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共同设计并由临床医生评估用于解决产前护理中体重歧视问题的资源。

Co-design and clinician evaluation of resources to address weight stigma in antenatal care.

作者信息

Hill Briony, Hailu Haimanot, Jenkinson Bec, Rakic Siarn, Nagpal Taniya S, Boyle Jacqueline A, Sheehan Penelope, Darlison Sarah, Skouteris Helen

机构信息

Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.

Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, Australia.

出版信息

BMC Pregnancy Childbirth. 2025 Mar 8;25(1):263. doi: 10.1186/s12884-025-07327-3.

Abstract

BACKGROUND

Weight stigma is a commonly reported experience in maternity care that negatively impacts the health of mothers and their babies. Knowledge to inform weight stigma reduction efforts in antenatal care is urgently required. This study aimed to co-design weight stigma reduction resources in antenatal care and evaluate clinician perspectives of the resources regarding their relevance to practice, strengths, and areas for improvement.

METHODS

We conducted a five-phase co-design project involving consumers (n = 8) and clinicians (midwives n = 16, obstetrician n = 1), with outputs from each stage informing the next: (1) engaging with key stakeholders; (2) prioritising the voices of lived experience through a consumer stories video; (3) three co-design workshops to inform resource development; (4) resource production; and (5) qualitative evaluation of the resources. The co-developed resources were evaluated via interview where clinicians viewed or listened to the resources and described their engagement and satisfaction with the resources, their relevance to practice, and perspectives on the strengths, areas for improvement, and feasibility for achieving the resources' intended goal. Transcripts were analysed using descriptive thematic analysis.

RESULTS

We produced a set of evidence-based resources co-designed by consumers and clinicians including a consumer video designed to elicit empathy about lived experiences of weight stigma in maternity care, images representing women with diverse body sizes for use in clinic waiting rooms, a short podcast to raise awareness of weight stigma in maternity care, and signposts for the antenatal clinic to prompt clinicians to consider weight stigma in everyday clinical interactions. Clinicians who saw the resources reported that they were valuable and relevant to practice and were important and helpful introductory materials to the issue of weight stigma. Pragmatic examples of reducing weight stigma in clinical interactions were requested.

CONCLUSIONS

Maternity care clinicians have an appetite to improve their learning opportunities to tackle weight stigma in practice. Further refinement of the resources, evaluation of the effectiveness at changing clinician behaviour, and implementation into health services are logical next steps. Reducing women's experiences of weight stigma should lead to better care and better pregnancy outcomes for larger bodied women.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

体重歧视是产科护理中常见的现象,会对母亲及其婴儿的健康产生负面影响。迫切需要相关知识来推动产前护理中减少体重歧视的工作。本研究旨在共同设计产前护理中减少体重歧视的资源,并评估临床医生对这些资源与实践的相关性、优势及改进领域的看法。

方法

我们开展了一个五阶段的共同设计项目,参与者包括消费者(n = 8)和临床医生(助产士n = 16,产科医生n = 1),每个阶段的产出为下一阶段提供信息:(1)与关键利益相关者接触;(2)通过消费者故事视频优先考虑有实际经历者的声音;(3)举办三次共同设计研讨会以指导资源开发;(4)制作资源;(5)对资源进行定性评估。通过访谈对共同开发的资源进行评估,临床医生观看或收听这些资源,并描述他们对资源的参与度和满意度、资源与实践的相关性,以及对优势、改进领域和实现资源预期目标的可行性的看法。使用描述性主题分析对访谈记录进行分析。

结果

我们制作了一套由消费者和临床医生共同设计的循证资源,包括一个旨在引发对产科护理中体重歧视实际经历的同理心的消费者视频、用于诊所候诊室的不同体型女性的图片、一个提高对产科护理中体重歧视认识的简短播客,以及产前诊所的指示牌,以促使临床医生在日常临床互动中考虑体重歧视问题。看过这些资源的临床医生表示,它们很有价值且与实践相关,是关于体重歧视问题重要且有用的入门材料。他们还要求提供在临床互动中减少体重歧视的实际例子。

结论

产科护理临床医生希望有更多机会学习如何在实践中应对体重歧视。下一步合理的做法是进一步完善这些资源,评估其改变临床医生行为的有效性,并将其应用于卫生服务中。减少女性的体重歧视经历应能为体型较大的女性带来更好的护理和妊娠结局。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa1d/11890724/f251e9790bb7/12884_2025_7327_Fig1_HTML.jpg

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