Gestational Weight Gain Clinical Trial
Official title:
Curbing Gestational Weight Gain in Primary Care: Using Technology Based on Behaviour Change Theory
Excess weight gain in pregnancy is linked to a number of adverse outcomes for mothers and
their offspring, and in 2011, 59 % of women in Nova Scotia gained weight in excess of
recommendations. A number of factors influence how much weight a woman gains, including lack
of knowledge, age, the number of previous pregnancies she's had, smoking, ethnicity, income,
and education. Although a clinician's advice also plays a role, simply giving advice does not
necessarily translate into patient behaviour change. On the other hand, advice that is given
through a patient-centred approach is significantly associated with increased patient
acceptance of and adherence to recommendations, and increased intentions and attempts at
behaviour change. In addition, this approach has been shown to decrease costs to the health
care system. Patient-centredness can measured from the perspective of the clinician, an
observer, or the patient. Research suggests that the patient's perspective of
patient-centredness is the perspective most significantly associated with improved health
outcomes.
Clinicians avoid discussing weight-related matters for a number of reasons, including a lack
of time and general discomfort in raising the subject. There are some tools that can address
some of these barriers, and example being the "5As of Obesity Management". This tool is based
on principles of behaviour change science and patient-centredness. Pilot data on the use of
this tool showed a two-fold increase in the initiation of weight-related discussions between
clinicians and their patients. Our team was instrumental in the development, dissemination
and initial evaluation of this tool, and Dr. Piccinini-Vallis has recently led a national
multidisciplinary endeavor to adapt it to pregnancy, which has resulted in the "5As of
Healthy Pregnancy Weight Gain" tool. It is now time to evaluate whether the use of this tool
is acceptable to clinicians and whether its use translates into any patient outcomes.
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