Heslehurst N, Newham J, Maniatopoulos G, Fleetwood C, Robalino S, Rankin J
Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
Obes Rev. 2014 Jun;15(6):462-86. doi: 10.1111/obr.12160. Epub 2014 Mar 16.
Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included 'knowledge', 'beliefs about consequences' and 'environmental context and resources'. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change.
孕期肥胖现象正在增加，且对母亲和孩子都会造成严重的健康后果。国际上越来越关注管理孕产妇肥胖临床风险及孕期体重管理的指南。然而，被动传播指南并不有效，需要更积极的策略才能将指南有效应用于实践。指南的实施是医疗保健专业人员行为改变的一种形式，因此实施策略应基于适当的行为改变理论。本系统评价旨在确定医疗保健专业人员在孕产妇肥胖和体重管理方面行为的决定因素。共纳入25项研究。对现有国际定性和定量证据库进行数据综合时，使用理论领域框架来确定医疗保健专业人员在孕产妇肥胖和体重管理实践中的障碍和促进因素。最常确定的领域包括“知识”、“对后果的信念”和“环境背景与资源”。与孕产妇肥胖实践的任何其他领域相比，医疗保健专业人员的体重管理实践障碍最多。本评价结果将用于为支持医疗保健专业人员行为改变的干预措施制定提供信息。
