Moira Williamson

Midwives and nutrition education during pregnancy: A literature review

OBJECTIVES This review explored the extent to which the role of midwives in nutrition education during pregnancy has been reported in the literature and areas requiring further research were identified. REVIEW METHOD A review of the literature was undertaken. Articles included in the review were published in English, in scholarly journals, and provided information about the knowledge, education, and attitudes of midwives towards nutrition during pregnancy. RESULTS AND DISCUSSION Few studies were identified. The included studies were exploratory and descriptive. Studies had reported that midwives lacked a basic knowledge of nutrition requirements during pregnancy. This might be attributed to inadequate nutrition education provided in both undergraduate and postgraduate midwifery programmes. The nutrition education components of midwifery courses were not identified within the studies reviewed. CONCLUSION Limited international or Australian research is available that reports on the role of midwives in nutrition education during pregnancy and the nutrition content of midwifery curricula. This represents an important omission in midwives capacity to support the health of pregnant women and their babies. More research is required to explore the educational needs of midwives to enhance nutritional care for pregnant women.

Exploring Australian women’s level of nutrition knowledge during pregnancy: a cross-sectional study

Background The Australian Guide to Healthy Eating (AGHE) for pregnancy provides a number of food- and nutrition-related recommendations to assist pregnant women in optimizing their dietary behavior. However, there are limited data demonstrating pregnant women’s knowledge of the AGHE recommendations. This study investigated Australian pregnant women’s knowledge of the AGHE and related dietary recommendations for maintaining a healthy pregnancy. The variations in nutrition knowledge were compared with demographic characteristics. Methods A cross-sectional study assessed eight different nutrition knowledge domains and the demographic characteristics of pregnant women. Four hundred women across Australia completed a multidimensional online survey based on validated and existing measures. Results More than half of the pregnant women surveyed (65%) were not familiar with the AGHE recommendations. The basic recommendations to eat more fruit, vegetables, bread, and cereals but less meat were poorly understood. An in-depth investigation of knowledge of nutrition information revealed misconceptions in a range of areas, including standard serving size, nutrients content of certain foods, energy density of fat, and the importance of key nutrients in pregnancy. Univariate analysis revealed significant demographic variation in nutrition knowledge scores. Multiple regression analysis confirmed the significant independent effects on respondents’ nutrition knowledge score (P<0.000) of the education level, income, age, stage of pregnancy, language, and having a health/nutrition qualification. The model indicated that independent variables explained 33% (adjusted R2) of the variance found between respondents’ knowledge scores. Conclusion Australian pregnant women’s knowledge regarding AGHE for pregnancy and other key dietary recommendations is poor and varies significantly with their demographic profile. The setting of dietary guidelines is not sufficient to ensure improvement in their nutrition knowledge. It is essential that women receive support to achieve optimal and healthy diets during pregnancy.

Social media used as a health intervention in adolescent health: A systematic review of the literature

Objective Adolescents are known to be high users of social media, and social media is beginning to be used in health care. The primary objective of this review was to determine the current state of play on the use of social media as a health intervention in addressing the health of adolescents. Methods Six databases were searched: CINAHL, Medline, Scopus, ProQuest, Psych Info and Science Direct, from 2000–2013. The review process followed PRISMA guidelines with quality assessments of the selected articles undertaken. Results Three studies used social media as a health intervention in adolescent health. Facebook was the social media of choice. The way this social media tool was incorporated as the intervention varied. None of the social media interventions had a significant or sustained impact on the primary outcomes of the studies reviewed. Measures of social media process were limited and lacked meaning. Conclusions The selected papers provided insight into the beginning phase of using social media as a health intervention to address adolescent health. The review highlights three important areas for consideration when undertaking research on the use of social media as a health intervention for adolescents: the newness of using social media as a health intervention, the importance of the use of rigorous methodological processes when using social media as a health intervention, and the need to develop further knowledge on adolescents’ use of social media, in particular their hidden world of social media.

