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Harrison CL, Brammall BR, Garad R, Teede H. OptimalMe Intervention for Healthy Preconception, Pregnancy, and Postpartum Lifestyles: Protocol for a Randomized Controlled Implementation Effectiveness Feasibility Trial. JMIR Res Protoc 2022; 11:e33625. [PMID: 35679115 PMCID: PMC9227652 DOI: 10.2196/33625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/15/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Reproductive-aged women are a high-risk population group for accelerated weight gain and obesity development, with pregnancy recognized as a critical contributory life-phase. Healthy lifestyle interventions during the antenatal period improve maternal and infant health outcomes, yet translation and implementation of such interventions into real-world health care settings remains limited. Objective We aim to generate key implementation learnings to inform the feasibility of future scale up and determine the effectiveness of intervention delivery methods on engagement, experience, acceptability, knowledge, risk perception, health literacy, and modifiable weight-related health behaviors in women during preconception, pregnancy, and postpartum periods. Methods This randomized hybrid implementation effectiveness study will evaluate the penetration, reach, feasibility, acceptability, adoption, and fidelity of a healthy lifestyle intervention (OptimalMe) implemented into, and in partnership with, private health care. Individual health outcomes associated with implementation delivery mode, including knowledge, risk perception, health literacy, self-management, and health behaviors, are secondary outcomes. A total of 300 women aged 18 to 44 years, who are not pregnant but wish to conceive within the next 12 months, and with access to the internet will be recruited. All participants will receive the same digital lifestyle intervention, OptimalMe, which is supported by health coaching and text messages during preconception, pregnancy, and postpartum periods. We will use a parallel 2-arm design to compare telephone with videoconference remote delivery methods for health coaching. Methods are theoretically underpinned by the Consolidated Framework for Implementation Research and outcomes based on the Reach, Engagement, Adaptation, Implementation and Maintenance framework. Results The study was approved on August 16, 2019 and has been registered. Recruitment commenced in July 2020, and data collection is ongoing. Results are expected to be published in 2022. Conclusions The study’s design aligns with best practice implementation research. Results will inform translation of evidence from randomized controlled trials on healthy lifestyle interventions into practice targeting women across preconception, pregnancy, and postpartum periods. Learnings will target consumers, program facilitators, health professionals, services, and policy makers to inform future scale up to ultimately benefit the health of women across these life-phases. Trial Registration Australian and New Zealand Clinical Trial Registry ACTRN12620001053910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378243&isReview=true International Registered Report Identifier (IRRID) DERR1-10.2196/33625
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Affiliation(s)
- Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Clayton, Australia.,Endocrine and Diabetes Unit, Monash Health, Clayton, Australia
| | - Bonnie R Brammall
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Clayton, Australia
| | - Rhonda Garad
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Clayton, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Clayton, Australia.,Endocrine and Diabetes Unit, Monash Health, Clayton, Australia
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Fealy S, Hollis J, Martin J, Leigh L, Oldmeadow C, Collins CE, Smith R, Wilkinson S, Hure A. Modeling the Predictive Value of Evidence-Based Referral Criteria to Support Healthy Gestational Weight Gain among an Australian Pregnancy Cohort. Nutrients 2022; 14:381. [PMID: 35057562 PMCID: PMC8779448 DOI: 10.3390/nu14020381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
Globally, there has been a renewed focus on addressing gestational weight gain (GWG). In Australia, the Department of Health pregnancy care guidelines recommend women be offered routine weighing and receive brief nutritional and physical activity support during antenatal care visits. Women gaining weight outside the Institute of Medicine (IOM)'s weight gain reference values are further recommended to be referred to a dietitian. However, professional and organizational barriers, including an absence of weight gain referral pathways and limited workforce resources, exist with the translation and scaling of these recommendations into practice. This study aimed to explore patterns of GWG among a cohort of Australian pregnant women and to determine if pregnancy weight gains of above or below 2 kg or 5 kg in the second and third trimester can be used to predict total GWG outside recommendations. Sensitivity, specificity, negative, and positive likelihood ratios were calculated. The most predictive time point was 24 weeks' gestation using the minimum weight change parameter of +/-2 kg, demonstrating reasonable sensitivity (0.81, 95% CI 0.61-0.83) and specificity (0.72, 95% CI 0.61-0.83), resulting in 55% (n = 72/131) of the cohort qualifying for dietetic referral. Given the current health service constraints, a review of dietetic services within maternity care is warranted.
