antenatal Care Practices to Support Healthy Pregnancy Weight Gain. J Midwifery Womens Health 2023; 68:449-457. [PMID: 36789484 DOI: 10.1111/jmwh.13477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Current antenatal guidelines advocate for regular weighing of women during their pregnancy, with supportive conversations to assist healthy gestational weight gain (GWG). To facilitate overcoming weight monitoring barriers, a pregnancy weight gain chart (PWGC), coupled with brief intervention advice, was implemented in 2016 to guide provider and woman-led routine weight monitoring. This study aimed to examine the extent to which the use of PWGCs and routine advice provision were normalized into routine antenatal care following enhanced implementation strategies and whether this led to a change in GWG. METHODS This pre-post study included data from 2010 (preimplementation), 2016, and 2019 (postimplementation). A retrospective audit of health records and PWGCs was undertaken to assess adherence to chart use and evaluate GWG outcomes. A survey was sent to women in 2010 and repeated in 2019 to understand the advice women received from health care professionals. RESULTS Compared with the preimplementation cohort (2010), more women achieved a healthy GWG in 2019 (42% vs 31%, P = .04). In 2019, having 3 or more weights recorded was associated with a reduction in excess GWG (P = .028). More women reported receiving helpful advice about healthy GWG in 2019 compared with 2010, although minimal changes to advice received about nutrition and physical activity were observed. DISCUSSION Enhanced implementation strategies and ongoing efforts to optimize supportive antenatal care practices are required to effect positive change in GWG. Further evaluation of the perspectives of pregnant women and counseling practices of health professionals is needed.
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Affiliation(s)
- Mikeeley Hoch
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Australia
| | - Nina Meloncelli
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
| | - Susan de Jersey
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
- Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Adamo KB, Semeniuk K, da Silva DF, Souza SCS, Baillargeon JP, Redman LM, Piccinini-Vallis H, Shen GX, Nerenberg K. SmartMoms Canada: An evaluation of a mobile app intervention to support a healthy pregnancy. Contemp Clin Trials 2023; 126:107066. [PMID: 36572241 DOI: 10.1016/j.cct.2022.107066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is a lack of cost-effective and readily available access to evidence-based information to manage healthy behaviours for pregnant individuals. Mobile health (mHealth) tools offer a cost-effective, interactive, personalized option that can be delivered anywhere at a time most convenient for the user. This study protocol was primarily developed to, i) assess the feasibility of the SmartMoms Canada intervention in supporting participants to achieve gestational weight gain (GWG) guidelines. The secondary objectives are to, ii) assess user experience with the app, measured by adherence to the program via app software metrics and frequency of use, iii) determine the impact of SmartMoms Canada app usage on the adoption of healthful behaviours related to nutrition, physical activity and sleep habits, improvements in health-related quality of life, pregnancy-related complications, and symptoms of depression, and iv) investigate the potential extended effects of the app on postpartum health-related outcomes. METHODS This is a feasibility trial. Pregnant individuals aged 18-40 years with pre-gravid body mass index between 18.5 and 39.9 kg/m2, carrying a singleton fetus, having Wi-Fi access, and at ≤20 weeks' gestation will be recruited. Eligible people will be followed from recruitment until 12 months postpartum. DISCUSSION SmartMoms Canada is the first bilingual Canadian-centric app designed for pregnant people. This mHealth intervention, with its ability to supply frequent interactions, provides pregnancy- related health knowledge to users, potentially leading to an improvement in pregnancy-related outcomes and behaviours, and, ultimately a reduction in the present economic burden related to in-person interventions. TRIAL REGISTRATION ISRCTN, ISRCTN16254958. Registered 20 December 2019, http://www.isrctn.com/ ISRCTN16254958.
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Affiliation(s)
- Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Kevin Semeniuk
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, QC, Canada.
| | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | | | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, LA, United States.
