School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.
Department of Nutrition and Dietetics, Royal Women's Hospital, Parkville, VIC, Australia.
BMC Health Serv Res. 2022 Oct 5;22(1):1231. doi: 10.1186/s12913-022-08587-x.
Food insecurity and hunger during pregnancy have significant implications for the health of the mother and baby. Assisting clinicians when they encounter women who are experiencing hunger or food insecurity during their pregnancy will increase the opportunity for better birth and pregnancy outcomes. At present there are no guidelines for Australian clinicians on how to do this.
This study uses a modified Delphi technique, allowing diverse participation in the process, to create consensus on the ways to address and respond to food insecurity during pregnancy. This modified Delphi collected data via two rounds of consensus. The opinions collected from the first round were thematically categorised and grouped. The topics were integrated into the survey for the second round and circulated to participants. During the second round, priorities were scored by giving five points to the topic considered most important, and one point to the least important.
Through two rounds of consultation, the panel achieved consensus on how to identify food insecurity during pregnancy, with some clear items of consensus related to interventions that could be implemented to address food insecurity during pregnancy. Experts achieved consensus on items that have importance at the institution and policy level, as well as services that exist in the community. The consensus across the spectrum of opportunities for assistance, from the clinical, to community-provided assistance, and on to government policy and practice demonstrate the complexity of this issue, and the multipronged approach that will be required to address it.
This is the first time such a consultation with experts on hunger and food insecurity during pregnancy has been conducted in Australia. Items that achieved consensus and the importance of the issue suggest several ways forward when working with pregnant women who are hungry and/or food insecure.
怀孕期间的食物不安全和饥饿对母婴健康有重大影响。当临床医生遇到怀孕期间饥饿或食物不安全的女性时，帮助他们将增加获得更好的分娩和妊娠结果的机会。目前，澳大利亚临床医生没有关于如何做到这一点的指南。
本研究使用改良 Delphi 技术，允许多元化参与该过程，就如何解决和应对怀孕期间的食物不安全问题达成共识。这项改良 Delphi 通过两轮共识收集数据。第一轮收集的意见按主题进行分类和分组。这些主题被整合到第二轮调查中，并分发给参与者。在第二轮中，通过给被认为最重要的主题打五分，给最不重要的主题打一分来对优先级进行评分。
通过两轮咨询，专家组就如何识别怀孕期间的食物不安全问题达成了共识，其中一些与可以实施的干预措施有关，以解决怀孕期间的食物不安全问题。专家们就机构和政策层面的重要事项以及社区中存在的服务达成了共识。从临床到社区提供的援助，再到政府政策和实践，所有这些援助机会都达成了共识，这表明了这个问题的复杂性，以及解决这个问题所需的多管齐下的方法。
这是澳大利亚首次就怀孕期间的饥饿和食物不安全问题与专家进行磋商。达成共识的项目和问题的重要性表明，在与饥饿和/或食物不安全的孕妇合作时，可以有几种方法。