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Affiliation(s)
- Shanna Fealy
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (S.F.); (J.H.); (J.M.); (R.S.)
- School of Nursing, Paramedicine and Healthcare Sciences, Faculty of Science and Health, Charles Sturt University, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
| | - Jenna Hollis
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (S.F.); (J.H.); (J.M.); (R.S.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Julia Martin
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (S.F.); (J.H.); (J.M.); (R.S.)
| | - Lucy Leigh
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
| | - Clare E. Collins
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- School of Health Sciences, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Roger Smith
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (S.F.); (J.H.); (J.M.); (R.S.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- Department of Endocrinology, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Shelley Wilkinson
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St. Lucia, QLD 4067, Australia;
| | - Alexis Hure
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (S.F.); (J.H.); (J.M.); (R.S.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
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Fealy S, Jones D, Davis D, Hazelton M, Foureur M, Attia J, Hure A. Pregnancy weight gain a balancing act: The experience and perspectives of women participating in a pilot randomised controlled trial. Midwifery 2021; 106:103239. [PMID: 35026536 DOI: 10.1016/j.midw.2021.103239] [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] [Received: 07/13/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Supporting women to achieve healthy gestational weight gain is a global health challenge. Inadequate and excessive gestational weight gains are associated with short and long-term adverse maternal and infant health outcomes. Qualitative studies suggest that symptoms of pregnancy, health professional attitudes, lack of guidance, personal knowledge and beliefs, lack of support, weight stigma, and lack of time and money, are barriers to achieving healthy weight gain. Less is known about women's perceptions and experience of gestational weight gain within normal body mass index categories with even less known about the experience of women motivated to participate in pregnancy weight management intervention trials. AIM To describe the experience and perspectives of women participating in an Australian weight management pilot randomised controlled trial. METHODS Five women from regional New South Wales enrolled in the Eating 4 Two trial, participated in semi - structured interviews during the post-natal period. A qualitative descriptive methodology and inductive thematic analysis was applied. FINDINGS Two main themes emerged: 1) Addressing weight gain in pregnancy; and 2) Pregnancy weight the balancing act. Women identified weight gain as an important topic, the need for improvements within maternity services, responsive feedback and realistic support strategies. Women identified pregnancy symptoms, occurring during early and late pregnancy as barriers to achieving healthy weight gain. CONCLUSION Further investigation into the effects of pregnancy symptoms on eating and physical activity patterns across pregnancy is warranted. Both qualitative and quantitative research is needed to monitor the translation of guideline recommendations into clinical practice.
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Affiliation(s)
- Shanna Fealy
- Charles Sturt University, Faculty of Science, School of Nursing, Paramedicine and Healthcare Sciences, 7 Major Innes Road, Port Macquarie, NSW, Australia, 2444; University of Newcastle, College of Health, Medicine and Wellbeing, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia, 2308; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia, 2305.
| | - Donovan Jones
- Charles Sturt University, Faculty of Science, School of Nursing, Paramedicine and Healthcare Sciences, 7 Major Innes Road, Port Macquarie, NSW, Australia, 2444; University of Newcastle, College of Health, Medicine and Wellbeing, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia, 2308
| | - Deborah Davis
- University of Canberra and ACT Government Health Directorate
| | - Michael Hazelton
- Charles Sturt University, Faculty of Science, School of Nursing, Paramedicine and Healthcare Sciences, 7 Major Innes Road, Port Macquarie, NSW, Australia, 2444; University of Newcastle, College of Health, Medicine and Wellbeing, School of Nursing and Midwifery, University Drive, Callaghan, NSW, Australia, 2308; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia, 2305
| | - Maralyn Foureur
- University of Newcastle, College of Health, Medicine and Wellbeing, School of Nursing and Midwifery, University Drive, Callaghan, NSW, Australia, 2308; Hunter New England Health Nursing and Midwifery Research Centre
| | - John Attia
