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

<h4>Objectives</h4>Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives.<h4>Study design</h4>A simultaneous mixed methods model...

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Main Authors: Nicola Heslehurst, Sarah Dinsdale, Gillian Sedgewick, Helen Simpson, Seema Sen, Carolyn Dawn Summerbell, Judith Rankin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0127122
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author Nicola Heslehurst
Sarah Dinsdale
Gillian Sedgewick
Helen Simpson
Seema Sen
Carolyn Dawn Summerbell
Judith Rankin
author_facet Nicola Heslehurst
Sarah Dinsdale
Gillian Sedgewick
Helen Simpson
Seema Sen
Carolyn Dawn Summerbell
Judith Rankin
author_sort Nicola Heslehurst
collection DOAJ
description <h4>Objectives</h4>Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives.<h4>Study design</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
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spelling doaj-art-ff77d4ddbbed4124bdf922ed715339022025-08-20T03:10:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01105e012712210.1371/journal.pone.0127122An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.Nicola HeslehurstSarah DinsdaleGillian SedgewickHelen SimpsonSeema SenCarolyn Dawn SummerbellJudith Rankin<h4>Objectives</h4>Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives.<h4>Study design</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0127122
spellingShingle Nicola Heslehurst
Sarah Dinsdale
Gillian Sedgewick
Helen Simpson
Seema Sen
Carolyn Dawn Summerbell
Judith Rankin
An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.
PLoS ONE
title An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.
title_full An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.
title_fullStr An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.
title_full_unstemmed An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.
title_short An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.
title_sort evaluation of the implementation of maternal obesity pathways of care a mixed methods study with data integration
url https://doi.org/10.1371/journal.pone.0127122
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