期刊论文详细信息
BMC Pregnancy and Childbirth
Knowledge translation tool to improve pregnant women’s awareness of gestational weight gain goals and risks of gaining outside recommendations: a non-randomized intervention study
Melissa Brouwers8  Valerie Mueller3  Joseph Beyene5  Valerie H Taylor1  Binod Neupane5  Helen McDonald6  Wendy Sword4  Keyna Bracken2  Eleanor Pullenayegum7  Christina K Park5  Sarah D McDonald5 
[1] Department of Psychiatry, Women’s College Hospital, 76 Grenville St, Toronto M5S 1B1, ON, Canada;Department of Family Medicine, McMaster University, 1280 Main St. West, Hamilton L8S 4L8, ON, Canada;Department of Obstetrics & Gynecology, McMaster University, 1280 Main St. West, Hamilton L8S 4L8, ON, Canada;School of Nursing, McMaster University, Hamilton L8S 4L8, ON, Canada;Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton L8S 4L8, ON, Canada;Midwifery Education Program, McMaster University, 1280 Main St. West, Hamilton L8S 4L8, ON, Canada;Child Health Evaluative Sciences Program, Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X8, ON, Canada;Department of Oncology, McMaster University, 1280 Main St. West, Hamilton L8S 4L8, ON, Canada
关键词: Counseling;    Lifestyle factors;    Gestational weight gain;    Surveys;    Intervention studies;    Knowledge translation;   
Others  :  1178968
DOI  :  10.1186/s12884-015-0534-z
 received in 2014-09-22, accepted in 2015-04-17,  发布年份 2015
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【 摘 要 】

Background

There is an urgent need to prevent excessive pregnancy weight gain, a contributor to both maternal and child obesity. However, the majority of women had reported not being counseled to gain an appropriate amount of gestational weight by their health care providers. We developed a knowledge translation (KT) tool designed to facilitate the clinical interaction between pregnant women and their health care providers (HCPs). We piloted the tool on the impact on women’s knowledge of gestational weight gain (GWG) goals, and evaluated its potential in promoting appropriate knowledge about GWG within the 2009 Institute of Medicine guidelines.

Methods

We conducted a prospective cohort study, comparing women’s knowledge about GWG after the KT tool to women from the same clinics and care providers the year prior. Our primary outcome was the proportion of women who reported receiving an appropriate GWG recommendation from their care provider. We evaluated knowledge on a survey conducted at enrollment in the cohort at ≤ 20 weeks gestation and evaluated participant satisfaction with the KT tool in the third trimester. We performed univariate and multivariable logistic regression analyses for differences in outcomes with historical controls from the same clinics. Our a priori sample size calculation required 130 participants to demonstrate a 15% increase in reported counseling about gestational weight gain.

Results

One hundred and forty-six women were recruited and 131 (90%) completed the enrollment survey. Women who received the KT tool were more likely to report receiving a specific GWG recommendation from their HCP (adjusted odds ratio [AOR] 3.45, 95% confidence interval [CI] 2.22-5.37) and discussing GWG topics with their HCP (AOR 7.96, 95% CI 4.41-14.37), and believing that there were risks to their infants with inadequate GWG (AOR 2.48, 95% CI 1.14-5.37). Half of women (49.5%) indicated that they would recommend the tool to a friend.

Conclusions

Women who received the KT tool reported receiving more counseling on GWG from their HCPs and were more aware of the risks of gaining outside appropriate GWG recommendations. The association between GWG education and GWG requires further research.

