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O'Connor H, Willcox JC, de Jersey S, Wright C, Wilkinson SA. Digital preconception interventions targeting weight, diet and physical activity: A systematic review. Nutr Diet 2024; 81:244-260. [PMID: 37845187 DOI: 10.1111/1747-0080.12842] [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: 05/30/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 10/18/2023]
Abstract
AIM Optimising preconception health increases the likelihood of conception, positively influences short- and long-term pregnancy outcomes and reduces intergenerational chronic disease risk. Our aim was to synthesise study characteristics and maternal outcomes of digital or blended (combining face to face and digital modalities) interventions in the preconception period. METHODS We searched six databases (PubMed, Cochrane, Embase, Web of Science, CINHAL and PsycINFO) from 1990 to November 2022 according to the PRISMA guidelines for randomised control trials, quasi-experimental trials, observation studies with historical control group. Studies were included if they targeted women of childbearing age, older than 18 years, who were not currently pregnant and were between pregnancies or/and actively trying to conceive. Interventions had to be delivered digitally or via digital health in combination with face-to-face delivery and aimed to improve modifiable behaviours, including dietary intake, physical activity, weight and supplementation. Studies that included women diagnosed with type 1 or 2 diabetes were excluded. Risk of bias was assessed using the Academy of Nutrition and Dietetics quality criteria checklist. Study characteristics, intervention characteristics and outcome data were extracted. RESULTS Ten studies (total participants n=4,461) were included, consisting of nine randomised control trials and one pre-post cohort study. Seven studies received a low risk of bias and two received a neutral risk of bias. Four were digitally delivered and six were delivered using blended modalities. A wide range of digital delivery modalities were employed, with the most common being email and text messaging. Other digital delivery methods included web-based educational materials, social media, phone applications, online forums and online conversational agents. Studies with longer engagement that utilised blended delivery showed greater weight loss. CONCLUSION More effective interventions appear to combine both traditional and digital delivery methods. More research is needed to adequately test effective delivery modalities across a diverse range of digital delivery methods, as high heterogeneity was observed across the small number of included studies.
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Affiliation(s)
- Hannah O'Connor
- Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Butterfield Street Herston, Brisbane, Queensland, Australia
| | - Jane C Willcox
- Faculty of Health, Charles Darwin University, Darwin, Northwest Territories, Australia
| | - Susan de Jersey
- Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Butterfield Street Herston, Brisbane, Queensland, Australia
| | - Charlotte Wright
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Shelley A Wilkinson
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Lifestyle Maternity, Brisbane, Queensland, Australia
- Department of Obstetric Medicine, Mater Mothers' Hospitals, Brisbane, Queensland, Australia
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Banafshe E, Javadifar N, Abbaspoor Z, Karandish M, Ghanbari S. Factors Influencing Weight Management in Pregnant Women with Overweight or Obesity: A Meta-Synthesis of Qualitative Studies. J Acad Nutr Diet 2024:S2212-2672(24)00191-6. [PMID: 38648889 DOI: 10.1016/j.jand.2024.04.011] [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: 08/12/2023] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Overweight and obesity have multiple negative consequences for the health of both the mother and the child. Interventions to prevent excessive weight gain during pregnancy have had varying success, and the proportion of pregnant women who exceed national guidelines for weight gain continues to increase. OBJECTIVE To investigate the influence of factors on weight management among pregnant women with overweight or obesity. METHODS This meta-synthesis of qualitative studies involved searching databases PubMed, Embase, Cochrane, Scopus, and Web of Science. The databases were searched on October 4, 2022, and the search was updated on April 21, 2023. The screening of titles, abstracts, and full texts was conducted utilizing Covidence software. The quality assessment of the articles was performed using the Critical Appraisal Skills Programme checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement was used to enhance transparency in reporting. A meta-aggregation approach was used to guide the data extraction and synthesis. RESULTS A total of 46 studies with appropriate Critical Appraisal Skills Programme scores were included for qualitative synthesis. Findings were extracted and integrated into 4 themes: psychological factors (personally driven negative emotions and society-driven negative emotions), social factors (societal attitudes and beliefs and social support resources), factors related to education and counseling (information provision and communication), and factors associated with effective care (provided care components and the method of providing effective care). CONCLUSIONS To improve weight management during pregnancy, health care providers should provide tailored and individualized recommendations that take into consideration the factors influencing these women.
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Affiliation(s)
- Elahe Banafshe
- Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Javadifar
- Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zahra Abbaspoor
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Ghanbari
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ledoux T, Gamal B, Duque A, Berens PD. Receiving gestational weight gain recommendations and associated risks: A qualitative study among low-income women. Midwifery 2024; 131:103939. [PMID: 38330743 DOI: 10.1016/j.midw.2024.103939] [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: 08/16/2023] [Revised: 11/15/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
Appropriate weight gain goals promote healthy gestational weight gain (GWG). Despite receiving recommendations from their providers, most women do not know how much weight they should gain during pregnancy. This study sought to describe the experiences of pregnant women when given GWG recommendations. The research proceeded using a phenomenological approach. With Institutional Review Board approval, primigravida women with a healthy singleton pregnancy at 8-20 weeks gestation were recruited from the community and purposively from a low-income obstetrics clinic. Within 60-minutes, trained interviewers 1) presented GWG recommendations and associated risks; and 2) interviewed participants using a semi-structured guide. Participants received a $40 gift card. Interviews were recorded and transcribed. Two trained coders used Braun and Clarke's (2020) reflexive thematic analysis procedures. When presented with GWG information, participants (n = 29, Mage = 25.5, 4.7 SD) proceeded to: 1) make sense of the information, 2) evaluate the credibility of the information, 3) weigh the importance of the information, 4) predict likely outcomes, and 5) plan behaviors. Participants who were able to understand the information, found it to be credible and important, and who predicted adverse outcomes for failing to adhere to recommendations reported intentions for health promoting behaviors. Future research should test GWG counseling methods based on these cognitive processes. Clinicians should consider these 5 cognitive processes when providing initial GWG counseling.
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Affiliation(s)
- Tracey Ledoux
- Department of Health and Human Performance, University of Houston, 3875 Holman Street, Houston 77204, TX, USA.
| | - Basant Gamal
- Department of Health and Human Performance, University of Houston, 3875 Holman Street, Houston 77204, TX, USA
| | - Alejandra Duque
- Department of Health and Human Performance, University of Houston, 3875 Holman Street, Houston 77204, TX, USA
| | - Pamela D Berens
- McGovern School of Medicine, University of Texas Health Sciences Center, 6431 Fannin St, Houston 77030, TX, USA
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4
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Conrad M. Health information-seeking internet behaviours among pregnant women: a narrative literature review. J Reprod Infant Psychol 2024; 42:194-208. [PMID: 35703164 DOI: 10.1080/02646838.2022.2088711] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pregnant women often turn to the internet as a primary source of pregnancy-related information. However, there is great concern about the accuracy of health-related information on the internet, making research on women's internet behaviours and decision-making critically important. Previous research has been conducted within a number of distinct but related fields, yet existing review papers have often failed to connect across the various disciplines. OBJECTIVE This review aims to synthesise the large and cross-disciplinary body of literature on women's health information-seeking internet behaviour regarding pregnancy and childbirth. METHODS A narrative literature review, which includes research from both health and social sciences, was conducted. RESULTS Findings address the 'who, where, what, why, and how' of information-seeking behaviour on the internet, with suggestions for future research in each area further discussed. CONCLUSIONS Additional research which addresses the remaining gaps in the literature can help providers be more aware of their patients' informational needs. Providers can be an important source of information, while also helping guide their patients on how to evaluate information. Enhanced patient portals and communication platforms can help to provide more timely and reliable information. Providing their patients with guides can be important for fostering enhanced health literacy.
