Planning, implementation and evaluation of antenatal weight management programmes: What are the key components? A mixed methods study

Sarah MacAuley, Briege M Lagan, Karen Casson

Research output: Contribution to journalArticle

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Abstract

Objective
To provide an understanding of the influential components required for the planning, delivery and evaluation of antenatal weight management programmes for women who are overweight or obese.

Design
Two phase sequential explanatory mixed methods design comprising of an online survey and one-to-one telephone interviews.

Setting and participants
All UK maternity services (n = 168) and local government councils (n = 417).

Findings
From the 378 responses, 49 maternity services and 28 local government councils reported having an antenatal weight management programme. Of the 62 responses that specified BMI as an inclusion criterion only two-fifths (40.3% n = 25) adhered to the recommended threshold to include women with a BMI ≥30 kg/m2. Although having a multi-disciplinary team was identified as fundamental when planning a programme, only 20.6% (n = 14/68) of the programmes involved service users during the planning phase. How the programme was communicated to a woman was a key factor which determined whether she partook in the programme or not. Having administrative support and staff with expertise in data collection were essential when evaluating a programme. Staff having protected time was identified as important when planning, delivering and evaluating a programme. Three overarching themes were identified from the individual interviews (n = 14) ‘choices and decisions’, ‘demands and resources’ and ‘engagement and disengagement’.

Key conclusions
National guidelines recommendations regarding service user involvement when planning programmes and the BMI threshold used for inclusion are not being met. In addition to having adequate time, personnel and finances, successful programmes are dependent on the confidence and communication skills of midwives to raise the issue of obesity with these women at the booking appointment. Without staff having the time and necessary knowledge and skills, evaluation, and hence demonstrating programme impact, will likely remain difficult. Organisational support is needed to release resources to plan, deliver and evaluate these programmes. Strategic communication strategies are needed to promote the programme to both women and staff within organisations. Future programmes need to ensure there is engagement with service users from the planning of the programme through to evaluation.
Original languageEnglish
Article number102545
JournalMidwifery
Volume79
Issue number102545
Early online date1 Oct 2019
DOIs
Publication statusPublished - 1 Dec 2019

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Keywords

  • Implementation, evaluation
  • Obesity
  • Pregnancy
  • Programme planning
  • Weight management

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