title: Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy.
abstract: BACKGROUND
  Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject.
  
  
  METHODS
  A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated.
  
  
  RESULTS
  43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as 'better' (95% CI 85 to 100), as opposed to 3% stating 'stayed the same'--60% stated 'much better'. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either 'much' or 'somewhat better' (95% CI 66 to 93), as opposed to 17% stating 'stayed the same'. 89% indicated confidence to discuss eating habits and physical activity was 'much' or 'somewhat better' (95% CI 73 to 97) as opposed to 11% stating 'stayed the same'. Emergent themes highlighted that training was positively received and relevant to midwifery practice.
  
  
  CONCLUSIONS
  This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended.
authors.affiliation: Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, UK. partridgeandrea@hotmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Basu
authors.forename: Lynne
authors.initials: L
authors.lastname: Kennedy
authors.forename: Karen
authors.initials: K
authors.lastname: Tocque
authors.forename: Sharn
authors.initials: S
authors.lastname: Jones
mesh_terms: D001291:Attitude of Health Personnel; D015992:Body Mass Index; D002983:Clinical Competence; D004032:Diet; D004496:Education, Continuing; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008880:Midwifery / Q000193:education*; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control*; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D020377:Self Efficacy; D014852:Wales; D015430:Weight Gain