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Affiliation(s)
- Megan Conrad
- Department of Psychology, William Paterson University, Wayne, NJ, USA
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5
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Hollis JL, Deroover K, Licata M, Tully B, Farragher E, Lecathelinais C, Bennett N, Foster M, Pennell CE, Wiggers J, Daly J, Kingsland M. Antenatal care addressing gestational weight gain (GWG): a cross sectional study of pregnant women's reported receipt and acceptability of recommended GWG care and associated characteristics. BMC Pregnancy Childbirth 2024; 24:111. [PMID: 38321389 PMCID: PMC10845753 DOI: 10.1186/s12884-023-06158-4] [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: 02/23/2023] [Accepted: 11/25/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The Australian Clinical Practice Guidelines for Pregnancy Care recommend that during the first and subsequent antenatal visits all pregnant women are weighed; advised of recommended gestational weight gain (GWG), dietary intake and physical activity; and offered referrals for additional support if needed. The extent to which these recommendations are implemented and women's acceptability of recommended care is unknown. This study examines women's reported receipt and acceptability of guideline care for GWG, and characteristics associated with receipt of such care and its acceptability. METHODS From September 2018 to February 2019 a telephone survey was undertaken with women who had recently had a baby and received antenatal care from five public maternity services within a health district in Australia. Women self-reported their demographic characteristics, and receipt and acceptability of recommended GWG care. Receipt and acceptability of such care, and their association with the characteristics of women and the maternity service they attended, were examined using descriptive statistics and multivariable logistic regression analyses. RESULTS Of 514 women, 13.1% (95%CI:10.3-16.5) reported that they received an assessment of weight at both their first and a subsequent antenatal visit, and less than one third (30.0%; 95%CI:26.0-33.9) received advice on their recommended GWG range, dietary intake and physical activity. Just 6.6% (95%CI:4.8-9.1) of women reported receiving all assessment and advice components of recommended antenatal care, and 9.9% (95%CI:7.6-12.8) of women reported being referred for extra support. Women who were younger (OR = 1.13;95%CI:1.05-1.21), identifying as Aboriginal and Torres Strait Islander (OR = 24.54;95%CI:4.98-120.94), had a higher pre-pregnancy BMI (OR = 1.13;95%CI:1.05-1.21), were experiencing their first pregnancy (OR = 3.36;95%CI:1.27-8.86), and lived in a least disadvantaged area (compared to mid-disadvantaged area (OR = 18.5;95%CI:2.6-130.5) and most disadvantaged area (OR = 13.1;95%CI:2.09-82.4)) were more likely to receive recommended assessment and advice. Most Aboriginal (92%) and non-Aboriginal (93%) women agreed that recommended GWG care is acceptable. CONCLUSION Most women perceive antenatal care for GWG as recommended by the Clinical Practice Guidelines as acceptable, but did not receive it. When provided, such care is not delivered consistently to all women regardless of their characteristics or those of the maternity service they attend. There is a need for service-wide practice change to increase routine GWG care in pregnancy for all women.
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Affiliation(s)
- Jenna L Hollis
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
| | - Kristine Deroover
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Milly Licata
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Belinda Tully
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Gomeroi Nation, New England North West, NSW, Australia
| | - Eva Farragher
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Nicole Bennett
- Hunter New England Local Health District Nursing and Midwifery Services, Newcastle, NSW, 2305, Australia
| | - Michelle Foster
- Hunter New England Local Health District Nursing and Midwifery Services, Newcastle, NSW, 2305, Australia
| | - Craig E Pennell
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - John Wiggers
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Justine Daly
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
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Fry J, Wilkinson SA, Willcox J, Henny M, McGuire L, Guthrie TM, Meloncelli N, de Jersey S. Improving Engagement in Antenatal Health Behavior Programs-Experiences of Women Who Did Not Attend a Healthy Lifestyle Telephone Coaching Program. Nutrients 2023; 15:nu15081860. [PMID: 37111079 PMCID: PMC10146126 DOI: 10.3390/nu15081860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Living Well during Pregnancy (LWdP) is a telephone-based antenatal health behavior intervention that has been shown to improve healthy eating behaviors and physical activity levels during pregnancy. However, one-third of eligible, referred women did not engage with or dropped out of the service. This study aimed to explore the experiences and perceptions of women who were referred but did not attend or complete the LWdP program to inform service improvements and adaptations required for scale and spread and improve the delivery of patient-centered antenatal care. Semi-structured telephone interviews were conducted with women who attended ≤2 LWdP appointments after referral. The interviews were thematically analyzed and mapped to the Theoretical Domains Framework and Behavior Change Wheel/COM-B Model to identify the barriers and enablers of program attendance and determine evidence-based interventions needed to improve service engagement and patient-centered antenatal care. Three key themes were identified: (1) the program content not meeting women's expectations and goals; (2) the need for flexible, multimodal healthcare; and (3) information sharing throughout antenatal care not meeting women's information needs. Interventions to improve women's engagement with LWdP and patient-centered antenatal care were categorized as (1) adaptations to LWdP, (2) training and support for program dietitians and antenatal healthcare professionals, and (3) increased promotion of positive health behaviors during pregnancy. Women require flexible and personalized delivery of the LWdP that is aligned with their individual goals and expectations. The use of digital technology has the potential to provide flexible, on-demand access to and engagement with the LWdP program, healthcare professionals, and reliable health information. All healthcare professionals are vital to the promotion of positive health behaviors in pregnancy, with the ongoing training and support necessary to maintain clinician confidence and knowledge of healthy eating, physical activity, and weight gain during pregnancy.
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Affiliation(s)
- Jessica Fry
- Dietetics and Foodservices, Royal Brisbane and Women's Hospital, James Mayne Building Level 2, Butterfield Street, Herston, QLD 4029, Australia
| | - Shelley A Wilkinson
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia
- Mothers, Babies and Women's Theme, Mater Research Institute-The University of Queensland, St Lucia, QLD 4072, Australia
| | - Jane Willcox
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia
- Impact Obesity, South Melbourne, VIC 3205, Australia
| | - Michaela Henny
- Dietetics and Foodservices, Royal Brisbane and Women's Hospital, James Mayne Building Level 2, Butterfield Street, Herston, QLD 4029, Australia
| | - Lisa McGuire
- Dietetics and Foodservices, Royal Brisbane and Women's Hospital, James Mayne Building Level 2, Butterfield Street, Herston, QLD 4029, Australia
| | - Taylor M Guthrie
- Dietetics and Foodservices, Royal Brisbane and Women's Hospital, James Mayne Building Level 2, Butterfield Street, Herston, QLD 4029, Australia
| | - Nina Meloncelli
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
- Office of the Chief Allied Health Practitioner, Metro North Health, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
| | - Susan de Jersey
- Dietetics and Foodservices, Royal Brisbane and Women's Hospital, James Mayne Building Level 2, Butterfield Street, Herston, QLD 4029, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
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7
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Goddard L, Astbury NM, McManus RJ, Tucker K, MacLellan J. Clinical guidelines for the management of weight during pregnancy: a qualitative evidence synthesis of practice recommendations across NHS Trusts in England. BMC Pregnancy Childbirth 2023; 23:164. [PMID: 36906551 PMCID: PMC10007759 DOI: 10.1186/s12884-023-05343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/02/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Women who enter pregnancy with a Body Mass Index above 30 kg/m2 face an increased risk of complications during pregnancy and birth. National and local practice recommendations in the UK exist to guide healthcare professionals in supporting women to manage their weight. Despite this, women report inconsistent and confusing advice and healthcare professionals report a lack of confidence and skill in providing evidence-based guidance. A qualitative evidence synthesis was conducted to examine how local clinical guidelines interpret national recommendations to deliver weight management care to people who are pregnant or in the postnatal period. METHODS A qualitative evidence synthesis of local NHS clinical practice guidelines in England was conducted. National Institute for Health and Care Excellence and Royal College of Obstetricians and Gynaecologists guidelines for weight management during pregnancy constructed the framework used for thematic synthesis. Data was interpreted within the embedded discourse of risk and the synthesis was informed by the Birth Territory Theory of Fahy and Parrat. RESULTS A representative sample of twenty-eight NHS Trusts provided guidelines that included weight management care recommendations. Local recommendations were largely reflective of national guidance. Consistent recommendations included obtaining a weight at booking and informing women of the risks associated with being obese during pregnancy. There was variation in the adoption of routine weighing practices and referral pathways were ambiguous. Three interpretive themes were constructed, exposing a disconnect between the risk dominated discourse evident in the local guidelines and the individualised, partnership approach emphasised in national level maternity policy. CONCLUSIONS Local NHS weight management guidelines are rooted in a medical model rather than the model advocated in national maternity policy that promotes a partnership approach to care. This synthesis exposes the challenges faced by healthcare professionals and the experiences of pregnant women who are in receipt of weight management care. Future research should target the tools utilised by maternity care providers to achieve weight management care that harnesses a partnership approach empowering pregnant and postnatal people in their journey through motherhood.
