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提高孕妇对孕期体重增加目标及超出建议范围增重风险的认识的知识转化工具:一项非随机干预研究。

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.

作者信息

McDonald Sarah D, Park Christina K, Pullenayegum Eleanor, Bracken Keyna, Sword Wendy, McDonald Helen, Neupane Binod, Taylor Valerie H, Beyene Joseph, Mueller Valerie, Brouwers Melissa

机构信息

Department of Obstetrics & Gynecology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.

Department of Radiology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.

出版信息

BMC Pregnancy Childbirth. 2015 Apr 30;15:105. doi: 10.1186/s12884-015-0534-z.

Abstract

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.

摘要

背景

迫切需要预防孕期体重过度增加,这是导致孕产妇和儿童肥胖的一个因素。然而,大多数女性报告称,她们的医疗保健提供者未就孕期体重增加的适宜量向她们提供咨询。我们开发了一种知识转化(KT)工具,旨在促进孕妇与其医疗保健提供者(HCP)之间的临床互动。我们对该工具在影响女性对孕期体重增加(GWG)目标的知晓方面进行了试点,并根据2009年医学研究所指南评估了其在促进关于GWG的适当知识方面的潜力。

方法

我们进行了一项前瞻性队列研究,将接受KT工具后的女性对GWG的知晓情况与前一年来自相同诊所和医疗服务提供者的女性进行比较。我们的主要结局是报告从其医疗服务提供者处获得适宜GWG建议的女性比例。我们在队列入组时(妊娠≤20周)进行的一项调查中评估知识,并在孕晚期评估参与者对KT工具的满意度。我们对来自相同诊所的历史对照的结局差异进行单变量和多变量逻辑回归分析。我们事先的样本量计算要求有130名参与者,以证明报告的关于孕期体重增加的咨询增加15%。

结果

招募了146名女性,131名(90%)完成了入组调查。接受KT工具的女性更有可能报告从其HCP处获得了特定的GWG建议(调整优势比[AOR]3.45,95%置信区间[CI]2.22 - 5.37),并与HCP讨论GWG话题(AOR 7.96,95%CI 4.41 - 14.37),且认为孕期体重增加不足对其婴儿有风险(AOR 2.48,95%CI 1.14 - 5.37)。一半的女性(49.5%)表示她们会向朋友推荐该工具。

结论

接受KT工具的女性报告从其HCP处获得了更多关于GWG的咨询,并且更了解超出适宜GWG建议范围增加体重的风险。GWG教育与GWG之间的关联需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c10/4423093/c542e79095d0/12884_2015_534_Fig1_HTML.jpg

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