Investigation of optimal care models for post­partum weight management: to inform future service development and implementation

What are the aims of this project?

The study aims to investigate the views of healthcare professionals and women following pregnancy towards weight management and identify appropriate service models for achieving sustainable weight reduction.

An additional aim of the study will be to explore possible strategies for implementation of health behaviour change interventions into clinical practice. Close links with the CLAHRC YH Translating Knowledge into Action Theme, where the lead applicant is the senior research lead, will accelerate the process by which we plan to achieve this objective. The Translating Knowledge into Action Theme team members will meet regularly with the core research team in order to identify ways that the findings might be utilised to develop an optimal implementation strategy. This will inform our thinking about the acceptability and feasibility of the service models identified in the interviews and focus groups at an early stage in the research process.

Why is this important?

Preliminary efforts to promote postpartum weight loss have encountered limited success, and little is known about the types of programs of greatest interest to postpartum women and clinicians (Phelan 2010). Current evidence is largely based on quantitative studies that offer limited insights into the perceptions, preferences and experiences of patients and healthcare professionals, and often rely on generic factors such as risk perceptions, health beliefs, social support and self-efficacy as the main causes of health enhancing behaviours (Kaiser & Razurel 2012). Much of this research has sought to evaluate different lifestyle modifications, with varying degrees of success (O’Toole et al 2003). However, important gaps seem to have been overlooked such as socio economic position on women’s responses to weight management advice post-partum, or the effect of multi morbidities on lifestyle choices and behaviour change. Notwithstanding the important contribution of treatment preferences of clinicians and the geographical and specialty related practice variations and approaches to best practice. The NICE Guideline (2010) recommends that research needs to focus on investigating the most effective and cost-effective ways of helping women to manage their weight after childbirth. This includes women who are obese, those who are under 18 and those from disadvantaged, low income and minority ethnic groups. In particular a research gap exists in our understanding of the most appropriate time to start managing weight after childbirth, the optimal rate of weight loss to ensure long-term success, and how resumption of behaviours such as smoking and drinking influence postpartum weight management.

How will the research be carried out?

The proposed research study is an investigation of optimal service models for the weight management of women at the post-natal phase following birth. The study will run alongside a scoping review currently being conducted by a Research Assistant at the School of Health and Related Research, University of Sheffield, on optimal models of post-natal weight management, an area identified as a public health priority by partners at Doncaster Council, who the lead applicant is currently working with on a related healthcare intervention. The proposed research will involve interviews with healthcare professionals and women post-pregnancy.

Timeframe:

August 2015 to April 2016

Who is undertaking the research?

The research is led by Dr Tom Sanders. The research team includes Professor Hora Soltani, Dr Jenny Stephenson (GP), Professor Paul Bissell, Ms Susan Hampshaw, Ms Rachel Manners, Ms Bernadette Hardware (RA), Ms Rebecca Stevenson (RA).

How are stakeholders being engaged?

We have engaged with a local maternity PPI group representative to facilitate group discussions with users of weight reduction services. We have also engaged with local maternity care, midwifery and health visitor networks in order to facilitate the recruitment of local stakeholders into the research study and to spread awareness about the research. We also have a GP representing Sheffield Clinical Commissioning Group, and two of the co-applicants [Rachel Manners – Head of Obesity Services and Susan Hampshaw – Head of Research] are staff members at Doncaster Borough Council. Their involvement will link the study into policy decisions and commissioning around obesity and weight management.

The CLAHRC YH Translating Knowledge to Action Theme supports this research and provides expertise from implementation science and knowledge mobilisation to accelerate the adoption of findings into practice.

Web link: http://clahrc-yh.nihr.ac.uk/our-themes/translating-knowledge-into-action/meet-the-team

What will be the outputs from the study?

The findings from this research will be used to develop a large grant application to NIHR RfPB or HSDR Programme to develop optimal support services and facilitate their implementation into community/maternity care pathways. Other outputs will include conference presentations and publication of peer reviewed articles.