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Affiliation(s)
- Lucy Goddard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Richard J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Katherine Tucker
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jennifer MacLellan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Wilkinson SA, Fjeldsoe B, Willcox JC. Evaluation of the Pragmatic Implementation of a Digital Health Intervention Promoting Healthy Nutrition, Physical Activity, and Gestational Weight Gain for Women Entering Pregnancy at a High Body Mass Index. Nutrients 2023; 15:nu15030588. [PMID: 36771295 PMCID: PMC9921852 DOI: 10.3390/nu15030588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
txt4two is a multi-modality intervention promoting healthy pregnancy nutrition, physical activity (PA), and gestational weight gain (GWG), which had been previously evaluated in a pilot randomized controlled trial (RCT). This study aimed to evaluate a pragmatic implementation of an adapted version of txt4two in a public tertiary hospital. Using a consecutive cohort design, txt4two was delivered to women with a pre-pregnancy BMI > 25 kg/m2, between 10 + 0 to 17 + 6 weeks. Control and intervention cohorts (n = 150) were planned, with surveys and weight measures at baseline and 36 weeks. The txt4two cohort received a dietetic goal-setting appointment and program (SMS, website, and videos). The navigation of disparate hospital systems and the COVID-19 pandemic saw adaptation and adoption take two years. The intervention cohort (n = 35; 43% full data) demonstrated significant differences (mean (SD)), compared to the control cohort (n = 97; 45% full data) in vegetable intake (+0.9 (1.2) versus +0.1 (0.7), p = 0.03), fiber-diet quality index (+0.6 (0.8) versus 0.1 (0.5), p = 0.012), and total diet quality index (+0.7 (1.1) versus +0.2 (±0.6), p = 0.008), but not for PA or GWG. Most (85.7%) intervention participants found txt4two extremely or moderately useful, and 92.9% would recommend it. Embedding the program in a non-RCT context raised implementation challenges. Understanding the facilitators and barriers to adaptation and adoption will strengthen the evidence for the refinement of implementation plans.
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Affiliation(s)
- Shelley A. Wilkinson
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia
- Correspondence: ; Tel.: +61-7-3365-6849
| | | | - Jane C. Willcox
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia
- Centre for Quality and Patient Safety, Institute of Health Transformation, Deakin University, Burwood, VIC 3125, Australia
- Impact Obesity, South Melbourne, VIC 3205, Australia
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Misita D, Aulakh S, Jain V, Quintanilha M, Ospina MB, Bell RC. Prenatal Nutrition Care in Alberta: The Perspectives of Pregnant Women and Registered Dietitians. CAN J DIET PRACT RES 2022:1-7. [DOI: 10.3148/cjdpr-2022-031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Optimizing women’s diets in pregnancy improves maternal and child health outcomes; however, the best format for supporting women’s nutrition goals in pregnancy is not clear, and access to dietetic services is not standard in prenatal care in Alberta. This study explored women’s perceptions about access to Registered Dietitians (RDs) throughout pregnancy and RDs experiences providing prenatal nutrition counselling. Methods: Two studies were conducted. Study A: Pregnant women completed a short survey while attending a prenatal appointment in a large prenatal clinic. The survey assessed women’s perspectives about accessing dietetic services during pregnancy. Survey data were analyzed using descriptive statistics. Study B: RDs participated in either a semi-structured phone interview or a focus group and described their experiences working with pregnant women. Data were analyzed using thematic analysis. Results: One hundred pregnant women completed the survey. Ninety percent indicated that they had not seen a RD at this time in pregnancy, and 48% reported that they would like to access a RD in pregnancy, if available. Dietitians discussed the diversity of women’s concerns and the challenges to providing prenatal nutrition support. Conclusions: Women have nutrition-related questions during pregnancy. Dietitians experience challenges providing services in the current care systems.
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Affiliation(s)
- Dragana Misita
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, Faculty of Agriculture, Life, and Environmental Sciences, University of Alberta, Edmonton, AB
| | - Sharan Aulakh
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, Faculty of Agriculture, Life, and Environmental Sciences, University of Alberta, Edmonton, AB
| | - Venu Jain
- Women and Children’s Health Research Institute, Edmonton, AB
- Departments of Obstetrics and Gynecology and Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB
| | - Maira Quintanilha
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, Faculty of Agriculture, Life, and Environmental Sciences, University of Alberta, Edmonton, AB
| | - Maria B. Ospina
- Women and Children’s Health Research Institute, Edmonton, AB
- Departments of Obstetrics and Gynecology and Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB
| | - Rhonda C. Bell
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, Faculty of Agriculture, Life, and Environmental Sciences, University of Alberta, Edmonton, AB
- Women and Children’s Health Research Institute, Edmonton, AB
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10
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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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11
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Ruart S, Sinnapah S, Hue O, Janky E, Antoine-Jonville S. Association Between Maternal Body Mass and Physical Activity Counseling During Pregnancy. Front Psychol 2021; 12:612420. [PMID: 34899448 PMCID: PMC8656300 DOI: 10.3389/fpsyg.2021.612420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: The antenatal period provides an important opportunity for giving advice on healthy lifestyle choices. However, the prevalence of maternal obesity is increasing, and women report that they do not receive counseling. We investigated the information given to pregnant women on gestational weight gain, physical activity, and nutrition during pregnancy in relation with their initial weight status, current gestational weight gain and diagnoses of either pre-pregnancy overweight/obesity or excessive gestational weight gain. Methods: Cross-sectional survey using a questionnaire. Pregnant participants (n = 141) were recruited from a midwife center. They completed a structured questionnaire on the information they received during their pregnancy and we assessed its relationship with their weight. Results: We found that many pregnant women did not receive advice about physical activity, gestational weight gain and nutrition (37.5, 53.2, and 66.2%, respectively). Women with weight problems (pre-pregnancy overweight/obesity and excessive gestational weight gain) were less targeted for counseling, although more than 80% of the women viewed receiving information on these topics as positive. Also, being informed of a weight problem was associated with a greater chance of receiving information about physical activity, gestational weight gain and nutrition (all p < 0.05). However, verbalization of the weight problems was low (14.0% of women with pre-pregnancy overweight were informed of their status). Conclusion: Health professionals should dispense more information, especially on PA and particularly for women with weight problems. Verbalization of the weight problem seems associated with more frequent transmission of information.
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Affiliation(s)
- Shelly Ruart
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| | - Stéphane Sinnapah
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| | - Olivier Hue
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| | - Eustase Janky
- Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France
| | - Sophie Antoine-Jonville
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
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Lawrence RL, Ward K, Wall CR, Bloomfield FH. New Zealand women's experiences of managing gestational diabetes through diet: a qualitative study. BMC Pregnancy Childbirth 2021; 21:819. [PMID: 34886814 PMCID: PMC8662890 DOI: 10.1186/s12884-021-04297-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
Background For women with gestational diabetes mellitus (GDM) poor dietary choices can have deleterious consequences for both themselves and their baby. Diet is a well-recognised primary strategy for the management of GDM. Women who develop GDM may receive dietary recommendations from a range of sources that may be inconsistent and are often faced with needing to make several dietary adaptations in a short period of time to achieve glycaemic control. The aim of this study was to explore how women diagnosed with GDM perceive dietary recommendations and how this information influences their dietary decisions during pregnancy and beyond. Methods Women diagnosed with GDM before 30 weeks’ gestation were purposively recruited from two GDM clinics in Auckland, New Zealand. Data were generated using semi-structured interviews and thematic analysed to identify themes describing women’s perceptions and experiences of dietary recommendations for the management of GDM. Results Eighteen women from a diverse range of sociodemographic backgrounds participated in the study. Three interconnected themes described women’s perceptions of dietary recommendations and experiences in managing their GDM through diet: managing GDM is a balancing act; using the numbers as evidence, and the GDM timeframe. The primary objective of dietary advice was perceived to be to control blood glucose levels and this was central to each theme. Women faced a number of challenges in adhering to dietary recommendations. Their relationships with healthcare professionals played a significant role in their perception of advice and motivation to adhere to recommendations. Many women perceived the need to follow dietary recommendations to be temporary, with few planning to continue dietary adaptations long-term. Conclusions The value of empathetic, individually tailored advice was highlighted in this study. A greater emphasis on establishing healthy dietary habits not just during pregnancy but for the long-term health of both mother and baby is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04297-0.