- University of Newcastle, College of Health, Medicine and Wellbeing, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia, 2308; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia, 2305
| | - Alexis Hure
- University of Newcastle, College of Health, Medicine and Wellbeing, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia, 2308; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia, 2305
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Liu S, Sun Y, Luo N. Doppler Ultrasound Imaging Combined with Fetal Heart Detection in Predicting Fetal Distress in Pregnancy-Induced Hypertension under the Guidance of Artificial Intelligence Algorithm. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:4405189. [PMID: 34659686 PMCID: PMC8519722 DOI: 10.1155/2021/4405189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
This study was to improve the feasibility and economic benefits of intelligent medical system Doppler ultrasound (DUS) imaging technology combined with fetal heart detection to predict the fetal distress in pregnancy-induced hypertension (PIH), so as to reduce the risk of deterioration of the patient's condition. The characteristics of DUS images were analyzed, and a diffusion filter reducing the specificity was adopted to improve the smooth speckle noise of DUS images. 120 pregnant women in hospital were the subjects of the study, all of whom received ultrasound cord blood flow testing and fetal heart monitoring. 88 PIH patients with fetal distress were diagnosed and included in the observation group, and 32 healthy pregnant women tested during the same period were identified as the control group. Clinical data were reviewed and analyzed. The diagnostic rates of fetal distress by simple fetal heart monitoring and DUS detection combined with fetal heart monitoring were compared. The results showed that 26.7% of fetal distress were diagnosed by fetal heart monitoring alone, and 73.3% of fetal distress were diagnosed by combined testing, so the diagnostic accuracy of the combined detection method was greatly higher than the single fetal heart detection (P < 0.05). The Pulsatility index (PI), resistance index (RI), and S/D values detected by the umbilical artery in the observation group were 1.48, 0.85, and 4.31, respectively. The PI, RI, and S/D values detected by the umbilical artery in the control group were 0.96, 0.64, and 3.59, respectively. The results of arterial detection were significantly higher than those of the control group, and the difference was of significant scientific significance (P < 0.05). In summary, the PI and RI values of the middle cerebral artery (MCA) detected by DUS diagnosis can effectively reflect the current status of the fetus in the uterus and reduce the mortality of the fetus. The images guided by DUS imaging technology can clearly show the current status of the fetus in the uterus, effectively improve the medical diagnostic efficiency, and have important reference value for the development of intelligent medical equipment.
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Affiliation(s)
- Su Liu
- Department of Obstetrics, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar 161000, Heilongjiang, China
| | - Yue Sun
- Department of Ultrasound, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar 161000, Heilongjiang, China
| | - Na Luo
- Department of Ultrasound, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar 161000, Heilongjiang, China
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Makama M, Skouteris H, Moran LJ, Lim S. Reducing Postpartum Weight Retention: A Review of the Implementation Challenges of Postpartum Lifestyle Interventions. J Clin Med 2021; 10:1891. [PMID: 33925502 PMCID: PMC8123857 DOI: 10.3390/jcm10091891] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/15/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
Postpartum weight retention (PPWR) is a strong predictor of obesity in later life with long term health consequences in women. Suboptimal lifestyle behaviours (e.g., diet and physical activity) contribute to PPWR. Postpartum lifestyle interventions are known to be efficacious in reducing PPWR; however, there are challenges to their successful implementation. To inform implementation, this narrative review provides an overview of the factors that contribute to PPWR, the efficacy of existing postpartum lifestyle interventions and key determinants of effective implementation using the Consolidated Framework for Implementation Research (CFIR) across intervention characteristics, implementation process, individual characteristics and outer and inner setting. We then suggest strategies to improve the translation of evidence into large-scale interventions that deliver on health impact in postpartum women. We have identified gaps that need to be addressed to advance postpartum lifestyle research, including the involvement of postpartum women and community members as key stakeholders for optimal reach and engagement, more complete reporting of intervention characteristics to optimize translation of evidence into practice, capacity building of health professionals and guidelines for postpartum lifestyle management.
