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Research article
Healthy Weight Services in England before, during and after pregnancy: a mixed methods approach
Hora Soltani
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9611-6777
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Health Services Research.
Background: Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England. This project explored and mapped healthy weight service availability at different stages of the childbearing cycle.
Methods: A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data.
Results: A total of 88 participants responded to the survey. All services were offered most frequently during pregnancy; with healthy eating and/or weight management services offered more often than physical activity services. Few services were targeted specifically at women with a raised body mass index. There was a high degree of inconsistency of service provision in different geographical areas.
Several themes were identified from qualitative data including "equity and variation in service provision", "need for rigorous evaluation", "facilitators” to encourage better access or more effective service provision, including prioritisation, a change in focus and co-design of services, "barriers" encountered including financial and time obstacles, poor communication and insufficiently clear strategic national guidance and "the need for additional support”.
Conclusions: There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. There is a need for more robust evaluation of services to ensure they are fit for purpose. An urgent need for clear national guidance so that healthcare providers can more effectively assist mothers achieve a healthy weight gain was identified. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use.
Keywords
Healthy weight, gestational weight gain, maternal obesity, service provision
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CURRENT STATUS: Published
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Posted 11 Jun, 2020
Published
On 22 Jun, 2020
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Editor assigned
On 04 Jun, 2020
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On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
No comments provided
Editorial decision: Major revision
On 28 May, 2020
Review #2 received
Received 18 May, 2020
Reviewer #2 agreed
On 05 May, 2020
Review #1 received
Received 04 Feb, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Editor assigned
On 10 Jan, 2020
Reviewers invited
Invitations sent on 10 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
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On 01 Jan, 2020
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Healthy Weight Services in England before, during and after pregnancy: a mixed methods approach
Hora Soltani
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9611-6777
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 11 Jun, 2020
Published
On 22 Jun, 2020
No community comments so far
Editor assigned
On 04 Jun, 2020
Submission checks complete
On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
No comments provided
Editorial decision: Major revision
On 28 May, 2020
Review #2 received
Received 18 May, 2020
Reviewer #2 agreed
On 05 May, 2020
Review #1 received
Received 04 Feb, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Editor assigned
On 10 Jan, 2020
Reviewers invited
Invitations sent on 10 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
First submitted
On 01 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Health Services Research.
Background: Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England. This project explored and mapped healthy weight service availability at different stages of the childbearing cycle.
Methods: A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data.
Results: A total of 88 participants responded to the survey. All services were offered most frequently during pregnancy; with healthy eating and/or weight management services offered more often than physical activity services. Few services were targeted specifically at women with a raised body mass index. There was a high degree of inconsistency of service provision in different geographical areas.
Several themes were identified from qualitative data including "equity and variation in service provision", "need for rigorous evaluation", "facilitators” to encourage better access or more effective service provision, including prioritisation, a change in focus and co-design of services, "barriers" encountered including financial and time obstacles, poor communication and insufficiently clear strategic national guidance and "the need for additional support”.
Conclusions: There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. There is a need for more robust evaluation of services to ensure they are fit for purpose. An urgent need for clear national guidance so that healthcare providers can more effectively assist mothers achieve a healthy weight gain was identified. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use.
Figure 1
Figure 2
Figure 3
Figure 4