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Affiliation(s)
- R L Lawrence
- The Liggins Institute, The University of Auckland, Building 505, Level 2, 85 Park Road, Grafton, Auckland, 1023, New Zealand
| | - K Ward
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - C R Wall
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - F H Bloomfield
- The Liggins Institute, The University of Auckland, Building 505, Level 2, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
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Simmons LA, Phipps JE, Overstreet C, Smith PM, Bechard E, Liu S, Walker C, Noonan D. Goals for reaching optimal wellness (GROWell): A clinical trial protocol of a digital dietary intervention for pregnant and postpartum people with prenatal overweight or obesity. Contemp Clin Trials 2021; 113:106627. [PMID: 34813963 PMCID: PMC9044978 DOI: 10.1016/j.cct.2021.106627] [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] [Received: 07/26/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022]
Abstract
Background: Excess gestational weight gain (EGWG) is associated with multiple
pregnancy complications and health risks for birthing people and their
infants. Likewise, postpartum weight retention (PPWR), or not losing all
pregnancy weight, has long-term health consequences. EGWG among people who
enter pregnancy with overweight or obesity have worse obstetric outcomes and
increased PPWR compared to women who gain within Institute of Medicine
guidelines. Methods: This study protocol describes the details of a blinded, randomized
clinical trial of GROWell: Goals for Reaching Optimal
Wellness, a mHealth tool designed to improve diet quality among people who
enter pregnancy with overweight or obese BMIs to help them achieve
appropriate GWG and safe postpartum pregnancy weight loss. Individuals with
overweight and obesity will be randomly assigned to an attention control or
intervention arm. The intervention group will receive personalized,
goal-oriented text messages regarding dietary choices, while the attention
control group will receive text messages about healthy pregnancy, labor,
delivery, and early infancy. Both groups will complete online surveys at
baseline, follow up, 3 and 6 months postpartum. Results and discussion: Currently, 162 subjects have been enrolled. Outcomes associated with
GWG and pregnancy are expected in late 2023, while outcomes on postpartum
weight retention GROWell adherence are expected in late
2024. The results of this trial will support the use of an evidence-based
mHealth tool to be integrated into clinical practice to reduce EGWG and PPWR
among pregnant people with overweight and obese BMIs, a resource that is
currently lacking. Trial registration: ClinicalTrials.gov identifier: NCT04449432. Registered on June 26, 2020.
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Affiliation(s)
- Leigh Ann Simmons
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America.
| | - Jennifer E Phipps
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America
| | - Courtney Overstreet
- University of California Davis Health, Obstetrics and Gynecology Department, Sacramento, CA 95817, United States of America
| | - Paige M Smith
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America
| | - Elizabeth Bechard
- Duke Integrative Medicine, Durham, NC 27705, United States of America
| | - Siwei Liu
- University of California Davis, Department of Human Ecology, Davis, CA 95616, United States of America
| | - Cheryl Walker
- University of California Davis Health, Obstetrics and Gynecology Department, Sacramento, CA 95817, United States of America
| | - Devon Noonan
- Duke University School of Nursing, Durham, NC 27710, United States of America
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Olander EK, Hill B, Skouteris H. Healthcare Professional Training Regarding Gestational Weight Gain: Recommendations and Future Directions. Curr Obes Rep 2021; 10:116-124. [PMID: 33609271 PMCID: PMC8159776 DOI: 10.1007/s13679-021-00429-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The aim of this review was to summarise recent evaluations of healthcare professional training regarding gestational weight gain and provide recommendations for future training. RECENT FINDINGS A number of evaluated healthcare professional training sessions regarding gestational weight gain show promising results in terms of increased participant confidence and knowledge and impact on women's outcomes. It is clear that the interventions which have also implemented resources in the practice environment to support training are the ones most likely to influence gestational weight gain. Support from healthcare professionals are key to influence pregnant women's weight gain and should be offered within the standard curriculum and through mandatory training. Factors influencing this support include women's and healthcare professional characteristics, interpersonal and healthcare system and policy factors. All of these need to be considered when developing healthcare professional training to support women with their gestational weight gain.
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Affiliation(s)
- Ellinor K. Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB UK
| | - Briony Hill
- National Health and Medical Research Council Early Career Fellow, Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3169 Australia
| | - Helen Skouteris
- Health and Social Care Improvement and Implementation Science, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3169 Australia
- Warwick Business School, Warwick University, Coventry, CV47AL UK
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15
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Sources of nutrition information for Indonesian women during pregnancy: how is information sought and provided? Public Health Nutr 2021; 24:3859-3869. [PMID: 34034850 DOI: 10.1017/s1368980021002317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Adequate and appropriate nutrition education is expected to contribute towards preventing risk of child stunting and maternal overweight/obesity. Understanding women's information-seeking behaviours is an important key step for health professionals and departments of health in order to improve the development of optimal and targeted nutrition education during pregnancy. This study investigated the experience of Indonesian women in seeking and receiving nutritional information during pregnancy and its relationship to women's socio-demographic and pregnancy characteristics. DESIGN An online cross-sectional study. SETTING Malang City, Indonesia. PARTICIPANTS Women who had given birth within the past 2 years (n 335). RESULTS All women in this study sought or received food and nutrition information from multiple sources, including social and health professional contacts and media sources. The women frequently discussed nutrition issues with their family, particularly their husband (98·2 %) and mother or mother-in-law (91·6 %). This study identified four groups of sources based on women's search habits. Women from high socio-economic strata were more likely to discuss food and nutrition issues or received nutrition information from obstetricians, their family or online sources (adjusted R2 = 26·3 %). Women from low socio-economic strata were more likely to receive nutrition information from midwives, health volunteers or Maternal and Child Health books (adjusted R2 = 14·5 %). CONCLUSIONS A variety of nutrition information sources needs to be provided for women from different socio-economic strata. Involvement of family members in antenatal nutrition education may improve the communication and effectiveness of young mothers' dietary and nutrition education.