Australian Pregnant Women’s Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action

Background. Excessive gestational weight gain (GWG) can negatively impact on maternal and foetal health. Guidelines based on Institute of Medicine (IOM) encourage managing GWG by following healthy eating recommendations and increasing physical activity. This study investigated pregnant womens knowledge of their optimal GWG and recommended dietary approaches for GWG management. Method. English-speaking pregnant women were recruited from five hospitals in New South Wales (Australia) and an online link. Prepregnancy Body Mass Index (BMI) was calculated from self-reported height and prepregnancy weight. Participants identified their recommended GWG. A survey assessed practical dietary knowledge and asked about broad dietary recommendations to prevent excessive GWG. Chi square and logistic regression analyses were used. Results. N = 326 pregnant women completed the surveys; 49% entered pregnancy overweight (25.2%) or obese (23.6%); and knowledge of recommended GWG was lacking. Prepregnancy BMI was a significant predictor of GWG recommendation knowledge (P < 0.000). Pregnant women were highly knowledgeable about broad dietary recommendations but had poor knowledge of detailed recommendations. Conclusions. Limited knowledge of IOMs GWG guidelines and of specific dietary recommendations for pregnancy should be addressed by health care providers and education initiatives to assist the high number of women who enter pregnancy overweight or obese.

Longitudinal intergenerational birth cohort designs: a systematic review of Australian and New Zealand studies

Background The longitudinal birth cohort design has yielded a substantial contribution to knowledge of child health and development. The last full review in New Zealand and Australia in 2004 identified 13 studies. Since then, birth cohort designs continue to be an important tool in understanding how intrauterine, infant and childhood development affect long-term health and well-being. This updated review in a defined geographical area was conducted to better understand the factors associated with successful quality and productivity, and greater scientific and policy contribution and scope. Methods We adopted the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, searching PubMed, Scopus, Cinahl, Medline, Science Direct and ProQuest between 1963 and 2013. Experts were consulted regarding further studies. Five inclusion criteria were used: (1) have longitudinally tracked a birth cohort, (2) have collected data on the child and at least one parent or caregiver (3) be based in Australia or New Zealand, (4) be empirical in design, and (5) have been published in English. Results 10665 records were initially retrieved from which 23 birth cohort studies met the selection criteria. Together these studies recruited 91,196 participants, with 38,600 mothers, 14,206 fathers and 38,390 live births. Seventeen studies were located in Australia and six in New Zealand. Research questions initially focused on the perinatal period, but as studies matured, longer-term effects and outcomes were examined. Conclusions This review demonstrates the significant yield from this effort both in terms of scientific discovery and social policy impact. Further opportunities have been recognised with cross-study collaboration and pooling of data between established and newer studies and international studies to investigate global health determinants.

Informing Nutrition Care in the Antenatal Period: Pregnant Women’s Experiences and Need for Support

This study aimed to provide insights into Australian womens experiences in gaining nutrition information during pregnancy. Individual semistructured telephone interviews were conducted with 17 pregnant (across all trimesters) and 9 postpartum women in five Australian states. Data were transcribed and analysed using inductive thematic analysis. Women valued nutrition information, actively sought it, and passively received it mainly from three sources: healthcare providers (HCPs), media, and their social networks. Women reported HCPs as highest for reliability but they had limited time and indifferent approaches. Various media were easily and most frequently accessed but were less reliable. Social networks were considered to be the least reliable and least accessed. Women reported becoming overwhelmed and confused. This in turn influenced their decisions (pragmatic/rational) and their eating behaviours (“overdo it,” “loosen it,” “ignore it,” and “positive response”). Individual and environmental barriers impacted their application of knowledge to dietary practice. Women wanted more constructive and interactive engagement with their HCPs. This study identified the need to establish and maintain mutually respectful environments where women feel able to raise issues with their HCPs throughout their pregnancies and where they are confident that the information they receive will be accurate and meet their needs.

