46 research outputs found
Perinatal mental health during the COVID-19 pandemic
The COVID-19 pandemic has influenced many aspects of life, including women's pregnancy, birth and postnatal period. Due to physically and immunologically adaptive perinatal changes, it is well known that pregnant women usually have an increased susceptibility to infection. Despite this, the majority of women affected by COVID-19 to date have exhibited mild symptoms and make a good recovery. However, there is no reliable evidence for transmission of COVID-19 from mother to infant during pregnancy. COVID-19 infection does not seem to increase likelihood of need for obstetric intervention at birth, with healthy infants born vaginally to mothers with the infection
Recommended from our members
The impact of COVID-19 on pregnant womens’ experiences and perceptions of antenatal maternity care, social support, and stress-reduction strategies
Background: The COVID-19 pandemic has impacted on maternity care, supports and women's mental health.
Aim: The aim of this study was to assess pregnant women's satisfaction with antenatal care and social support and to examine stress-reduction strategies women used during the pandemic.
Methods: An online survey was conducted between June and July 2020. Pregnant women, aged over 18 years were recruited. The survey included closed and open-ended questions to assess women's perceptions and satisfaction with their antenatal care, social support, and stress-reduction strategies. Descriptive statistics and multivariate analysis were used for quantitative analyses; qualitative content analysis was used for open-ended questions.
Findings: 573 pregnant women completed the survey. Women reported low levels of social support which was predicted by women's mental health and demographic factors and was related to public health and maternity service restrictions. Women reported that restrictions implemented in the maternity services limited their face-to face interactions with healthcare professionals and meant their partners could not attend antenatal appointments or support them in the postpartum period in the maternity setting. The lack of information on COVID-19 and pregnancy meant women had greater uncertainty about pregnancy and birth.
Discussion: Our findings indicate how the lack of access to antenatal care and reduced perceived social support as a result of the restrictions implemented in response to the COVID-19 pandemic, potentially intensifies pregnancy specific stress.
Conclusions: There is a need for the provision of supportive care, both formally and informally, particularly with women who may be more vulnerable during a pandemic
Recommended from our members
Prenatal stress, health, and health behaviours during the COVID-19 pandemic: An international survey.
BACKGROUND: Pregnant women's stress, mental and physical health, and health behaviours can have important implications for maternal and child health outcomes. AIM: To examine pregnant women's levels of stress, mental and physical health, and health behaviours during the COVID-19 pandemic.
METHODS: A cross-sectional survey was conducted online, with recruitment and data collection occurring between 16/6/20 and 17/7/20. Participants were pregnant women recruited via online pregnancy/parenting communities. Participants self-reported their levels of general stress, pregnancy-specific stress and COVID-19 related stress, mental and physical health, general health behaviours, and COVID-19 related health behaviours.
FINDINGS: 573 pregnant women participated in the survey. Participants were most commonly resident in the United States (42.6%, n=243), Ireland (41.2%, n=235) or the United Kingdom (10%, n=57). The majority (80.0%, n=457) were married and educated to degree level or above (79.3, n=453). Pregnant women reported high levels of pregnancy-specific and COVID-19-related stress, and low levels of mental and physical health, during the pandemic. Encouragingly, pregnant women in this study generally reported high levels of adherence to public health advice and pregnancy health behaviours. Stress and general mental health outcomes were best predicted by well-being factors (including stress and social support). Health impairing behaviours (e.g. poor diet) were predicted by both well-being and demographic factors.
