An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration

Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives. A simultaneous mixed methods model with data integration was used. Three component studies were g...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2015-05, Vol.10 (5), p.e0127122-e0127122
Main Authors: Heslehurst, Nicola, Dinsdale, Sarah, Sedgewick, Gillian, Simpson, Helen, Sen, Seema, Summerbell, Carolyn Dawn, Rankin, Judith
Format: Article
Language:English
Subjects:
Analysis
Body mass index
Body weight
Care and treatment
Clinical Audit
Data integration
Delivery of Health Care - methods
Delivery of Health Care - standards
Development and progression
Diabetes
Female
Guideline Adherence
Health aspects
Health care
Health Knowledge, Attitudes, Practice
Health Personnel - statistics & numerical data
Health services
Hospitals
Humans
Integration
Management
Maternal child nursing
Medical personnel
Medical research
Methods
Mixed methods research
Models, Statistical
Mortality
Mothers
Obesity
Obesity - therapy
Patient outcomes
Pregnancy
Pregnancy Complications - therapy
Pregnant women
Primary care
Priorities
Professionals
Public health
Response rates
Risk communication
Risk factors
Risk management
Studies
Surveys
Surveys and Questionnaires
Weight control
Womens health
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives. A simultaneous mixed methods model with data integration was used. Three component studies were given equal priority. 1: Semi-structured qualitative interviews explored obese pregnant women's experiences of being on the pathways. 2: A quantitative and qualitative postal survey explored healthcare professionals' experiences of delivering the pathways. 3: A case note audit quantitatively assessed pathway compliance. Data were integrated using following a thread and convergence coding matrix methods to search for agreement and disagreement between studies. Study 1: Four themes were identified: women's overall (positive and negative) views of the pathways; knowledge and understanding of the pathways; views on clinical and weight management advice and support; and views on the information leaflet. Key results included positive views of receiving additional clinical care, negative experiences of risk communication, and weight management support was considered a priority. Study 2: Healthcare professionals felt the pathways were worthwhile, facilitated good practice, and increased confidence. Training was consistently identified as being required. Healthcare professionals predominantly focussed on women's response to sensitive obesity communication. Study 3: There was good compliance with antenatal clinical interventions. However, there was poor compliance with public health and postnatal interventions. There were some strong areas of agreement between component studies which can inform future development of the pathways. However, disagreement between studies included a lack of shared priorities between healthcare professionals and women, different perspectives on communication issues, and different perspectives on women's prioritisation of weight management. The differences between healthcare professionals' and women's priorities and perspectives are important factors to consider when developing care pathways. Shared perspectives could help facilitate more effective implementation of the pathway interventions that have poor compliance.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0127122