Promoting Healthy Pregnancy Weight Gain to Pregnant Women

Background

To learn more about the needs, gaps, and opportunities in health care delivery systems around supporting pregnant and postpartum women in Alberta, ENRICH researchers interviewed health care providers and ran focus groups with women across the province. Our goal was to find ways to not only address these needs and gaps, but also to harness opportunities to promote nutrition, physical activity and healthy weights during and after pregnancy.

As part of ENRICH’s partnership with Alberta Health Services (AHS), a province-wide survey of women and health care providers was also conducted. Women were asked questions about their pregnancy and the advice they received about weight gain, nutrition, and physical activity from their health care providers. Health care providers were asked about their practices with pregnant women with respect to weight, nutrition, and physical activity. To see the final evaluation report, click here

More information on the activities that were completed for this work are outlined below

ENRICH Activities

Focus Groups with Women

ENRICH and AHS worked together to conduct focus groups across the province of Alberta. We asked women about their experiences with gestational weight gain and nutrition, and their interactions with care providers. We also asked women what they think they need in order to have a healthy pregnancy. Results from this study are available here.

Interviews with Health Care Providers

We interviewed health care providers who work with pregnant women (e.g. obstetricians, gynaecologists, family physicians, nurses, and midwives) from across Alberta. We asked them about their practices with pregnant women regarding weight gain and nutrition and about what they need to better support women to achieve healthy pregnancies. We collected similar data from a group of health care providers from British Columbia. Results from this study are available here.

Survey with Women and Health Care Providers

AHS conducted a province-wide survey. Women within one-year postpartum were asked questions about their pregnancy regarding the advice they received about weight gain, nutrition, and physical activity from their health care providers. In turn, health care providers were asked about their practices with pregnant women with respect to weight, nutrition, and physical activity. A report detailing our findings is available through AHS here. Related research findings were presented at the 4th Canadian Obesity Summit; the abstracts can be found here and here.

e-Learning Program for Health Care Providers

There is strong evidence to suggest that many health care providers do not provide weight gain counselling during pregnancy, do not follow the recommended guidelines for gestational weight gain 78-81, and only talk about weight after a women has already gained excess weight during her pregnancy35. Health care providers may be avoiding this topic for a number of different reasons, some of which may include a lack of time or a lack of training how to counsel on sensitive topics such as body weight 83 84-86. Through interviews conducted with health care providers as part of the ENRICH project, several barriers to pregnancy weight gain counselling were identified, including a lack of training, lack of resources for sharing, time constraints and sensitivity of the topic. Health care providers shared that they would like to learn more about pregnancy weight gain and identified online learning modules as the preferred educational strategy. These findings were used to inform the development of a Healthy Pregnancy Weight Gain eLearning Program for health care providers. The module was developed by AHS with support from ENRICH funding and the University of Calgary. The objectives of the program are to:
  • Increase knowledge and awareness of healthy pregnancy weight gain information and guidelines
  • Increase comfort in having conversations with pregnant women about weight
  • Increase awareness of resources to support practice
The Healthy Pregnancy Weight Gain online course was launched in June of 2018. Evaluation feedback from Survey responses showed that overall, participants felt they increased their competence in supporting healthy weight gain during pregnancy. Almost all agreed or strongly agreed that the program content enhanced their knowledge of healthy pregnancy weight gain, and that they learned something in this module that they will incorporate into their practice (95% and 97%). This module is available here.

Digital Media Campaign

Women reported that they want information about weight management during pregnancy and postpartum from a trusted, credible source, specifically, a licensed health care provider. Due to limited time during medical appointments and competing health priorities, women were often left searching through resources (e.g. Internet, books) trying to find answers, unsure of what information was credible.

In Alberta, AHS had developed and launched the Healthy Parents, Healthy Children (print and online) resources. These resources are evidence based, incorporate Albertan parent perspectives, and include key information on healthy weight gain, healthy eating and physical activity during pregnancy. They are also available provincially free of charge. In focus groups with women, many benefits of the resources were identified: “Well written and easy to follow”, “Gave parents peace of mind”, “Illustrations are good for those who cannot read English”, “Better to receive a book rather than multiple pamphlets” and “Getting the information in early in pregnancy” (was beneficial).

Given the positive feedback from women and the availability of a credible, evidence based resource, a digital media campaign was identified as an opportunity to raise awareness and utilization of these provincial resources.

The digital media campaign was designed and implemented by AHS to increase women’s knowledge and awareness of healthy pregnancy weight gain information hosted on the Healthy Parents, Healthy Children website. ENRICH funding was used to cover in market expenses and enhancement of the healthy pregnancy weight gain tool on the website. Going forward, AHS will incorporate healthy pregnancy weight gain messages as part of their ongoing marketing and communication plans. Facebook ads that were developed are included below.

 

Related Publications

  • Morris J, Nikolopoulos H, Berry T, Jain V, Vallis M, Piccinini-Vallis H, Bell R, (2017). Healthcare providers’ gestational weight gain counselling practises and the influence of knowledge and attitudes: a cross-sectional mixed methods study.. BMJ open, 7 (11), pp. e018527
  • Nikolopoulos H, Mayan M, MacIsaac J, Miller T, Bell RC, (2017). Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study.. BMC pregnancy and childbirth, 17 (1), pp. 97
  • Graham, J.E., Moore, J.L., Bell, R.C., & Miller, T. (2019). Digital marketing to promote healthy weight gain among pregnant women in Alberta: An implementation study. Journal of Medical Internet Research, 21 (2) doi: 10.2196/11534