Nutrition Education in Australian Midwifery Programmes: A Mixed-Methods Study

Little research has explored how nutrition content in midwifery education prepares midwives to provide prenatal nutrition advice. This study examined the nature and extent of nutrition education provided in Australian midwifery programmes. A mixed-methods approach was used, incorporating an online survey and telephone interviews. The survey analysis included 23 course coordinators representing 24 of 50 accredited midwifery programmes in 2012. Overall, the coordinators considered nutrition in midwifery curricula and the midwife’s role as important. All programmes included nutrition content; however, eleven had only 5 to <10 hours allocated to nutrition, while two had a designated unit. Various topics were covered. Dietitians/other nutrition experts were rarely involved in teaching or reviewing the nutrition content. Interviews with seven coordinators revealed that nutrition education tended to be problem-oriented and at times based on various assumptions. Nutrition content was not informed by professional or theoretical models. The development of nutrition assessment skills or practical training for midwifery students in providing nutrition advice was lacking. As nutrition is essential for maternal and foetal health, nutrition education in midwifery programmes needs to be reviewed and minimum requirements should be included to improve midwives’ effectiveness in this area. This may require collaboration between nutrition experts and midwifery bodies.

Using Colaizzi’s method of data analysis to explore the experiences of nurse academics teaching on satellite campuses

BACKGROUND Phenomenology is a useful methodological approach in qualitative nursing research. It enables researchers to put aside their perceptions of a phenomenon and give meaning to a participants experiences. Exploring the experiences of others enables previously unavailable insights to be discovered. AIM To delineate the implementation of Colaizzis ( 1978 ) method of data analysis in descriptive phenomenological nursing research. DISCUSSION The use of Colaizzis method of data analysis enabled new knowledge to be revealed and provided insights into the experiences of nurse academics teaching on satellite campuses. Local adaptation of the nursing curriculum and additional unnoticed responsibilities had not been identified previously and warrant further research. CONCLUSION Colaizzis ( 1978 ) method of data analysis is rigorous and robust, and therefore a qualitative method that ensures the credibility and reliability of its results. It allows researchers to reveal emergent themes and their interwoven relationships. Researchers using a descriptive phenomenological approach should consider using this method as a clear and logical process through which the fundamental structure of an experience can be explored. IMPLICATIONS FOR RESEARCH Colaizzis phenomenological methodology can be used reliably to understand peoples experiences. This may prove beneficial in the development of therapeutic policy and the provision of patient-centred care.

Developing a Systematic Literature Review on the Use of Social Media as a Health Intervention in Adolescent Health: A Case Study

A systematic literature review provides the basis for identifying consistency in research processes, quality of research methodology, current knowledge, and gaps in knowledge. This information is important as it provides researchers with guidance on a particular area of knowledge, including what worked well, what did not work well, and the direction that future research may take. A systematic review is different to other forms of literature reviews, and this difference is reflected in the method. The following case study looks at the process undertaken when systematically reviewing the literature on “the use of social media as a health intervention in adolescent health.” In particular, the case study highlights the importance of clearly identifying the topic under review, the use of a tested or proven tool to assess the literature, and the dissemination of the findings, that is, writing up the review so that others may understand and if required replicate the study. The case study provides an opportunity to reflect on the processes of a systematic literature review with examples to demonstrate that process.

Social networking sites (SNS) as a tool for midwives to enhance social capital for adolescent mothers

OBJECTIVE to explore ways in which midwives can enhance the support provided by social networking sites for adolescent mothers. DESIGN a narrative approach was employed to guide the research design and processes. Approval was obtained from Edith Cowan University human ethics department. SETTING focus groups and interviews were undertaken with adolescent mothers and midwives in Western Australia. FINDINGS the four key themes identified across both groups were validation by midwives, importance of ownership, enhanced community connections and the importance of guideline development. CONCLUSIONS findings suggest both mothers and midwives consider there are a variety of ways in which healthcare professionals could enhance the support afforded to adolescent mothers by their use of SNS. Midwives were more likely to consider the need for guideline development, but the underlying value of accessible, professionally mediated online support and information was consistent across the two groups. IMPLICATIONS FOR PRACTICE Midwives would benefit from acknowledging the role played by SNS in providing support to adolescent mothers and by considering ways in which this technology can be used to lend further support to this group of mothers.