DISCUSSION: Interventions targeting pregnancy- and pandemic-specific stress at the population level will be essential to support mental health and minimise adverse outcomes for women and children during the pandemic
Recommended from our members
Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention
Responsive infant feeding is a critical component of childhood obesity prevention. However, there is little guidance for caregivers on how to do this successfully. The first step to developing an intervention to promote responsive feeding is to systematically identify its barriers and enablers. Searches were conducted in CINAHL, Cochrane Library, Medline, Embase, PubMed, PsycINFO, Maternity, and Infant Care from inception to November 2020. All study designs were included if they reported a barrier or enabler to responsive feeding during the first 2 years of life. We used a "best fit" framework synthesis, with the Capacity, Opportunity, Motivation, and Behaviour (COM-B) model. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. Forty-three studies were included in the review. Barriers (n = 36) and enablers (n = 21) were identified across five COM-B domains: psychological capacity, physical and social opportunity, and reflective and automatic motivation. Enablers were recognition of infant feeding cues, feeding knowledge and family and friends. Caregiver attitude toward control of feeding was a barrier, together with health care professional advice about formula feeding and breastfeeding expectation. These barriers and enablers provide a comprehensive evidence base to guide intervention development to improve responsive feeding and prevent obesity across individual and population levels
Recommended from our members
Prenatal mental and physical health, behaviours, and maternity care experiences during the COVID-19
Recommended from our members
Differences in levels of stress, social support, health behaviours, and stress-reduction strategies for women pregnant before and during the COVID-19 pandemic, and based on phases of pandemic restrictions, in Ireland
Background
The COVID-19 pandemic and related restrictions can adversely impact antenatal maternal well-being and health behaviours.
Aim
To examine antenatal stress and stress-reduction strategies, social support, and health behaviours between women pregnant before and during the pandemic in Ireland.
Methods
210 pregnant women were recruited online and in the antenatal department of a tertiary maternity hospital before the pandemic, and 235 women recruited online during the pandemic. Only women resident in Ireland were included in this study. Women completed measures of stress, social support, health-behaviours, and self-reported stress-reduction strategies. Differences in outcomes were examined between women pregnant before and during the pandemic, and between Phase 2 and Phase 3 of the Irish Government COVID-19 restrictions.
Findings
Women pregnant during the pandemic reported lower perceived social support, including support from a significant other, friends and family, than women pregnant before the pandemic. There were no significant differences in stress in health behaviours but women reported higher stress and less physical activity during the pandemic. Women reported a range of comparable stress-reduction strategies before and during the pandemic. No differences were observed between phases of pandemic-related restrictions for any outcome.
Discussion
Our findings highlight negative impacts of the pandemic on social support, stress, and physical activity, which can have implications for maternal and child health. Lack of differences between restriction phases suggests on-going negative effects for antenatal well-being and behaviours.
Conclusion
Development of supports for pregnant women during the pandemic should include social-support and stress-reduction components
A study protocol of qualitative data sharing practices in clinical trials in the UK and Ireland: towards the production of good practice guidance [version 2; peer review: 2 approved]
BACKGROUND: Data sharing enables researchers to conduct novel research with previously collected data sets, thus maximising scientific findings and cost effectiveness, and reducing research waste. The value of sharing anonymised data from clinical trials is well recognised with a moderated access approach recommended. While substantial challenges to data sharing remain, there are additional challenges for qualitative data. Qualitative data including videos, interviews, and observations are often more readily identifiable than quantitative data. Existing guidance from UK Economic and Social Research Council applies to sharing qualitative data but does not address the additional challenges related to sharing qualitative data collected within trials, including the need to incorporate the necessary information and consent into already complex recruitment processes, with the additional sensitive nature of health-related data. METHODS: Work package 1 will involve separate focus group interviews with members of each stakeholder group: trial managers, clinical trialists, qualitative researchers, members of research funding bodies and trial participants who have been involved in qualitative research. Data will be analysed using thematic analysis and managed within QSR NVivo to enhance transparency. Work package 2 will involve a documentary analysis of current consent procedures for qualitative data collected as part of the conduct of clinical trials. We will include documents such as participant information leaflets and consent forms for the qualitative components in trials. We will extract data such as whether specific clauses for data sharing are included in the consent form. Content analysis will be used to analyse whether and how consent is being obtained for qualitative data sharing. CONCLUSIONS: This study will provide insight into the existing practice of sharing of qualitative data in clinical trials and the current issues and opportunities, to help shape future research and development of guidance to encourage maximum learning to be gained from this valuable dat