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Affiliation(s)
- Maureen Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
| | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
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A Revalidation of the Weight Related Behaviours Questionnaire within an Australian Pregnancy Cohort. Midwifery 2021; 97:102951. [PMID: 33677171 DOI: 10.1016/j.midw.2021.102951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/17/2020] [Accepted: 02/10/2021] [Indexed: 11/23/2022]
Abstract
PROBLEM Studies investigating the direct and indirect relationships between psychosocial factors (i.e. attitudes, beliefs and values), health related behaviour (diet and physical activity) and gestational weight gain are increasing. To date heterogeneity of psychosocial measurement tools has limited research progress in this area, preventing measurement of effects by meta-analysis techniques. AIM To conduct a revalidation analysis of a Weight Related Behaviours Questionnaire, originally developed by Kendall, Olson and Frangelico within the United States of America and assess its performance for use within the Australian context. METHODS A revalidation study using Exploratory Factor Analysis was undertaken to assess the factor structure and internal consistency of the six psychosocial scales of the Weight Related Behaviours Questionnaire, within the Woman and Their Children's Health (WATCH), pregnancy cohort. The questionnaire was self-completed between 18 - 20 weeks gestation. Psychosocial factors included; Weight locus of control; Self-efficacy; Attitudes towards weight gain; Body image, Feelings about the motherhood role; and Career orientation. FINDINGS Weight locus of control, Self-efficacy and Body image, retained the same factor structure as the original analysis. The remaining psychosocial factors observed a different factor structure in terms of loadings or number of factors. Deleted items modelling suggests the questionnaire could be strengthened and shortened. CONCLUSION Weight Locus of control, Self-efficacy and Body image were observed as consistent, valid and reliable psychosocial measures for use within the Australian context. Further research is needed to confirm the model and investigate the potential for combining these scales into a shorter psychosocial measurement tool.
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Larsen JK, Bode L. Obesogenic Programming Effects during Lactation: A Narrative Review and Conceptual Model Focusing on Underlying Mechanisms and Promising Future Research Avenues. Nutrients 2021; 13:nu13020299. [PMID: 33494303 PMCID: PMC7911998 DOI: 10.3390/nu13020299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/09/2021] [Accepted: 01/19/2021] [Indexed: 12/18/2022] Open
Abstract
Animal studies have consistently demonstrated that maternal obesity and a high-fat diet during lactation enhances obesity risk in the offspring. However, less is known about these potential obesogenic programming effects in obese humans. We propose three important pathways that may explain obesogenic programming effects of human breastmilk. First, human milk components and hormones may directly affect child eating and satiety characteristics. Second, human milk constituents can affect child microbiota that, in turn, may influence child eating and weight outcomes. Third, human milk composition may affect child eating and weight outcomes through flavor exposure. We reviewed a few very recent findings from well-powered longitudinal or experimental human research with regard to these three pathways. Moreover, we provide a research agenda for future intervention research with the overarching aim to prevent excessive pediatric weight gain during lactation and beyond. The ideas presented in this paper may represent important “black box” constructs that explain obesogenic programming effects during lactation. It should be noted, however, that given the scarcity of studies, findings should be seen as working hypotheses to further test in future research.
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Affiliation(s)
- Junilla K. Larsen
- Behavioural Science Institute, Radboud University, PO Box 9104, 6500 HE Nijmegen, The Netherlands
- Correspondence:
| | - Lars Bode
- Department of Pediatrics and Larsson-Rosenquist-Foundation Mother-Milk-Infant Center of Research Excellence, University of California, San Diego, CA 92101, USA;
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Bergmeier HJ, Vandall-Walker V, Skrybant M, Teede HJ, Bailey C, Baxter JAB, Borges ALV, Boyle JA, Everitt A, Harrison CL, Herrera M, Hill B, Jack B, Jones S, Jorgensen L, Lim S, Montanaro C, Redman LM, Stephenson J, Sundseth H, Thangaratinam S, Thynne P, Walker R, Skouteris H. Global Health in Preconception, Pregnancy and Postpartum Alliance: development of an international consumer and community involvement framework. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:47. [PMID: 32793390 PMCID: PMC7419190 DOI: 10.1186/s40900-020-00218-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The goal of the Global Health in Preconception, Pregnancy and Postpartum (HiPPP) Alliance, comprising consumers and leading international multidisciplinary academics and clinicians, is to generate research and translation priorities and build international collaboration around healthy lifestyle and obesity prevention among women across the reproductive years. In doing so, we actively seek to involve consumers in research, implementation and translation initiatives. There are limited frameworks specifically designed to involve women across the key obesity prevention windows before (preconception), during and after pregnancy (postpartum). The aim of this paper is to outline our strategy for the development of the HiPPP Consumer and Community (CCI) Framework, with consumers as central to co-designed, co-implemented and co-disseminated research and translation. METHOD The development of the framework involved three phases: In Phase 1, 21 Global HiPPP Alliance members participated in a CCI workshop to propose and discuss values and approaches for framework development; Phase 2 comprised a search of peer-reviewed and grey literature for existing CCI frameworks and resources; and Phase 3 entailed collaboration with consumers (i.e., members of the public with lived experience of weight/lifestyle issues in preconception, pregnancy and postpartum) and international CCI experts to workshop and refine the HiPPP CCI Framework (guided by Phases 1 and 2). RESULTS The HiPPP CCI Framework's values and approaches identified in Phases 1-2 and further refined in Phase 3 were summarized under the following five key principles: 1. Inclusive, 2. Flexible, 3. Transparent, 4. Equitable, and 5. Adaptable. The HiPPP Framework describes values and approaches for involving consumers in research initiatives from design to translation that focus on improving healthy lifestyles and preventing obesity specifically before, during and after pregnancy; importantly it takes into consideration common barriers to partnering in obesity research during perinatal life stages, such as limited availability associated with family caregiving responsibilities. CONCLUSION The HiPPP CCI Framework aims to describe approaches for implementing meaningful CCI initiatives with women in preconception, pregnancy and postpartum periods. Evaluation of the framework is now needed to understand how effective it is in facilitating meaningful involvement for consumers, researchers and clinicians, and its impact on research to improve healthy lifestyle outcomes.