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Birch EM, Leziak K, Jackson J, Dahl E, Niznik CM, Yee LM. What Are Patients Watching? A Quality and Content Evaluation of YouTube Videos About Gestational Diabetes. (Preprint). JMIR Diabetes 2021; 7:e30156. [PMID: 35389355 PMCID: PMC9030909 DOI: 10.2196/30156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/17/2021] [Accepted: 01/23/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with gestational diabetes have enhanced learning requirements during pregnancy, and management of their disease often requires the translation of health information into new health behavior changes. Seeking information from the internet to augment learning from health professionals is becoming more common during pregnancy. YouTube is a popular free and accessible web-based resource, which may be particularly useful for individuals with low health literacy or other barriers to receiving high-quality health care; however, the quality and content of YouTube videos varies, and little is known about those covering gestational diabetes. OBJECTIVE We aimed to systematically evaluate the quality, content, and reliability of YouTube videos about gestational diabetes. METHODS A systematic search of YouTube videos was conducted over the course of 1 week in April 2020 using the following keywords: "gestational diabetes," "gestational diabetes management," "gestational diabetes treatment," and "pregnancy and diabetes." The search results were displayed by relevance, replicating a default YouTube search attempt. The first 60 results from each keyword were reviewed (n=240). Exclusion criteria were videos unrelated to gestational diabetes, videos not in English, and those for which the full video was not available at the time of review. For each unique video, a gestational diabetes content score was used to rate video comprehensiveness and accuracy, and the DISCERN instrument, a validated metric to assess consumer health information, was used to evaluate the reliability of information presented. Videos were further categorized by quality: videos with DISCERN scores lower than 3 (out of 5) or a content score less than 4 (out of 7) were categorized as low quality, and all others were designated high quality. We performed descriptive analysis and compared video characteristics by source and quality rating. RESULTS For 115 unique videos, the mean content score (out of 7) was 3.5 (SD 2.0) , and the mean DISCERN score (out of 5) was 2.7 (SD 0.7), representing low to moderate information comprehensiveness and reliability respectively. Video sources were categorized as personal vlog (12/115, 10.4%), web-based education (37/115, 32.2%), medical (52/115, 45.2%), business or company (13/115, 11.3%), and media clip (1/115, 0.9%). DISCERN and content scores trended higher among medical and web-based education videos. The majority of videos (n=88) were categorized as low quality, while 27 videos were categorized as high quality. Video duration was longer for high-quality videos (P<.001); high- and low-quality videos otherwise had similar views and viewer interaction numbers. CONCLUSIONS Although high-quality videos about gestational diabetes exist, reliability, accuracy, and comprehensiveness were low overall, and higher quality was not associated with increased viewer interaction. It is important to acknowledge the limitations of this platform and to assist patients in accessing high quality content and differentiating the quality of information sources.
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Affiliation(s)
- Eleanor M Birch
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Karolina Leziak
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jenise Jackson
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Emma Dahl
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Charlotte M Niznik
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lynn M Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Sources of information about gestational weight gain, diet and exercise among Brazilian immigrant women living in the USA: a cross-sectional study. Public Health Nutr 2021; 24:5720-5729. [PMID: 33904387 DOI: 10.1017/s1368980021001798] [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: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to assess sources of information about gestational weight gain (GWG), diet and exercise among first-time pregnant Brazilian women in the USA. DESIGN Cross-sectional survey. SETTING Massachusetts, USA. PARTICIPANTS First-time pregnant Brazilian women. RESULTS Eighty-six women, the majority of whom were immigrants (96·5 %) classified as having low acculturation levels (68 %), participated in the study. Approximately two-thirds of respondents had sought information about GWG (72·1 %), diet (79·1 %) and exercise (74·4 %) via the internet. Women classified as having low acculturation levels were more likely to seek information about GWG via the internet (OR = 7·55; 95 % CI 1·41, 40·26) than those with high acculturation levels after adjusting for age and receiving information about GWG from healthcare provider (doctor or midwife). Moreover, many respondents reported seeking information about GWG (67 %), diet (71 %) and exercise (52 %) from family and friends. Women who self-identified as being overweight pre-pregnancy were less likely to seek information about diet (OR = 0·32; 95 % CI 0·11, 0·93) and exercise (OR = 0·33; 95 % CI 0·11, 0·96) from family and friends than those who self-identified being normal-weight pre-pregnancy. CONCLUSIONS This is the first study to assess sources of information about GWG, diet and exercise among pregnant Brazilian immigrants in the USA. Findings have implications for the design of interventions and suggest the potential of mHealth intervention as low-cost, easy access option for delivering culturally and linguistically tailored evidence-based information about GWG incorporating behavioural change practices to this growing immigrant group.
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Okafor UB, Goon DT. Physical Activity in Pregnancy: Beliefs, Benefits, and Information-Seeking Practices of Pregnant Women in South Africa. J Multidiscip Healthc 2021; 14:787-798. [PMID: 33859477 PMCID: PMC8043848 DOI: 10.2147/jmdh.s287109] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/20/2020] [Indexed: 12/23/2022] Open
Abstract
Background Notwithstanding the benefits of physical activity (PA) during pregnancy, anecdotal evidence suggests ignorance, unscientific beliefs, and lack of awareness about PA among pregnant South African women. Aim This study examined the beliefs, perceived benefits, and sources of information on PA during pregnancy. Methods A cross-sectional descriptive study was employed between June and September 2019 using an interviewer-administered questionnaire with 1,082 pregnant women. These women were attending antenatal primary health–care clinics in Buffalo City, Eastern Cape, South Africa. A self-designed questionnaire solicited information on beliefs, benefits, and sources of information regarding PA during pregnancy. Results A majority of the participants held positive beliefs concerning PA during pregnancy. They maintained that PA was safe for mother and fetus, improved labor and delivery (93.1%), promoted energy (89.0%), and should be discontinued when tired (76.6%). Most held negative convictions that PA during pregnancy increased body temperature (64.5%) and that pregnancy was a time to rest and refrain from PA (56.5%). Predominantl sources of information received about PA during pregnancy were television, the radio, and other media (70.2%). Most participants were aware of the benefits of PA during pregnancy —— reduction in infant weight (61.4%), lessening of moodiness (90.4), and decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). An overwhelming majority affirmed that PA improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). Conclusion Our findings suggested that women hold positive beliefs and perceive PA as beneficial to their health and the baby; however, they received most of their information from the Internet. Most women regarded pregnancy as a period to relax and rest. Interventions to promote PA during pregnancy are needed.
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Affiliation(s)
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, East London, South Africa
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19
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Noncungu TM, Chipps JA. Information-seeking in first visit pregnant women in Khayelitsha, South Africa. Health SA 2020; 25:1478. [PMID: 33240533 PMCID: PMC7670028 DOI: 10.4102/hsag.v25i0.1478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/05/2020] [Indexed: 12/02/2022] Open
Abstract
Background The quality of the decisions made by women during pregnancy, especially their first visit, depends on their health needs, their health-seeking behaviour and the type of information available to them. Aim This study describes the health education needs, information barriers and health information-seeking behaviour of pregnant women on their first visit to antenatal clinics in a low-income setting in the Western Cape. Setting The setting was two antenatal facilities in Khayelitsha Health District facilities in South Africa. Methods A quantitative descriptive survey was conducted. A systematic random sample of 261 antenatal first visit attendees between May and July 2016 was selected. Data were collected using a researcher-administered questionnaire and was analysed using descriptive statistics, 95% confidence intervals and non-parametric tests. Results The response rate of the study was 92% (n = 240). Pregnant women attending an antenatal clinic for the first time reported high information needs with low health information-seeking behaviours and high information barriers. Doctors, nurses (2.2, ±1.0), family and friends (2.0, ±0.6) were the most frequently used sources of health information, while watching television or listening to the radio (1.5, ±0.9) were the least used sources of health information. Having a medical diagnosis (p < 0.001) and being of an advanced maternal age (p = 0.005) were predictive of higher health-seeking behaviour. The reliance on passively receiving information from health sources may indicate low levels of health literacy and its inverse relationship to health promoting behaviours which should be the subject of further investigation.
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Affiliation(s)
- Thabani M Noncungu
- School of Nursing, Faculty of Community Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Jennifer A Chipps
- School of Nursing, Faculty of Community Health Sciences, University of the Western Cape, Cape Town, South Africa
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20
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Snyder A, Neufeld HT, Forbes L. A mixed-methods investigation of women's experiences seeking pregnancy-related online nutrition information. BMC Pregnancy Childbirth 2020; 20:377. [PMID: 32590955 PMCID: PMC7320538 DOI: 10.1186/s12884-020-03065-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to describe women's processes for finding pregnancy-related nutrition information, their experiences seeking this information online and their ideas for improving internet sources of this information. METHODS In total, 97 pregnant women completed an online quantitative questionnaire and 10 primiparous pregnant women completed semi-structured telephone interviews. Questionnaires and interviews asked participants to describe sources of pregnancy-related nutrition information; time of seeking; processes of searching online; experiences searching online; ideas for improving information found online. Survey data were analyzed using descriptive statistics and Chi square tests; interview data were analyzed using thematic analysis. RESULTS Nearly all (96%) survey participants sought nutrition information online. Information was most commonly sought during the first trimester of pregnancy. Motivators for using the internet included convenience and lack of support from health care providers. Barriers to using online information included lack of trust, difficulty finding information and worry. Women adapted the information they found online to meet their needs and reported making positive changes to their diets. CONCLUSIONS The internet is a key source of prenatal nutrition information that women report using to make positive dietary changes. Women would benefit from improved access to trustworthy internet sources, increased availability of information on different diets and health conditions, and increased support from health care providers.
