Is a motivational interviewing based lifestyle intervention for obese pregnant women across Europe implemented as planned? Process evaluation of the DALI study

BMC Pregnancy and Childbirth

Peter Damm¹  Elisabeth R. Mathiesen¹  Frank J. Snoek²  Gernot Desoye³  Judith G. M. Jelsma⁴  Mireille N. M. van Poppel⁴  Fabiola Juarez⁵  Rosa Corcoy⁵  David Simmons⁶  Sander Galjaard⁷  Goele Jans⁷  Roland Devlieger⁷  Andre van Assche⁷  Dirk Timmerman⁷  Agnieszka Zawiejska⁸  Ewa Wender-Ożegowska⁸  Kinga Blumska⁸  Jürgen Harreiter⁹  Alexandra Kautzky-Willer⁹  Fidelma Dunne^1,10  Dorte M. Jensen^1,11  Liselotte Andersen^1,11  David Hill^1,12  Stephen Rollnick^1,13  Nina Gobat^1,13  Maria G. Dalfrà^1,14  Annunziata Lapolla^1,14  Alessandra Bertolotto^1,15  Stefano del Prato^1,15 

[1] Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen;Department of Medical Psychology, Amsterdam Public Health research institute, VU University Medical Centre;Department of Obstetrics and Gynecology, Medizinische Universität Graz;Department of Public and Occupational Health and, Amsterdam Public Health research institute, VU University Medical Centre;Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau;Institute of Metabolic Science, Addenbrookes Hospital;KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate Gynaecology and Obstetrics, University Hospitals Leuven;Medical Faculty I, Poznan University of Medical Sciences;Medical University of Vienna;National University of Ireland;Odense University Hospital;Recherche en Santé Lawson SA;School of Medicine, Cardiff University;Universita Degli Studi di Padova;Università di Pisa;

关键词: Counselling;    Fidelity;    Dose;    Motivational interviewing;    Lifestyle behaviour;    Process evaluation;   

DOI  :  10.1186/s12884-017-1471-9

来源: DOAJ

【 摘 要 】

Abstract Background Process evaluation is an essential part of designing and assessing complex interventions. The vitamin D and lifestyle intervention study (DALI) study is testing different strategies to prevent development of gestational diabetes mellitus among European obese pregnant women with a body mass index ≥29 kg/m2. The intervention includes guidance on physical activity and/or healthy eating by a lifestyle coach trained in motivational interviewing (MI). The aim of this study was to assess the process elements: reach, dose delivered, fidelity and satisfaction and to investigate whether these process elements were associated with changes in gestational weight gain (GWG). Methods Data on reach, dose delivered, fidelity, and satisfaction among 144 participants were collected. Weekly recruitment reports, notes from meetings, coach logs and evaluation questionnaires (n = 110) were consulted. Fidelity of eight (out of twelve) lifestyle coach practitioners was assessed by analysing audio recorded counselling sessions using the MI treatment integrity scale. Furthermore, associations between process elements and GWG were assessed with linear regression analyses. Results A total of 20% of the possible study population (reach) was included in this analysis. On average 4.0 (of the intended 5) face-to-face sessions were delivered. Mean MI fidelity almost reached ‘expert opinion’ threshold for the global scores, but was below ‘beginning proficiency’ for the behavioural counts. High variability in quality of MI between practitioners was identified. Participants were highly satisfied with the intervention, the lifestyle coach and the intervention materials. No significant associations were found between process elements and GWG. Conclusion Overall, the intervention was well delivered and received by the study population, but did not comply with all the principles of MI. Ensuring audio recording of lifestyle sessions throughout the study would facilitate provision of individualized feedback to improve MI skills. A larger sample size is needed to confirm the lack of association between process elements and GWG. Trial registration ISRCTN registry: ISRCTN70595832 ; Registered 12 December 2011.

【 授权许可】

Unknown