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Affiliation(s)
- Heidi J. Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | | | - Magdalena Skrybant
- NIHR Applied Reseach Collaboration West Midlands, Midlands, UK
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Monash Partners Advanced Health Research Translation Centre, Clayton, Victoria Australia
- Monash Health, Melbourne, Clayton, Victoria Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Jo-Anna B. Baxter
- Centre for Global Child Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada
| | | | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Monash Health, Melbourne, Clayton, Victoria Australia
| | - Ayesha Everitt
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Margely Herrera
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Brian Jack
- Boston University Institute for Health Systems Innovation and Policy, Boston, MA USA
| | - Samuel Jones
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Laura Jorgensen
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Cynthia Montanaro
- Wellington-Dufferin-Guelph Public Health, 160 Chancellors Way, Guelph, Ontario Canada
| | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, USA
| | - Judith Stephenson
- Institute of Women’s Health, University College London, EGA Institute for Women’s Health, London, UK
| | - Hildrun Sundseth
- European Institute of Women’s Health, Dublin, Republic of Ireland
| | - Shakila Thangaratinam
- Institute of Metabolism and Systems Research, WHO Collaborating Centre for Women’s Health University of Birmingham, Birmingham, UK
| | - Paula Thynne
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Warwick Business School, University of Warwick, Coventry, UK
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9
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Haakstad LAH, Mjønerud JMF, Dalhaug EM. MAMMA MIA! Norwegian Midwives' Practices and Views About Gestational Weight Gain, Physical Activity, and Nutrition. Front Psychol 2020; 11:1463. [PMID: 32848969 PMCID: PMC7396544 DOI: 10.3389/fpsyg.2020.01463] [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: 02/13/2020] [Accepted: 06/02/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives Most studies regarding prevalence of prenatal lifestyle counseling are based on patient report of provider advice. The aim of the present study was to describe midwives' practice and views in promoting three distinct, but importantly related lifestyle factors: gestational weight gain (GWG), regular physical activity (PA), and nutrition. Design A cross-sectional study. Setting Healthcare clinics in Oslo and Akershus County, Norway. Participants Clinics that expressed interest to participate provided an email list of the midwives. Of 107 midwives invited to participate, 65 completed the 15-min electronic survey (SurveyXact), giving a response rate of 60.7%. Outcome Measures We developed a new questionnaire based on questions and results from similar studies, as no validated questionnaires existed when we initiated this project in 2014. The final electronic questionnaire included a mix of close-ended questions, semi-close-ended questions, and 11-point Likert scales and covered demographics, personal health behaviors, counseling practice, views, and self-perceived role in lifestyle counseling. Results Mean workload in prenatal care was 78%, and mean years practicing was 8.9 (±7.5). Across all three health topics, most (74-95%) reported to give advice on the first meeting, with a mean frequency of 2.2 (±1.4), 2.7 (±1.8), and 2.7 (±2.0) for GWG, PA, and nutrition counseling, respectively. Approximately 40% did not report advice on GWG or give advice discordant with the Institute of Medicine (IOM) recommendations (2009) for at least one prepregnancy body mass index (BMI) category. GWG was rated as more unpleasant to talk about than PA (3.0 ± 2.8 vs. 1.1 ± 2.5, p < 0.001) and nutrition (3.0 ± 2.8 vs. 1.2 ± 2.5, p = 0.002). Also, regarding the importance of giving lifestyle advice, PA (9.6 ± 0.9 vs. 8.3 ± 2.2, p < 0.001) and nutrition (9.9 ± 0.4 vs. 8.3 ± 2.2, p < 0.001) were rated as more important than advice about GWG. Postpartum, nearly 40% gave advice about PA, whereas only two (3.1%) reported to discuss weight/weight retention (p < 0.001). Conclusion While most midwives gave advice on GWG, PA, and nutrition at the first meeting and rated lifestyle counseling as an important topic, the advice on GWG was often discordant with IOM recommendations, and the topic was viewed as more unpleasant to talk about than PA and nutrition.
