Gestational Weight Gain in Primary Care

NCT02174809 | Completed

• 1 other identifier: P12PiccVall
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 2

Brief Summary

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.

Conditions

Gestational Weight Gain

Keywords

Pregnancy; Gestational Weight Gain; Primary Care; Guidelines

Outcome Measures

Primary Outcomes (1)

• Guideline-concordance of women's total gestational weight gain

  The congruence of total gestational weight gain with Institute of Medicine guidelines based on pre-pregnancy body mass index

  12 months

Study Arms (2)

5As

EXPERIMENTAL

Physicians' use of the 5As tool to discuss gestational weight gain with their pregnant patients

Behavioral: Use of 5As to discuss gestational weight gain

Usual care

ACTIVE COMPARATOR

Usual care by physicians in addressing gestational weight gain with their pregnant patients

Behavioral: Usual care

Interventions

Use of 5As to discuss gestational weight gain BEHAVIORAL

Also known as: 5As of Healthy Pregnancy Weight Gain

5As

Usual care BEHAVIORAL

Also known as: Usual care by physicians in addressing gestational weight gain

Usual care

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Family physicians providing prenatal care
• Patients who are pregnant

You may not qualify if:

• Multiple pregnancy
• Abnormal pregnancy
• Inability to read and inability to speak English

Sponsors & Collaborators

• Helena Piccinini: lead
• Nova Scotia Health Authority: collaborator

Study Sites (2)

Halifax Regional Municipality

Halifax, Nova Scotia, Canada

Location

Nova Scotia Health Authority

Halifax, Nova Scotia, Canada

Location

MeSH Terms

Conditions

Gestational Weight Gain

Condition Hierarchy (Ancestors)

Weight Gain; Body Weight Changes; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Family Physician

Study Record Dates

• First Submitted: March 28, 2014
• First Posted: June 26, 2014
• Study Start: January 1, 2017
• Primary Completion: March 31, 2018
• Study Completion: March 31, 2018
• Last Updated: April 30, 2018

Record last verified: 2018-04

Locations

CA (2)