"Scaling out" evidence-informed antenatal care to support healthy pregnancy weight gain: a context assessment using the Consolidated Framework for Implementation Research.

Autor: Meloncelli N; Centre for Health Services Research, Faculty of Medicine, University of Queensland.; Office of the Chief Allied Health Practitioner, Metro North Hospital and Health Service, Brisbane., James S; Nutrition and Dietetics, Redcliffe District Hospital, Redcliffe., Riggs K; Nutrition and Dietetics, Caboolture Hospital, Caboolture., de Jersey S; Centre for Health Services Research, Faculty of Medicine, University of Queensland.; Dietetics and Food Services, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Qld, Australia.
Jazyk: angličtina
Zdroj: JBI evidence implementation [JBI Evid Implement] 2023 Sep 01; Vol. 21 (3), pp. 259-268. Date of Electronic Publication: 2023 Sep 01.
DOI: 10.1097/XEB.0000000000000369
Abstrakt: Introduction and Aims: Excess gestational weight gain is a challenge within antenatal care. Low-intensity interventions that offer opportunities for individualization, such as pregnancy weight-gain charts (PWGCs) combined with brief advice, have been a promising strategy but scaling out such interventions requires planning. The aim of this study was to examine current practices and conduct a context assessment using the Consolidated Framework for Implementation Research (CFIR) to guide implementation of PWGCs and brief intervention advice to support healthy pregnancy weight gain in two hospitals that provide antenatal care.
Methods: Retrospective chart audits and surveys of staff and women were used to understand current practice as well as barriers and enablers to implementing change according to the domains and constructs reported in the CFIR.
Results: Forty-eight percent (site A) and 46% (site B) of pregnant women who were audited ( n  = 180, site A; n  = 176, site B) gained weight above recommendations. Most women were unable to accurately report their recommended weight gain for pregnancy (93% site A, 94% site B). Although more than 50% of women reported discussions about weight gain during pregnancy, advice about physical activity and healthy eating (in the context of helping women to achieve healthy gestational weight gain) was low. Mapping barriers and enablers to the CFIR helped guide the selection of implementation strategies, including audit and feedback, informing local opinion leaders, obtaining consensus, identifying champions, and building a coalition.
Conclusion: Scaling out of interventions can be enhanced by undertaking a detailed context assessment guided by implementation frameworks.
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Databáze: MEDLINE