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Affiliation(s)
- Lene A H Haakstad
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Julie M F Mjønerud
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Emilie Mass Dalhaug
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Hill B, Skouteris H, Boyle JA, Bailey C, Walker R, Thangaratinam S, Sundseth H, Stephenson J, Steegers E, Redman LM, Montanaro C, Lim S, Jorgensen L, Jack B, Borges ALV, Bergmeier HJ, Baxter JAB, Harrison CL, Teede HJ. Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Pregnancy Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications. J Clin Med 2020; 9:E822. [PMID: 32197374 PMCID: PMC7141234 DOI: 10.3390/jcm9030822] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 12/19/2022] Open
Abstract
In this article, we describe the process of establishing agreed international pregnancy research priorities to address the global issues of unhealthy lifestyles and rising maternal obesity. We focus specifically on the prevention of maternal obesity to improve related clinical pregnancy and long-term complications. A team of multidisciplinary, international experts in preconception and pregnancy health, including consumers, were invited to form the Health in Preconception, Pregnancy and Postpartum (HiPPP) Global Alliance. As an initial activity, a priority setting process was completed to generate pregnancy research priorities in this field. Research, practice and policy gaps were identified and enhanced through expert and consumer consultation, followed by a modified Delphi process and Nominal Group Technique, including an international workshop. Research priorities identified included optimising: (1) healthy diet and nutrition; (2) gestational weight management; (3) screening for and managing pregnancy complications and pre-existing conditions; (4) physical activity; (5) mental health; and (6) postpartum (including intrapartum) care. Given extensive past research in many of these areas, research priorities here recognised the need to advance pregnancy research towards pragmatic implementation research. This work has set the agenda for large-scale, collaborative, multidisciplinary, implementation research to address the major public health and clinical issue of maternal obesity prevention.
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Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
- Warwick Business School, Warwick University; Coventry CV47AL, UK
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Shakila Thangaratinam
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, 58 Turner Street, London E1 2AB, UK; (S.T.); (L.J.)
| | - Hildrun Sundseth
- European Institute of Women’s Health, 33 Pearse Street, Dublin 2, Ireland;
| | - Judith Stephenson
- Institute for Women’s Health, University College London, EGA Institute for Women’s Health, 74 Huntley St, London WC1E 6AU, UK;
| | - Eric Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Centre–Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands;
| | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, USA;
| | - Cynthia Montanaro
- Wellington-Dufferin-Guelph Public Health, 160 Chancellors Way, Guelph, ON N1G 0E1, Canada;
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Laura Jorgensen
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, 58 Turner Street, London E1 2AB, UK; (S.T.); (L.J.)
| | - Brian Jack
- Department of Family Medicine, Boston University School of Medicine, 771 Albany St, Boston, MA 02118, USA;
| | - Ana Luiza Vilela Borges
- Public Health Nursing Department, University of Sao Paulo, 419 Cerqueira Cesar, Sao Paulo 05403000, Brazil;
| | - Heidi J. Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Jo-Anna B. Baxter
- Centre for Global Child Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON MG5 0A4, Canada;
- Department of Nutritional Sciences, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
- Monash Partners Advanced Health Research Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia
- Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia
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Madden SK, Skouteris H, Bailey C, Hills AP, Ahuja KDK, Hill B. Women in the Workplace: Promoting Healthy Lifestyles and Mitigating Weight Gain during the Preconception, Pregnancy, and Postpartum Periods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030821. [PMID: 32013002 PMCID: PMC7037665 DOI: 10.3390/ijerph17030821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 12/19/2022]
Abstract
Overweight and obesity before, during, and after pregnancy are associated with adverse outcomes for mothers and their offspring. Workplaces have been identified as important settings for improving health and wellbeing. However, the value of workplace interventions for women across the reproductive life stages has yet to be realized. This paper aims to explore the potential of workplaces to facilitate healthy lifestyle behaviors, prevent further weight gain, and devise tailored interventions for working women, specifically during the preconception, pregnancy, and postpartum periods. Workplaces can be used to engage women, including preconception women, who are detached from clinical settings. Potential benefits of workplace health promotion for women and employers include improved employee wellbeing, productivity, and corporate competitiveness. However, workplaces also need to overcome implementation barriers such as activity scheduling and availability. A systems approach may address these barriers. Consequently, designing and implementing workplace health promotion interventions to meet the specific needs of working women of reproductive age will necessitate collaboration with a range of key stakeholders across all stages of intervention design. Given that these women make up a considerable proportion of the workforce, workplaces can help optimize the health status of employees and prevent excess weight gain during the preconception, pregnancy, and postpartum periods.