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Affiliation(s)
- Alexandra Snyder
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd., Guelph, ON, N1G 2W1, Canada
| | - Hannah Tait Neufeld
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| | - Laura Forbes
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd., Guelph, ON, N1G 2W1, Canada
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Dalhaug EM, Haakstad LAH. What the Health? Information Sources and Maternal Lifestyle Behaviors. Interact J Med Res 2019; 8:e10355. [PMID: 31278731 PMCID: PMC6640074 DOI: 10.2196/10355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 01/16/2019] [Accepted: 04/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Regular physical activity (PA), adequate gestational weight gain (GWG), and healthy eating are important for the long-term health of both mother and baby. Hence, it is important that women receive current and updated advice on these topics and are encouraged to adopt a healthy lifestyle during pregnancy. Objective The aim of this study was to investigate the main information sources among pregnant women regarding PA, GWG, and nutrition as well as to evaluate how these information sources may affect their health behaviors. Methods A cross-sectional study design, comprising an electronic questionnaire, was distributed to 2 antenatal clinics, as well as pregnancy-related online chat forums and social media. The inclusion criteria were ≥18 years, ≥20 weeks gestation, and able to read and write Norwegian. In total, 150 pregnant women answered the questionnaire, which was a mix of 11-point Likert scales, close-ended questions, and semi–close-ended questions with the option to elaborate. The relationship between information sources and selected variables, including health behaviors and descriptive variables, were assessed by logistic regression, linear regression, or chi-square as appropriate (P<.05). Results Mean age (years), gestation week, and prepregnancy body mass index (kg/m2) were 31.1 (SD 4.3), 30.6 (SD 5.9), and 24.2 (SD 4.2), respectively. More than eight out of 10 had received or retrieved information about nutrition (88.7%, 133/150) and PA (80.7%, 121/150), whereas 54.0% (81/150) reported information on GWG. When combining all 3 lifestyle factors, 38.5% had retrieved information from blogs and online forums and 26.6%, from their midwife or family physician. Women who reported
the internet and media as their primary source of information on weight gain had increased odds of gaining weight below the Institute of Medicine (IOM) guidelines compared with gaining within the guidelines (odds ratio [OR] 15.5, 95% CI 1.4-167.4; P=.02). Higher compliance with nutritional guidelines was seen among those who cited the internet and media as their main source of information on nutrition (beta=.7, 95% CI 0.07-1.3; P=.03). On the other side, receiving advice from friends and family on weight gain was significantly associated with gaining weight above the IOM guidelines compared with gaining within the guidelines (OR 12.0, 95% CI 1.3-111.7; P=.03). No other associations were found between information sources and health behaviors. Conclusions The small number of health professionals giving information and the extensive use of internet- and media-based sources emphasize the need to address the quality of internet advice and guide women toward trustworthy sources of information during pregnancy. The association between information sources and PA, GWG, and nutrition requires further research.
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Affiliation(s)
- Emilie Mass Dalhaug
- The Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway
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22
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Tebbani F, Oulamara H, Agli A. Facteurs associés au gain pondéral insuffisant au cours de la grossesse. Rev Epidemiol Sante Publique 2019; 67:253-260. [DOI: 10.1016/j.respe.2019.03.121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 01/27/2023] Open
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Ghiasi A. Health information needs, sources of information, and barriers to accessing health information among pregnant women: a systematic review of research. J Matern Fetal Neonatal Med 2019; 34:1320-1330. [PMID: 31216921 DOI: 10.1080/14767058.2019.1634685] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Awareness of health information needs, sources of health information, and barriers to accessing health information among pregnant women is critical for the development of health interventions and provides high-quality prenatal care for them. Hence, the aim of this review study was to summarize evidence from studies evaluating health information needs, sources of information and barriers to accessing health information of women during pregnancy. METHODS A systematic literature search was conducted using Web of Science, Scopus, PubMed, ScienceDirect, and Google Scholar for relevant studies published between 1 January 2000 and 24 May 2018. The methodological quality of cross-sectional studies was assessed using the STROBE checklist. The Critical Appraisal Skills Programme (CASP, 2018) was used to appraise the qualitative studies. Data were analyzed descriptively. RESULTS Thirty-one studies from 14 countries met criteria for inclusion in this review. The majority of articles focused on information needs and sources of information used by women during pregnancy. The most common information needs among women during pregnancy were information about unborn child, nutrition, and labor/delivery. The most frequent information source used by women during pregnancy was health professionals followed by informal source (family and friends), and Internet. The most prominent barriers to information access included the following: feeling ashamed or embarrassed to talk about pregnancy-related issues, long waiting times at clinic to see a health provider, and lack of adequate information resources. CONCLUSIONS Due to the limited number of studies examining barriers to health information seeking among pregnant women, further research is warranted. Further qualitative research is also recommended to explore pregnant women's perceptions of, and satisfaction with the use of health information sources.
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Affiliation(s)
- Ashraf Ghiasi
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Henning Cruickshank A, Lilley TS, Radcliffe B, Nosa V, Fenwick J. Māori and Pasifika perceptions of their local maternity care in Logan, Australia. Women Birth 2019; 32:e359-e365. [DOI: 10.1016/j.wombi.2018.08.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/24/2018] [Accepted: 08/21/2018] [Indexed: 10/28/2022]
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Harvey ME, David AL, Dyer J, Spencer R. Pregnant women's experiences and perceptions of participating in the EVERREST prospective study; a qualitative study. BMC Pregnancy Childbirth 2019; 19:144. [PMID: 31039749 PMCID: PMC6492343 DOI: 10.1186/s12884-019-2277-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 04/01/2019] [Indexed: 02/04/2023] Open
Abstract
Background The EVERREST Prospective Study is a multicentre observational cohort study of pregnancies affected by severe early-onset fetal growth restriction. The study recruits women with singleton pregnancies where the estimated fetal weight is less than the 3rd centile and below 600 g, between 20 + 0 and 26 + 6 weeks of pregnancy, in the absence of a known chromosomal, structural or infective cause. Method The reported study was retrospective descriptive qualitative interview study of women who had participated in the EVERREST Prospective Study. The aim of this study was to explore the experiences and perceptions of pregnant women taking part in research during a pregnancy affected by severe early-onset fetal growth restriction. Audio-recorded semi-structured telephone interviews were conducted with a purposive sample of 12 women, at least 1 year after delivery of their baby. Two of these pregnancies had ended in stillbirth and one in neonatal death, reflecting the outcomes seen in the EVERREST Prospective Study. Participants gave informed consent, were 16 years or older and were interviewed in English. A topic guide was used to ensure a consistent approach. Questions focused on pregnancy experiences, involvement with the EVERREST study and potential involvement in future research. Recordings were transcribed verbatim for thematic analysis using NVivo10. Results Four broad themes were identified; ‘before joining the EVERREST Prospective Study’, ‘participating in research’, ‘information and support’ and ‘looking back and looking forwards’. Each broad theme incorporated several subthemes. All participants recalled their reaction to being told their baby was smaller than expected. The way this news was given had a lasting impact. A range of benefits of participation in the EVERREST Prospective Study were described and the participants were positive about the way it was conducted. As a consequence, they were receptive to participating in future research. However, the findings suggest that research teams should be sensitive when approaching families at a difficult time or when they are already participating in other research. Conclusions This study highlights the willingness of pregnant women to participate in research and identifies strategies for researchers to engage participants. Electronic supplementary material The online version of this article (10.1186/s12884-019-2277-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Merryl E Harvey
- Faculty of Health, Education and Life Sciences, Birmingham City University, City South Campus, Westbourne Road, Edgbaston, Birmingham, B15 3TN, UK
| | - Anna L David
- EGA Institute for Women's Health, University College London, NIHR University College London Hospitals Biomedical Research Centre, Maple House, 149 Tottenham Court Road, London, W1T 7DN, UK
| | - Jade Dyer
- Comprehensive Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, 90 High Holborn, London, WC1V 6LJ, UK
| | - Rebecca Spencer
- EGA Institute for Women's Health, University College London, 86-98 Chenies Mews, London, WC1E 6HX, UK.
