Women’s, partners’ and providers’ experiences of the ESTEEM dietary intervention for pregnant women with metabolic risk factors: A qualitative study

Problem

IntroductionWomen with metabolic risk factors such as obesity, gestational diabetes and preeclampsia are at significant risk to perinatal complications, and also increases their babies’ predisposition to obesity and diabetes. We need to understand more about women’s diet and lifestyle and their views and experiences of interventions in order to understand the mechanisms which engender the success of these and look at areas where these can be improved. The aim of this study is to explore the views and experiences of the ESTEEM dietary intervention in a pregnant cohort with metabolic risk factors. This is an ethnographic study nested within a larger RCT. The views of women’s partners and also healthcare professionals will be examined to find out how these may impact upon women’s dietary habits and preferences.

Approach

Data collection Demographic variation, that is people related characteristics (age, parity, period of gestation (middle/end of pregnancy), ethnicity, time in UK, previous experience of risk factors, employment (fulltime, part-time, unemployed), will be included to ensure a broad and inclusive sample of experiences of the intervention. Interpretation and data analysisThematic analysis (Braun and Clarke, 2006) a 6 stage inductive approach will be employed, therefore the themes identified will be strongly linked to the data themselves. The Consolidated criteria for reporting qualitative research (COREQ): 32-item checklist for interviews and focus groups was used to during the development, conduct and reporting of this research (Tong, 2007).

Findings

FindingsWomen’s worry and anxiety was very present most palpable across the data set. Women made their own decisions to problem-solve and adjust their diet when they had personal concerns that they tried to amend using their own expertise. Many women said that they were short of ideas or lacked skills about how to cook certain fodstuffs.Partners associated their early years with being taught about food and learning from their own mother. Most partners’ provided histories of their life and eating habits during the interviews incorporating accounts of their physical activity and their weight control. Partners intimated that baby’s health took precedence. The ESTEEM meetings also made the couple “realise” they had to change their “way of eating” and these were valued for the learning which took place.Health care professionals understood the intervention using their own professional knowledge and their personal comprehension of the research process. They fulfilled their role by doing what they thought was right and had to find a balance between following protocol and satisfying women’s needs.

Consequences

ConclusionsFood, bodies and eating must be embodied and engaged in the social contexts in which people live their lives. Health care professionals must base practice on evidence that includes both socio-economic and lifecourse variables.