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Affiliation(s)
- Seonad K. Madden
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham 7248, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham 7248, Australia
| | - Kiran D. K. Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham 7248, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia
- Correspondence: ; Tel.: +613-8572-2380
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12
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Hill B, Skouteris H, Teede HJ, Bailey C, Baxter JAB, Bergmeier HJ, Borges ALV, Harrison CL, Jack B, Jorgensen L, Lim S, Montanaro C, Redman L, Steegers E, Stephenson J, Sundseth H, Thangaratinam S, Walker R, Boyle JA. Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Preconception Research Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications. J Clin Med 2019; 8:E2119. [PMID: 31810312 PMCID: PMC6947427 DOI: 10.3390/jcm8122119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 11/16/2022] Open
Abstract
The preconception period is a key public health and clinical opportunity for obesity prevention. This paper describes the development of international preconception priorities to guide research and translation activities for maternal obesity prevention and improve clinical pregnancy outcomes. Stakeholders of international standing in preconception and pregnancy health formed the multidisciplinary Health in Preconception, Pregnancy, and Postpartum (HiPPP) Global Alliance. The Alliance undertook a priority setting process including three rounds of priority ranking and facilitated group discussion using Modified Delphi and Nominal Group Techniques to determine key research areas. Initial priority areas were based on a systematic review of international and national clinical practice guidelines, World Health Organization recommendations on preconception and pregnancy care, and consumer and expert input from HiPPP members. Five preconception research priorities and four overarching principles were identified. The priorities were: healthy diet and nutrition; weight management; physical activity; planned pregnancy; and physical, mental and psychosocial health. The principles were: operating in the context of broader preconception/antenatal priorities; social determinants; family health; and cultural considerations. These priorities provide a road map to progress research and translation activities in preconception health with future efforts required to advance evidence-translation and implementation to impact clinical outcomes.
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Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
- Warwick Business School, Warwick University, Coventry CV4 7AL, UK
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
- Monash Partners Advanced Health Research Translation Centre, Locked Bag 29, Clayton, Victoria 3168, Australia
- Monash Health, Melbourne, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
| | - Jo-Anna B Baxter
- Centre for Global Child Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON M5G 0A4, Canada;
- Department of Nutritional Sciences, Medical Sciences Building, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Heidi J Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
| | - Ana Luiza Vilela Borges
- Public Health Nursing Department, University of Sao Paulo, 419 Cerqueira Cesar, Sao Paulo 05403000, Brazil;
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
| | - Brian Jack
- Department of Family Medicine, Boston University School of Medicine, 771 Albany St, Boston, MA 02118, USA;
| | - Laura Jorgensen
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, 58 Turner Street, London E1 2AB, UK; (L.J.); (S.T.)
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
| | - Cynthia Montanaro
- Wellington-Dufferin-Guelph Public Health, 160 Chancellors Way, Guelph, ON N1G 0E1, Canada;
| | - Leanne Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, USA;
| | - Eric Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Centre—Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands;
| | - Judith Stephenson
- Institute of Women’s Health, University College London, EGA Institute for Women’s Health, 74 Huntley St, London WC1E 6AU, UK;
| | - Hildrun Sundseth
- European Institute of Women’s Health, 33 Pearse Street, Dublin 2, Ireland;
| | - Shakila Thangaratinam
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, 58 Turner Street, London E1 2AB, UK; (L.J.); (S.T.)
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; (B.H.); (H.S.); (H.J.T.); (C.B.); (H.J.B.); (C.L.H.); (S.L.); (R.W.)