Addressing fidelity within complex health behaviour change interventions: A protocol of a scoping review of intervention fidelity frameworks and models
Intervention fidelity is crucial to facilitate accurate interpretation of research outcomes, but has been inadequately addressed within complex health behaviour change interventions. Recent research has highlighted a need for practical guidance to improve understanding and use of existing fidelity frameworks and models within complex health behaviour change intervention research. The aim of this paper is to present a protocol for a scoping review of existing intervention fidelity frameworks and models. // In accordance with scoping review guidelines, the following stages will be conducted: (1) identifying the research question, (2) identifying potentially relevant studies of fidelity frameworks and models, (3) study screening and selection, (4) charting and extracting data from identified frameworks and models, (5) collating, summarising and reporting the results and (6) consultation with stakeholders. Two reviewers will independently conduct the screening and extraction stages. Identified frameworks will be collated, summarized and categorized iteratively by one reviewer in consultation with the review team. // The findings of this review will provide a useful resource by identifying and comparing existing fidelity frameworks and models. It is intended that increased clarity and understanding in this area will facilitate the appropriate selection and application of fidelity frameworks for complex health behaviour change interventions, inform areas for future research, and ultimately contribute towards improving how intervention fidelity is addressed in this area
Selective outcome reporting in trials of behavioural health interventions in health psychology and behavioural medicine journals: a review
Selective outcome reporting can result in overestimation of treatment effects, research waste, and reduced openness and transparency. This review aimed to examine selective outcome reporting in trials of behavioural health interventions and determine potential outcome reporting bias. A review of nine health psychology and behavioural medicine journals was conducted to identify randomised controlled trials of behavioural health interventions published since 2019. Discrepancies in outcome reporting were observed in 90% of the 29 trials with corresponding registrations/protocols. Discrepancies included 72% of trials omitting prespecified outcomes; 55% of trials introduced new outcomes. Thirty-eight percent of trials omitted prespecified and introduced new outcomes. Three trials (10%) downgraded primary outcomes in registrations/protocols to secondary outcomes in final reports; downgraded outcomes were not statistically significant in two trials. Five trials (17%) upgraded secondary outcomes to primary outcomes; upgraded outcomes were statistically significant in all trials. In final reports, three trials (7%) omitted outcomes from the methods section; three trials (7%) introduced new outcomes in results that were not in the methods. These findings indicate that selective outcome reporting is a problem in behavioural health intervention trials. Journal- and trialist-level approaches are needed to minimise selective outcome reporting in health psychology and behavioural medicine
Which outcome measurement instruments are used to measure core infant feeding outcomes in children up to 1 year of age? A scoping review protocol
BackgroundHow, what, and when infants are fed plays a role in the aetiology of childhood obesity. Heterogeneity in how infant feeding outcomes are measured in trials of interventions to prevent childhood obesity limits evidence syntheses and understanding of intervention effectiveness. An infant feeding core outcome set (COS) was previously developed to standardised outcome measurement and reporting. The COS represents what to measure; determining how best to measure these outcomes is the next essential step to improve intervention evaluations. The aim of this scoping review is therefore to identify what outcome measurement instruments have been used in trials, and how they have been used, to measure the core infant feeding outcomes.MethodsA scoping review will be conducted. MEDLINE, EMBASE, CINAHL, PsychINFO, the Cochrane Central Register of Controlled Trials, OpenGrey and GreyNet will be searched from inception. Papers areeligible for inclusion if they report trials involving primary data collection that measure and report at least one core infant feeding outcome in infants ≤one year of age. Following searching and screening, eligible studies will be categorised into the following four overarching categories for data extraction, synthesis and write-up: caregiver-related outcomes; diet-related outcomes; feeding environment outcomes; child weight outcomes. Data will be narratively described and presented in tabular format, with findings presented in four separate review papers delineated by the four overarching categories.DiscussionThis scoping review forms part of the Standardised measurement for Childhood Obesity Prevention (SCOPE) study (www.eiascope.com). Evidence from this scoping review on what measurement instruments are used, and how they are used, represents an essential first step in developing recommendations and guidance about how best to measure core infant feeding outcomes for childhood obesity prevention. This can improve evidence syntheses and understanding of what infant feeding interventions are most effective for childhood obesity prevention