Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.
School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
Syst Rev. 2019 Nov 23;8(1):285. doi: 10.1186/s13643-019-1193-3.
Despite existing best practice care recommendations for addressing tobacco smoking, alcohol consumption and weight management in preconception and antenatal care, such recommendations are often not implemented into routine practice. Effective strategies that target known barriers to implementation are key to reducing this evidence to practice gap. The aim of this review is to synthesise the evidence on the effectiveness of implementation strategies in improving the provision of preconception and antenatal care for these modifiable risk factors.
Randomised and non-randomised study designs will be eligible for inclusion if they have a parallel control group. We will include studies that either compare an implementation strategy to usual practice or compare two or more strategies. Participants may include any health service providing preconception or antenatal care to women and/or the health professionals working within such a service. The primary outcome will be any measure of the effectiveness of implementation strategies to improve preconception and/or antenatal care for tobacco smoking, alcohol consumption and/or weight management (including care to improve nutrition and/or physical activity). Secondary outcomes will include the effect of the implementation strategy on women's modifiable risk factors, estimates of absolute costs or cost-effectiveness and any reported unintentional consequences. Eligible studies will be identified via searching Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, ProQuest Dissertations and Theses and other sources (e.g. contacting experts in the field). Study selection, data extraction and risk of bias will be assessed independently by two review authors and differences resolved by a third reviewer. If data permits, we will conduct fixed-effects or random-effects meta-analysis where appropriate. If studies do not report the same outcome or there is significant heterogeneity, results will be summarised narratively.
This review will identify which implementation strategies are effective in improving the routine provision of preconception and antenatal care for tobacco smoking, alcohol consumption and weight management. Such a review will be of interest to service providers, policy makers and implementation researchers seeking to improve women's modifiable risk factors in preconception and antenatal care settings.
PROSPERO CRD42019131691.
尽管存在针对孕前和产前护理中烟草使用、酒精消费和体重管理的最佳实践护理建议，但这些建议往往并未落实到常规实践中。针对实施障碍的有效策略是缩小这一证据与实践差距的关键。本综述旨在综合评估改善这些可改变风险因素的孕前和产前护理的实施策略的有效性。
如果具有平行对照组，随机和非随机研究设计将有资格入选。我们将纳入比较实施策略与常规实践或比较两种或更多策略的研究。参与者可以包括向女性提供孕前或产前护理的任何卫生服务机构和/或在该服务机构工作的卫生专业人员。主要结局将是任何衡量实施策略改善烟草使用、酒精消费和/或体重管理（包括改善营养和/或体力活动的护理）的有效性的指标。次要结局将包括实施策略对女性可改变风险因素的影响、绝对成本或成本效益的估计以及任何报告的意外后果。将通过搜索 Cochrane 对照试验中心注册库、MEDLINE、EMBASE、母婴护理、CINAHL、ProQuest 论文和论文以及其他来源（例如联系该领域的专家）来确定合格的研究。研究选择、数据提取和偏倚风险将由两名综述作者独立评估，分歧由第三名综述作者解决。如果数据允许，我们将在适当的情况下进行固定效应或随机效应荟萃分析。如果研究未报告相同的结局或存在显著的异质性，将以叙述性方式总结结果。
本综述将确定哪些实施策略可有效改善常规的孕前和产前护理，以改善烟草使用、酒精消费和体重管理。对于寻求在孕前和产前护理环境中改善女性可改变风险因素的服务提供者、政策制定者和实施研究人员来说，这样的综述将是有意义的。
PROSPERO CRD42019131691。