【 授权许可】

   
2015 McDonald et al.; licensee BioMed Central.

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【 参考文献 】
  • [1]Fraser A, Tilling K, Macdonald-Wallis C, Hughes R, Sattar N, Nelson SM, et al.: Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). Am J Clin Nutr 2011, 93:1285-92.
  • [2]Fraser A, Tilling K, Macdonald-Wallis C, Sattar N, Brion MJ, Benfield L, et al.: Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation 2010, 121:2557-64.
  • [3]Ferraro ZM, Barrowman N, Prud’homme D, Walker M, Wen SW, Rodger M, et al.: Excessive gestational weight gain predicts large for gestational age neonates independent of maternal body mass index. J Matern Fetal Neonatal Med 2012, 25:538-42.
  • [4]McDonald SD, Han Z, Mulla S, Lutsiv O, Lee T, Beyene J, et al.: High gestational weight gain and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. J Obstet Gynaecol Can 2011, 33:1223-33.
  • [5]Nohr EA, Vaeth M, Baker JL, Sorensen TI, Olsen J, Rasmussen KM: Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr 2008, 87:1750-9.
  • [6]Stotland NE, Hopkins LM, Caughey AB: Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas. Obstet Gynecol 2004, 104:671-7.
  • [7]Institute of Medicine: Weight gain during pregnancy: reexamining the guidelines. The National Academies Press, Washington, DC; 2009.
  • [8]Dzakpasu S, Fahey J, Kirby RS, Tough SC, Chalmers B, Heaman MI, et al.: Contribution of prepregnancy body mass index and gestational weight gain to caesarean birth in Canada. BMC Pregnancy Childbirth 2014, 14:106. BioMed Central Full Text
  • [9]McDonald SD, Pullenayegum E, Taylor V, Lutsiv O, Bracken K, Good C, et al.: Despite 2009 guidelines few women report being counseled correctly about weight gain during pregnancy. Am J Obstet Gynecol 2011, 205:e1-6 (Editor’s Choice).
  • [10]Lutsiv O, Bracken K, Pullenayegum E, Sword W, Taylor VH, McDonald SD: Little congruence between health care provider and patient perceptions of counselling on gestational weight gain. J Obstet Gynaecol Can 2012, 36:518-24.
  • [11]Raynor DK, Blenkinsopp A, Knapp P, Grime J, Nicolson DJ, Pollock K, et al.: A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines. Health Technol Assess 2007, 11:1-181.
  • [12]Gysels M, Richardson A, Higginson IJ: Does the patient-held record improve continuity and related outcomes in cancer care: a systematic review. Health Expect 2007, 10:75-91.
  • [13]Murray EBJTS, Lai R, Nazareth I: Interactive Health Communication Appliations for people with chronic disease. Cochrane Database Syst Rev 2005., 4Article ID CD004274
  • [14]Garg AX, Adhikari NK, McDonald H, Rosas-Arellano MP, Devereaux PJ, Beyene J, et al.: Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 2005, 293:1223-38.
  • [15]Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, et al.: Lost in knowledge translation: time for a map? J Contin Educ Health Prof 2006, 26:13-24.
  • [16]Health Canada. Prenatal nutrition guidelines for health professionals: gestational weight gain [http://www.hc-sc.gc.ca/fn-an/nutrition/prenatal/ewba-mbsa-eng.php]
  • [17]The American College of Obstetricians and Gynecologists. Nutrition During Pregnancy [http://www.acog.org/~/media/For%20Patients/faq001.pdf?dmc=1&ts=20130702T1112568013]
  • [18]Statistics Canada. Census Profile [http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/index.cfm?Lang=E]
  • [19]Dillman DA, Smyth JD, Christian LM: Implementation procedures. In Internet, mail, and mixed-mode surveys. The tailored design method. 3rd edition. John Wiley & Sons, Hoboken, New Jersey, USA; 2009:234-99.
  • [20]Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, et al.: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess 2004, 8:iii-72.
  • [21]Vittinghoff E, McCulloch CE: Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 2007, 165:710-8.
  • [22]Wilkinson SA, McIntyre HD: Evaluation of the’healthy start to pregnancy’ early antenatal health promotion workshop: a randomized controlled trial. BMC Pregnancy Childbirth 2012, 12:131. BioMed Central Full Text
  • [23]Brown MJ, Sinclair M, Liddle D, Hill AJ, Madden E, Stockdale J: A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain. PLoS One 2012., 7Article ID e39503
  • [24]Tanentsapf I, Heitmann BL, Adegboye AR: Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. BMC Pregnancy Childbirth 2011, 11:81. BioMed Central Full Text
  • [25]Ehrenberg HM, Dierker L, Milluzzi C, ercer BM: Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes. Am J Obstet Gynecol 2003, 189:1726-30.
  • [26]Kessels RP: Patients’ memory for medical information. J R Soc Med 2003, 96:219-22.
  • [27]Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B: Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling? J Womens Health (Larchmt) 2010, 19:807-14.
  • [28]Chang T, Llanes M, Gold KJ, Fetters MD: Perspectives about and approaches to weight gain in pregnancy: a qualitative study of physicians and nurse midwives. BMC Pregnancy Childbirth 2013, 13:47. BioMed Central Full Text
  • [29]Edvardsson K, Ivarsson A, Eurenius E, Garvare R, Nystrom ME, Small R, et al.: Giving offspring a healthy start: parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Public Health 2011, 11:936. BioMed Central Full Text
  • [30]Cogswell ME, Scanlon KS, Fein SB, Schieve LA: Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstet Gynecol 1999, 94:616-22.
  • [31]Brawarsky P, Stotland NE, Jackson RA, Fuentes-Afflick E, Escobar GJ, Rubashkin N, et al.: Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. Int J Gynaecol Obstet 2005, 91:125-31.
  • [32]Herring SJ, Nelson DB, Davey A, Klotz AA, Dibble LV, Oken E, et al.: Determinants of excessive gestational weight gain in urban, low-income women. Womens Health Issues 2012, 22:e439-46.
  • [33]Grimshaw J, Freemantle N, Wallace S, Russell I, Hurwitz B, Watt I, et al.: Developing and implementing clinical practice guidelines. Qual Health Care 1995, 4:55-64.
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