Acceptability of a Weight Management Intervention for Pregnant and Postpartum Women with BMI ≥30 kg/m2: A Qualitative Evaluation of an Individualized, Home-Based Service
- 561 Downloads
There have been recent calls for more evidence regarding effective antenatal and postnatal interventions to address the serious health risks of maternal obesity and associated childhood obesity. The Maternal and Early Years Healthy Weight Service (MAEYS) is an innovative service, delivered by specialist healthy weight advisors, for obese women (BMI ≥30 kg/m2) during pregnancy and up to 2 years after delivery. The service focuses on healthy gestational weight gain, postpartum weight loss and establishing healthy infant feeding and active play. MAEYS was adopted by six local health organizations in the UK as a 1 year pilot program. The aim of the present research was to assess the acceptability of this intervention among MAEYS participants.
Semi-structured interviews with 20 women, with data analyzed thematically.
High levels of acceptability were reported. The convenience and comfort of home visits, personalized advice on diet and physical activity, supportive approach of the healthy weight advisor and regular weight monitoring were all cited as advantages of the service. Service users suggested that more frequent contact with advisors and practical support such as recipes would improve the service.
MAEYS is a novel, community-based intervention delivered in the home which has demonstrated acceptability to its recipients. It therefore shows promise as an early intervention to reduce the risks of maternal obesity and subsequently reduce childhood obesity. An evaluation of the efficacy of MAEYS in preventing excess gestational weight gain and losing weight postpartum is now needed.
KeywordsObesity Pregnancy Qualitative Service evaluation Intervention
This study was funded by NHS West Midlands’ Investing for Health programme. The authors would like to express their thanks to the research team; Kubra Anwar, Carol Bryce, Puja Joshi and Hannah Kendall, who contributed to data collection and analysis. We are also grateful to the local area leads, all the participants, and to Naomi Bartle for helpful comments on an earlier draft of the manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors confirm that they have no conflict of interests to declare.
- 9.Centre for Maternal and Child Enquiries, & Royal College of Obestricians and Gynaecologists. (2010). Management of women with obesity in pregnancy. London: CMACE.Google Scholar
- 10.Davis, D. L., Raymond, J. E., Clements, V., Adams, C., Mollart, L. J., Teate, A. J., & Foureur, M. J. (2012). Addressing obesity in pregnancy: The design and feasibility of an innovative intervention in NSW, Australia. Women and Birth, 25(4), 174–180. doi: 10.1016/j.wombi.2011.08.008.PubMedCrossRefGoogle Scholar
- 11.Denison, F. C., Norwood, P., Bhattacharya, S., Duffy, A., Mahmood, T., Morris, C., et al. (2014). Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: A population-based study. BJOG: An International Journal of Obstetrics & Gynaecology, 121(1), 72–82. doi: 10.1111/1471-0528.12443.CrossRefGoogle Scholar
- 12.Department of Health. (2008). Healthy weight, healthy lives: A cross-government strategy for England. London: Department of Health.Google Scholar
- 13.Department of Health. (2010). Healthy lives, healthy people: Our strategy for public health in England. London: Department of Health.Google Scholar
- 15.Edmunds, J. K., Atkinson, L., Pottinger, E. (2008). Investing in health: Pregnancy and early infancy obesity prevention service—Final report of service user focus groups. Coventry: Coventry University.Google Scholar
- 16.Foresight. (2007). Tackling obesity: Future choices—Project report. London: Department for Business, Innovation and Skills.Google Scholar
- 20.Heslehurst, N., Simpson, H., Ells, L. J., Rankin, J., Wilkinson, J., Lang, R., et al. (2008). The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: A meta-analysis. Obesity Reviews, 9(6), 635–683. doi: 10.1111/j.1467-789X.2008.00511.x.PubMedCrossRefGoogle Scholar
- 22.National Institute for Health and Care Excellence (2010). NICE public health guidance 27: Dietary interventions and physical activity interventions for weight management before, during and after pregnancy. London: NICE. http://guidance.nice.org.uk/PH27.
- 23.National Institute for Health and Care Excellence (2011). NICE weight management before, during and after pregnancy (CMG36). London: NICE. https://www.nice.org.uk/guidance/cmg36.
- 24.Nicklas, J. M., Zera, C. A., Seely, E. W., Abdul-Rahim, Z. S., Rudloff, N. D., & Levkoff, S. E. (2011). Identifying postpartum intervention approaches to prevent type 2 diabetes in women with a history of gestational diabetes. BMC Pregnancy and Childbirth. doi: 10.1186/1471-2393-11-23.PubMedPubMedCentralGoogle Scholar
- 26.Pawson, R., & Tilley, N. (1997). Realistic evaluation. London: Sage.Google Scholar
- 27.Petrella, E., Malavolti, M., Bertarin, V., Pignatti, L., Neri, I., Battistini, N. C., & Facchinetti, F. (2013). Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program. Journal of Maternal and Fetal Neonatal Medicine. doi: 10.3109/14767058.2013.858318.Google Scholar
- 28.Pirkola, J., Pouta, A., Bloigu, A., Hartikainen, A., Laitenen, J., Järvelin, M., et al. (2010). Risks of overweight and abdominal obesity at age 16 years associated with prenatal exposures to maternal prepregnancy overweight and gestational diabetes mellitus. Diabetes Care, 33(5), 1115–1121. doi: 10.2337/dc09-1871.PubMedPubMedCentralCrossRefGoogle Scholar
- 29.Poston, L., Briley, A. L., Barr, S., Bell, R., Croker, H., Coxon, K., et al. (2013). Developing a complex intervention for diet and activity behavior change in obese pregnant women (the UPBEAT trial); assessment of behavioral change and process evaluation in a pilot randomized controlled trial. BMC Pregnancy and Childbirth. doi: 10.1186/1471-2393-13-148.PubMedPubMedCentralGoogle Scholar
- 30.Putnam, H. (1999). The threefold cord: Mind, body, and world. New York: Columbia University Press.Google Scholar
- 31.Sheikh, A. E., Malik, A. & Gardosi, J. (2010). West midlands perinatal and infant mortality 2008–9. Birmingham: West Midlands Perinatal Institute. http://www.perinatal.nhs.uk/pnm/KHD_2008-9.pdf.
- 32.The Society of Obstetricians and Gynecologists of Canada (2010). Obesity in pregnancy. Clinical practice guideline No. 239. Journal of Obstetrics and Gynaecology Canada, 110(2), 165–173.Google Scholar
- 33.Soltani, H., Furness, P. J., Arden, M. A., McSveney, K., Garland, C., Sustar, H., & Dearden, A. (2012). Women’s and midwives’ perspectives on the design of a text messaging support for maternal obesity services: An exploratory study. Journal of Obesity. doi: 10.1155/2012/835464.PubMedPubMedCentralGoogle Scholar
- 35.World Health Organization. (2012). Prioritizing areas for action in the field of population-based prevention of childhood obesity: A set of tools for Member States to determine and identify priority areas for action. Geneva: WHO.Google Scholar