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Bryant J, Waller AE, Cameron EC, Sanson-Fisher RW, Hure AJ. Receipt of information about diet by pregnant women: A cross-sectional study. Women Birth 2018; 32:e501-e507. [PMID: 30559008 DOI: 10.1016/j.wombi.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 01/12/2023]
Abstract
PROBLEM Given the influence of diet on infant and maternal health outcomes, adequate knowledge about nutrition during pregnancy is critical. AIMS To examine among women receiving antenatal care the proportion who: (1) believe information about diet should be provided as part of routine antenatal care; (2) recall receiving advice about diet as part of care including: (a) when information was provided, (b) the healthcare provider who gave information, and (c) the format in which it was provided; and (3) attitudes towards information received. METHODS A cross-sectional survey was conducted with women attending a public antenatal clinic in New South Wales, Australia. Women were eligible to participate if they were: pregnant or had given birth in the previous 10 weeks; ≥18 years; and had at least one prior antenatal appointment for their current pregnancy. FINDINGS A total of 223 women (64% consent rate) participated. While the majority (86%) believed healthcare providers should be giving dietary information to pregnant women, only 63% recalled receiving information during their current pregnancy. Most often it was given by a midwife (76%). Information was initially provided in the first (52%) or second (38%) trimester, in both written and verbal form (60%). Approximately one third of participants felt overwhelmed or confused by which foods should be avoided during pregnancy. CONCLUSIONS A third of women did not recall receiving advice about diet as part of routine antenatal care. There is a need to develop a pathway to provide women with reliable, comprehensive advice about diet early in pregnancy.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Amy E Waller
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Emilie C Cameron
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rob W Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alexis J Hure
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Priority Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, New South Wales, Australia
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Inconsistent Weight Communication Among Prenatal Healthcare Providers and Patients: A Narrative Review. Obstet Gynecol Surv 2018; 73:423-432. [PMID: 30169887 DOI: 10.1097/ogx.0000000000000588] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Importance Gestational weight gain (GWG) is an independent and modifiable factor for a healthy pregnancy. Gestational weight gain above or below the Institute of Medicine Guidelines has been shown to impact both maternal and fetal health (eg, gestational diabetes, hypertension, downstream obesity). Healthcare providers (HCPs) have the potential to be reliable sources of evidence-based weight information and advice during pregnancy. Objective The aim of this study was to summarize the literature assessing GWG discussions between patients and their HCPs in a clinical setting to better understand the knowledge that is currently being exchanged. Evidence Acquisition A literature review was conducted by searching Ovid Medline, CINAHL, and Embase databases. All relevant primary research articles in English that assessed GWG discussions were included, whereas intervention studies were excluded. Results A total of 54 articles were included in this review. Although the overall prevalence and content of GWG counseling varied between studies, counseling was often infrequent and inaccurate. Healthcare providers tended to focus more on women experiencing obesity and excessive GWG, as opposed to the other body mass index categories or inadequate GWG. Women of higher socioeconomic status, older age, nulliparous, history of dieting, low physical activity, and those categorized as overweight/obese were more likely to receive GWG advice. Patients also reported receiving conflicting facts between different HCP disciplines. Conclusions The evidence regarding GWG counseling in prenatal care remains variable, with discrepancies between geographic regions, patient populations, and HCP disciplines. Relevance Healthcare providers should counsel their pregnant patients on GWG with advice that is concordant with the Institute of Medicine Guidelines.
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Wilkinson SA, Donaldson E, McCray SJ. Re-evaluating the nutritional awareness, knowledge and eating behaviours of women attending a tertiary maternity hospital following iterative service redesign. Nutr Diet 2018; 75:372-380. [DOI: 10.1111/1747-0080.12475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/12/2018] [Accepted: 08/17/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Shelley A. Wilkinson
- Department of Nutrition and Dietetics; Mater Group; Brisbane Queensland Australia
- Mater Research Institute; University of Queensland; Brisbane Queensland Australia
| | - Elin Donaldson
- Department of Nutrition and Dietetics; Mater Group; Brisbane Queensland Australia
| | - Sally J. McCray
- Department of Nutrition and Dietetics; Mater Group; Brisbane Queensland Australia
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Christenson A, Johansson E, Reynisdottir S, Torgerson J, Hemmingsson E. Shame and avoidance as barriers in midwives’ communication about body weight with pregnant women: A qualitative interview study. Midwifery 2018; 63:1-7. [DOI: 10.1016/j.midw.2018.04.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 01/20/2023]
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Emery RL, Benno MT, Salk RH, Kolko RP, Levine MD. Healthcare provider advice on gestational weight gain: uncovering a need for more effective weight counselling. J OBSTET GYNAECOL 2018; 38:916-921. [PMID: 29564951 DOI: 10.1080/01443615.2018.1433647] [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] [Indexed: 10/17/2022]
Abstract
Limited research has examined the factors related to knowledge of gestational weight gain (GWG) recommendations and the receipt of advice from healthcare providers regarding GWG recommendations among women with pre-pregnancy overweight/obesity. Women with pre-pregnancy overweight/obesity (N = 191) reported the amount of gestational weight they believed they should gain and that healthcare providers advised them to gain. Only 24% (n = 46) of women had a correct knowledge of GWG recommendations. Women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged. Meanwhile, only 17% (n = 32) of women reported being correctly advised about GWG recommendations by healthcare providers. There were no differences between women who did and did not report being correctly advised about GWG recommendations from healthcare providers. These findings indicate that women with pre-pregnancy overweight/obesity lack knowledge of GWG recommendations and report being incorrectly advised about GWG recommendations from healthcare providers. Impact statement What is already known on this subject? Extant literature indicates that women's knowledge of gestational weight gain (GWG) recommendations and women's receipt of information from their healthcare providers regarding GWG recommendations are predictive of meeting the Institute of Medicine guidelines for GWG. What do the results of this study add? Findings from the present study indicate that the majority of women with pre-pregnancy overweight/obesity lack knowledge of GWG recommendations and report that education on GWG recommendations from healthcare providers is an aspect of their prenatal care that is largely insufficient. Although there were no differences between women who did and did not report being correctly advised about GWG recommendations by healthcare providers, women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged. What are the implications of these findings for clinical practise and/or further research? These findings highlight a need for more effective tailoring of prenatal care to ensure that women receive accurate advice from healthcare providers regarding GWG recommendations.
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Affiliation(s)
- Rebecca L Emery
- a Department of Psychology , University of Pittsburgh , Pittsburgh , PA , USA
| | - Maria Tina Benno
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Rachel H Salk
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Rachel P Kolko
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Michele D Levine
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
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Bessett D, Murawsky S. 'I guess I do have to take back what I said before, about television': pregnant women's understandings and use of televisual representations of childbearing. SOCIOLOGY OF HEALTH & ILLNESS 2018; 40:478-493. [PMID: 29274085 DOI: 10.1111/1467-9566.12658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research on television as a source of childbearing information is divided on its importance. Drawing from a sample of 64 pregnant women in the greater New York and Connecticut metropolitan area, we examine how women understand the influence of television on their expectations for pregnancy and birth. A sizable minority (44%) regularly watched reality television programmes on childbearing; all engaged in active viewing practices, such as recognising programme formula and evaluating plausibility of depictions. We find clear educational differences in how viewers believed television influenced their pregnancy knowledge: women with higher levels of education generally disavowed all television as an information source, but used reality programming to educate their children about pregnancy and for entertainment. Women who had lower educational attainment were more likely to include reality programmes as part of their comprehensive approach to information gathering. Only one woman asserted that fictional television was a good source of pregnancy information. Although many devalued television, women referenced television programmes and imagery as they described their expectations and concerns for pregnancy. A large proportion of respondents were unaware of the influence television exerted on them. Health scholars must better engage with the complexities of media use.
