Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol.
Background: Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence, and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.
Methods: Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ two behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped wedge RCTs, and non-randomised control trials will be eligible. Studies that include a no intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.
Discussion: The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care, and will help researchers, policy makers, and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short and long term health outcomes for women and their children.
Systematic review registration: PROSPERO 2018 CRD42018095315
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On 02 Sep, 2020
On 12 Aug, 2020
On 05 Aug, 2020
On 04 Aug, 2020
On 04 Aug, 2020
Posted 28 Apr, 2020
On 13 Jul, 2020
Received 08 Jul, 2020
Received 08 Jul, 2020
On 07 Jul, 2020
Received 03 Jun, 2020
On 28 May, 2020
On 25 May, 2020
Invitations sent on 18 May, 2020
On 06 May, 2020
On 05 May, 2020
On 23 Apr, 2020
On 22 Apr, 2020
Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol.
On 02 Sep, 2020
On 12 Aug, 2020
On 05 Aug, 2020
On 04 Aug, 2020
On 04 Aug, 2020
Posted 28 Apr, 2020
On 13 Jul, 2020
Received 08 Jul, 2020
Received 08 Jul, 2020
On 07 Jul, 2020
Received 03 Jun, 2020
On 28 May, 2020
On 25 May, 2020
Invitations sent on 18 May, 2020
On 06 May, 2020
On 05 May, 2020
On 23 Apr, 2020
On 22 Apr, 2020
Background: Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence, and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.
Methods: Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ two behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped wedge RCTs, and non-randomised control trials will be eligible. Studies that include a no intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.
Discussion: The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care, and will help researchers, policy makers, and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short and long term health outcomes for women and their children.
Systematic review registration: PROSPERO 2018 CRD42018095315