- Monash Partners Advanced Health Research Translation Centre, Locked Bag 29, Clayton, Victoria 3168, Australia
- Monash Health, Melbourne, 246 Clayton Road, Clayton, Victoria 3168, Australia
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Maternal body dissatisfaction in pregnancy, postpartum and early parenting: An overlooked factor implicated in maternal and childhood obesity risk. Appetite 2019; 147:104525. [PMID: 31756411 DOI: 10.1016/j.appet.2019.104525] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Current evidence indicates that to prevent the intergenerational transfer of overweight and obesity from parent to child, interventions are needed across the early life stages, from preconception to early childhood. Maternal body image is an important but often overlooked factor that is potentially implicated in both short- and long-term maternal and child health outcomes, including maternal gestational weight gain, postpartum weight retention, obesity, child feeding practices and early parenting. AIM The aim of this paper is to propose a conceptual model of the relationship between maternal body image (with a specific focus on body dissatisfaction) and maternal and child excess body weight risk across the pregnancy, postpartum and early childhood periods, as well as to highlight opportunities for intervention. CONCLUSION Our conceptual model proposes factors that mediate the associations between antenatal and postpartum maternal body dissatisfaction and maternal and childhood obesity risk. Pregnancy and postpartum present key risk periods for excess weight gain/retention and body dissatisfaction. Psychosocial factors associated with maternal body dissatisfaction, including psychopathology and disordered eating behaviours, may increase maternal and child obesity risk as well as compromise the quality of mother-child interactions underpinning child development outcomes, including physical weight gain. Our conceptual model may be useful for understanding modifiable psychosocial factors for preventing the intergenerational transfer of obesity risk from mothers to their children, from as early as pregnancy, and highlights next steps for multidisciplinary research focused on combatting maternal and child obesity during critical risk periods.
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Diehl AM, Farpour-Lambert NJ, Zhao L, Tilg H. Why we need to curb the emerging worldwide epidemic of nonalcoholic fatty liver disease. Nat Metab 2019; 1:1027-1029. [PMID: 32694863 DOI: 10.1038/s42255-019-0140-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Anna Mae Diehl
- Department of Medicine, Duke University, Durham, NC, USA.
| | - Nathalie J Farpour-Lambert
- Obesity Prevention and Care Program "Contrepoids", Service of Therapeutic Education for Chronic Diseases, Department of Primary Care, University Hospitals of Geneva, Geneva, Switzerland
| | - Liping Zhao
- Department of Biochemistry and Microbiology, Institute of Food, Nutrition and Health, Rutgers University, Newark, NJ, USA
- State Key Laboratory for Microbial Metabolism, Shanghai Jiao Tong University, Shanghai, China
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Metabolism & Endocrinology, Innsbruck, Austria.
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Patient Attitudes toward Gestational Weight Gain and Exercise during Pregnancy. J Pregnancy 2019; 2019:4176303. [PMID: 31637057 PMCID: PMC6766150 DOI: 10.1155/2019/4176303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/30/2019] [Indexed: 02/08/2023] Open
Abstract
Body mass index (BMI) and gestational weight gain (GWG) are important factors for neonatal and maternal health. Exercise helps women moderate their BMI and GWG, and provides health benefits to mother and child. This survey study assessed patients' perceptions of counseling they received during pregnancy, their sources of information about GWG, and their attitudes toward exercise during pregnancy. We distributed an anonymous survey to 200 pregnant women over the age of 18 at a tertiary care center in Danville, Pennsylvania. Survey questions included demographics, discussions with medical providers regarding GWG and exercise, and their exercise habits before and during pregnancy. 182 women (91%) responded. Most reported their provider discussed weight and diet (78.8%), expected GWG (81.6%), and exercise during pregnancy (79.8%); however, 28% of obese women and 25% of women who did not plan to exercise during pregnancy reported not receiving exercise counseling. Approximately 20% of women did not plan to exercise during pregnancy. Women decreased the number of days per week they exercised (40.6% with 3 or more days prepregnancy versus 30.7% during pregnancy, P = 0.002). Some patients who did not exercise prior to pregnancy (12%) expressed interest in a personal training session. Among women in the eight month or later, 42.4% were above GWG recommendations. Our study found barriers to adequate activity during pregnancy; 20% of pregnant women not receiving/remembering counseling regarding exercise. Interest in personal training from patients that did not exercise suggests they would benefit from increased efforts to encourage physical activity. Exercise and GWG counseling based in medical science as well as patient psychological needs will help efforts to reduce GWG and improve pregnancy outcomes.
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