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Affiliation(s)
| | - Stef Murawsky
- Department of Sociology, University of Cincinnati, USA
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Morais SS, Nascimento SL, Godoy-Miranda AC, Kasawara KT, Surita FG. Body Mass Index Changes during Pregnancy and Perinatal Outcomes - A Cross-Sectional Study. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2018; 40:11-19. [PMID: 29253913 PMCID: PMC10467363 DOI: 10.1055/s-0037-1608885] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/17/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes. METHODS A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared. RESULTS An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetal macrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83). CONCLUSION Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.
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Forbes L, Baarda J, Mayan M, Bell RC. Qualitative Assessment of Key Messages about Nutrition and Weight Gain in Pregnancy in Printed Educational Materials in Alberta. CAN J DIET PRACT RES 2017; 78:182-186. [PMID: 28537130 DOI: 10.3148/cjdpr-2017-011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Printed educational materials are a common source of health information, although their effectiveness in improving women's knowledge or self-care in pregnancy has been questioned. This study describes the information in printed educational materials that address healthy eating during pregnancy and gestational weight gain (GWG) that are currently used in Alberta, Canada. Content of 6 resources was analyzed using a constant comparison qualitative approach. Resources emphasized healthy eating, prenatal supplements, folate supplementation, and healthy weight gain. More resources discussed the importance of "eating enough" than provided guidance on avoiding excessive GWG. Themes identified were: "everything is important" meaning that all healthy behaviours are important, making prioritization difficult; "more is more" emphasized eating more over moderation; "everyone is individual" suggests women seek individualized care through the care provider; and "contradictions" describes differences in content and recommendations within and between resources. New or revised versions of resources should provide congruent information with up-to-date recommendations that are easily prioritized. Care providers should be aware of contradictory information or information that does not align with current recommendations within printed educational materials and be ready to help women address the areas important for her personal behaviour change.
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Affiliation(s)
- Laura Forbes
- a Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - Janis Baarda
- b Department of Agriculture, Food and Nutritional Sciences, University of Alberta, Edmonton, AB
| | - Maria Mayan
- c Faculty of Extension, University of Alberta, Edmonton, AB
| | - Rhonda C Bell
- b Department of Agriculture, Food and Nutritional Sciences, University of Alberta, Edmonton, AB
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Piccinini-Vallis H. Clinician self-efficacy in initiating discussions about gestational weight gain. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e341-e349. [PMID: 28701460 PMCID: PMC5507245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To compare prenatal care providers' perceived self-efficacy in starting discussions about gestational weight gain with pregnant women under a variety of conditions of gradated difficulty, when weight gain has been in excess of current guidelines. DESIGN A 42-item online questionnaire related to the known barriers to and facilitators of having discussions about gestational weight gain. SETTING Canada. PARTICIPANTS Prenatal care providers were contacted through the Family Medicine Maternity Care list server of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES The 42 items were clustered into categories representing patient factors, interpersonal factors, and system factors. Participants scored their self-efficacy on a scale from 0 ("cannot do at all") to 5 ("moderately certain can do") to 10 ("highly certain can do"). The significance level was set at α = .05. RESULTS Overall, clinicians rated their self-efficacy to be high, ranging from a low mean (SD) score of 5.14 (3.24) if the clinic was running late, to a high mean score of 8.97 (1.34) if the clinician could externalize the reason for undertaking the discussion. There were significant differences in self-efficacy scores within categories depending on the degree of difficulty proposed by the items in those categories. CONCLUSION The results were inconsistent with previous studies that have demonstrated that prenatal care providers do not frequently raise the subject of excess gestational weight gain. On the one hand providers rate their self-efficacy in having these discussions to be high, but on the other hand they do not undertake the behaviour, at least according to their patients. Future research should explore this discrepancy with a view to informing interventions to help providers and patients in their efforts to address excess gestational weight gain, which is increasingly an important contributor to the obesity epidemic.
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Affiliation(s)
- Helena Piccinini-Vallis
- Associate Professor of Family Medicine at Dalhousie University in Halifax, NS, and a doctoral candidate in family medicine at Western University in London, Ont.
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Mercado A, Marquez B, Abrams B, Phipps MG, Wing RR, Phelan S. Where Do Women Get Advice About Weight, Eating, and Physical Activity During Pregnancy? J Womens Health (Larchmt) 2017; 26:951-956. [PMID: 28525293 DOI: 10.1089/jwh.2016.6078] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most women report not receiving information about gestational weight gain (GWG) from prenatal providers, but less is known about other sources of information and their potential impacts on GWG. The purpose of this study was to investigate sources of information about diet, physical activity, and weight control during pregnancy, and the impact of information sources on maternal GWG. MATERIALS AND METHODS Participants were 183 women with normal weight and 172 women with overweight/obesity who had enrolled in a prenatal lifestyle intervention trial. At 6 weeks postpartum, women were asked whether they had received information about "diet, physical activity, or weight control" from 12 sources uninvolved in the trial (e.g., physician, Internet, and friend) and, if received, the extent to which they followed the advice. Information sources were examined in relation to odds of exceeding Institute of Medicine (IOM) GWG guidelines based on measured weights. RESULTS Most women reported receiving information from a book (60.6%) or the Internet (58.3%). Advice from physicians, dietitians, or nurses was reported in 55.6%, 48.2%, and 33.9% of women, respectively. Reported receipt of information from physicians was associated with reduced Odds Ratio ([95% Confidence Interval] = 0.55 [0.35-0.88]; p = 0.01) of exceeding IOM GWG guidelines. Reported receipt of information from other sources was not related to GWG. CONCLUSIONS Books and the Internet were the most prevalent information sources reported for prenatal diet, physical activity, and weight control. However, of all sources, only physician provision of information was associated with reduced odds of excessive GWG.
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Affiliation(s)
- Adrian Mercado
- 1 Kinesiology Department, California Polytechnic State University , San Luis Obispo, California
| | - Becky Marquez
- 2 Department of Family Medicine and Public Health, University of California , San Diego, San Diego, California
| | - Barbara Abrams
- 3 Epidemiology Division, School of Public Health, University of California , Berkeley, Berkeley, California
| | - Maureen G Phipps
- 5 Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University , Providence, Rhode Island
| | - Rena R Wing
- 4 Department of Psychiatry, The Miriam Hospital, Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University , Providence, Rhode Island
| | - Suzanne Phelan
- 1 Kinesiology Department, California Polytechnic State University , San Luis Obispo, California
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Willcox JC, Wilkinson SA, Lappas M, Ball K, Crawford D, McCarthy EA, Fjeldsoe B, Whittaker R, Maddison R, Campbell KJ. A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial. BJOG 2017; 124:1718-1728. [DOI: 10.1111/1471-0528.14552] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 01/06/2023]
Affiliation(s)
- JC Willcox
- Institute for Physical Activity and Nutrition; Deakin University; Burwood Vic. Australia
| | - SA Wilkinson
- Mater Research Institute; University of Queensland; South Brisbane QLD Australia
- Department of Nutrition & Dietetics; Mater Mothers Hospital; South Brisbane QLD Australia
| | - M Lappas
- Department of Obstetrics and Gynaecology; University of Melbourne; Melbourne Vic. Australia
| | - K Ball
- Institute for Physical Activity and Nutrition; Deakin University; Burwood Vic. Australia
| | - D Crawford
- Institute for Physical Activity and Nutrition; Deakin University; Burwood Vic. Australia
| | - EA McCarthy
- Department of Obstetrics and Gynaecology; University of Melbourne; Melbourne Vic. Australia
- Mercy Hospital for Women; Melbourne Vic. Australia
| | - B Fjeldsoe
- School of Public Health; The University of Queensland; Herston QLD Australia
| | - R Whittaker
- National Institute for Health Innovation; University of Auckland; Auckland New Zealand
| | - R Maddison
- Institute for Physical Activity and Nutrition; Deakin University; Burwood Vic. Australia
| | - KJ Campbell
- Institute for Physical Activity and Nutrition; Deakin University; Burwood Vic. Australia
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