| | - Helena Piccinini-Vallis
- Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Garry X Shen
- Department of Internal Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Kara Nerenberg
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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The short-term effect of a mHealth intervention on gestational weight gain and health behaviors: The SmartMoms Canada pilot study. Physiol Behav 2022; 257:113977. [PMID: 36181787 DOI: 10.1016/j.physbeh.2022.113977] [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: 03/31/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Gestational weight gain (GWG) has been shown to impact several maternal-infant outcomes. Since healthcare provider guidance on weight gain and healthy behaviors alone has failed to help women to meet guidelines during pregnancy, a practical adjunctive approach is to deliver evidence-based behavior change programs through mobile interventions. The present study aimed to assess the short-term effect of the SmartMoms Canada app to promote adequate GWG and healthy behaviors. Twenty-nine pregnant women were recruited in this app-based intervention trial to test whether a higher app usage (≥ 3.8 min·week-1) between 12-20 gestational weeks and 24-28 gestational weeks improved GWG, diet, physical activity, and sleep, compared to women with a lower app usage (< 3.8 min·week-1). Two-way mixed ANOVA for repeated measures was used to estimate the effect of the app usage and time, as well as their interaction on GWG and healthy behaviors. The likelihood ratio was used to examine the association between app usage categorization and GWG classification. Cramer's V statistic was used to estimate the effect size for interpretation of the association. Pregnant women using the SmartMoms Canada app more frequently had a higher moderate-to-vigorous physical activity (MVPA) daily average when compared with women with a lower usage (mean difference: 17.84 min/day, 95% CI: 2.44; 33.25). A moderate effect size (28.6% vs. 15.4%; Cramer's V = 0.212) was found for the association between app categorization and rate of GWG, representing a greater adherence to the GWG guidelines in women in the higher app usage group vs. the lower app usage group. Considering other physical activity, diet, and sleep variables, no app categorization effect was observed. A short-term higher usage of SmartMoms Canada app has a positive effect on objectively-measured MVPA.
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Souza SCS, da Silva DF, Piccinini-Vallis H, Nagpal TS, Paludo AC, Mattes VV, Salas XR, Adamo KB. Thinking ahead: Brazilian healthcare providers also need culturally relevant tools to communicate gestational weight gain recommendations. Am J Clin Nutr 2022; 115:588-589. [PMID: 35139167 DOI: 10.1093/ajcn/nqab376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sara C S Souza
- From the Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Danilo F da Silva
- From the Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Helena Piccinini-Vallis
- Departments of Family Medicine and Obstetrics and Gynecology, Dalhousie University, Halifax, Canada
| | - Taniya S Nagpal
- Department of Kinesiology, Brock University, St. Catharines, Canada
| | - Ana C Paludo
- Incubator of Kinanthropology Research, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Verônica V Mattes
- Department of Physical Education, Midwestern Parana State University, Guarapuava, Brazil
| | | | - Kristi B Adamo
- From the Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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8
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Unhealthy gestational weight gain: are we neglecting inadequate gestational weight gain? Midwifery 2022; 107:103277. [DOI: 10.1016/j.midw.2022.103277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 01/19/2022] [Accepted: 02/06/2022] [Indexed: 11/23/2022]
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Moffat T, McKerracher L, Oresnik S, Atkinson SA, Barker M, McDonald SD, Murray-Davis B, Sloboda DM. Investigating the normalization and normative views of gestational weight gain: Balancing recommendations with the promotion and support of healthy pregnancy diets. Am J Hum Biol 2021; 33:e23604. [PMID: 33956376 DOI: 10.1002/ajhb.23604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/23/2021] [Accepted: 03/24/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Gestational weight gain (GWG) is increasingly monitored in the United States and Canada. While promoting healthy GWG offers benefits, there may be costs with over-surveillance. We aimed to explore these costs/benefits. METHODS Quantitative data from 350 pregnant survey respondents and qualitative focus group data from 43 pregnant/post-partum and care-provider participants were collected in the Mothers to Babies (M2B) study in Hamilton, Canada. We report descriptive statistics and discussion themes on GWG trajectories, advice, knowledge, perceptions, and pregnancy diet. Relationships between GWG monitoring/normalization and worry, knowledge, diet quality, and sociodemographics-namely low-income and racialization-were assessed using χ2 tests and a linear regression model and contextualized with focus group data. RESULTS Most survey respondents reported GWG outside recommended ranges but rejected the mid-20th century cultural norm of "eating for two"; many worried about gaining excessively. Conversely, respondents living in very low-income households were more likely to be gaining less than recommended GWG and to worry about gaining too little. A majority had received advice about GWG, yet half were unable to identify the range recommended for their prepregnancy BMI. This proportion was even lower for racialized respondents. Pregnancy diet quality was associated with household income, but not with receipt or understanding of GWG guidance. Care-providers encouraged normalized GWG, while worrying about the consequences of pathologizing "abnormal" GWG. CONCLUSIONS Translation of GWG recommendations should be done with a critical understanding of GWG biological normalcy. Supportive GWG monitoring and counseling should consider clinical, socioeconomic, and community contexts.
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Affiliation(s)
- Tina Moffat
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
| | - Luseadra McKerracher
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Oresnik
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
| | | | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sarah D McDonald
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada.,Departments of Radiology and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Maternal-Fetal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Beth Murray-Davis
- McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Deborah M Sloboda
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.,Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada.,Farncombe Family Digestive Diseases Research Institute, McMaster University, Hamilton, Ontario, Canada
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Nagpal TS, Liu RH, Gaudet L, Cook JL, Adamo KB. Summarizing recommendations to eliminate weight stigma in prenatal health care settings: A scoping review. PATIENT EDUCATION AND COUNSELING 2020; 103:2214-2223. [PMID: 32624327 DOI: 10.1016/j.pec.2020.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/30/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE As the prevalence of obesity increases, more women are at risk of potentially experiencing weight stigma in prenatal health care settings. The objective of this scoping review was to summarize the primary literature assessing potential causes of weight stigma in prenatal health care settings and synthesize recommendations for health care providers to improve clinical practice. METHODS A search strategy was developed combining the terms pregnancy, weight stigma, obesity, and prenatal care. A systematic search was completed in the following databases: Medline, EMBASE, PsycInfo, CINAHL, Opengrey, and Proquest. RESULTS Eighteen resources were included in this review, of which 17 were qualitative, and one was a mixed-methods study design. Weight stigma occurred in prenatal health care settings when providers: avoided weight-related discussions, assumed lifestyle behaviors, and had poor communication when discussing risks associated with obesity. Recommendations to prevent weight stigma included: offering sensitivity training to discuss obesity during pregnancy, implementing a patient-centred approach, including evaluating individual health behaviors, and providing educational resources to patients explaining potential risks and referrals. CONCLUSION This review summarizes recommendations to eliminate weight stigma in prenatal health care settings. PRACTICE IMPLICATIONS These recommendations can be implemented in clinical practice and can improve the delivery of prenatal care.
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Affiliation(s)
- Taniya S Nagpal
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada.
| | - Rebecca H Liu
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Women's College Hospital, Institute for Health System Solutions & Virtual Care, Toronto, Ontario, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Canada
| | - Jocelynn L Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada; Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada
| | - Kristi B Adamo
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Souza SCS, da Silva DF, Nagpal TS, Adamo KB. Eating Habits, Advice from Family/Friends, and Limited Personal Effort May Increase the Likelihood of Gaining Outside Gestational Weight Gain Recommendations. Matern Child Health J 2020; 24:1473-1481. [PMID: 32975725 DOI: 10.1007/s10995-020-03007-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The present study analyzed the association between (i) eating habits during pregnancy, (ii) advice from family or friends about gestational weight gain (GWG), and iii) personal effort to stay within weight gain limits, and meeting GWG recommendations. METHODS Participants included pregnant and postpartum women who completed the validated electronic maternal health survey (EMat). Sociodemographic, lifestyle variables, and body mass index were covariates used in the analyses. RESULTS Among all eligible women (1171), and a subset of women receiving a specific GWG target from HCP (365, 31.2%), participants who considered that their eating habits became less healthy, or could not evaluate if habits changed, had a higher likelihood of gaining above (adjusted odds ratio, aOR = 2.62; 95% CI 1.84; 3.73 for the total sample (TS); aOR = 4.79; CI 2.32;9.88 for the subset) GWG guidelines after adjusting for the covariates. Women who received advice from family or friends about how much weight they should gain while pregnant were more likely to experience GWG below (TS: aOR = 1.49; CI 1.02;2.17; subset: aOR = 1.95; CI 1.03;3.68) and above (TS: aOR = 1.42; CI 1.01;1.99; subset: aOR = 1.92; CI 1.06;3.48) guidelines, when compared to women who did not receive family/friends advice. Moreover, lower personal effort to stay within weight gain limits was associated with gaining below (TS: aOR = 1.77; CI 1.07;2.92; subset: aOR = 2.71; CI 1.30; 5.65) GWG guidelines. CONCLUSIONS FOR PRACTICE Women self-reporting less healthy eating habits than before pregnancy, receiving advice from family/friends about GWG, and lower personal effort to stay within guidelines, had an increased odds of weight gain discordant with recommendations.
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Affiliation(s)
- Sara C S Souza
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada
| | - Danilo F da Silva
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada
| | - Taniya S Nagpal
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada
| | - Kristi B Adamo
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada.
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"They Just Need to Come Down a Little Bit to your Level": A Qualitative Study of Parents' Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103605. [PMID: 32455567 PMCID: PMC7277501 DOI: 10.3390/ijerph17103605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 12/28/2022]
Abstract
The first 1000 days is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role, in part due to the large number of routine contacts they have with parents. There is an absence of research on the views of parents towards obesity prevention and the range of associated behaviours during this time period. This study aimed to elicit parents’ views on early life interventions to promote healthy growth/prevent childhood obesity, particularly those delivered by health professionals. Semi-structured interviews were conducted with 29 parents (24 mothers, 5 fathers) who were resident in Ireland and had at least one child aged under 30 months. Data were analysed using reflexive thematic analysis. Two central themes were generated: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Parents would welcome support during this critical time period; particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, multi-level, non-judgemental, and from trusted sources, including both health professionals and peers. Interventions to promote healthy growth and related behaviours need to be developed and implemented in a way that supports parents and their views and circumstances.
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