Knowledge translation tool to improve pregnant women's awareness of gestational weight gain goals and risks of gaining outside recommendations: a non-randomized intervention study.
BACKGROUND
There is an urgent need to prevent excessive pregnancy weight gain, a contributor to both maternal and child obesity. However, the majority of women had reported not being counseled to gain an appropriate amount of gestational weight by their health care providers. We developed a knowledge translation (KT) tool designed to facilitate the clinical interaction between pregnant women and their health care providers (HCPs). We piloted the tool on the impact on women's knowledge of gestational weight gain (GWG) goals, and evaluated its potential in promoting appropriate knowledge about GWG within the 2009 Institute of Medicine guidelines.


METHODS
We conducted a prospective cohort study, comparing women's knowledge about GWG after the KT tool to women from the same clinics and care providers the year prior. Our primary outcome was the proportion of women who reported receiving an appropriate GWG recommendation from their care provider. We evaluated knowledge on a survey conducted at enrollment in the cohort at ≤ 20 weeks gestation and evaluated participant satisfaction with the KT tool in the third trimester. We performed univariate and multivariable logistic regression analyses for differences in outcomes with historical controls from the same clinics. Our a priori sample size calculation required 130 participants to demonstrate a 15% increase in reported counseling about gestational weight gain.


RESULTS
One hundred and forty-six women were recruited and 131 (90%) completed the enrollment survey. Women who received the KT tool were more likely to report receiving a specific GWG recommendation from their HCP (adjusted odds ratio [AOR] 3.45, 95% confidence interval [CI] 2.22-5.37) and discussing GWG topics with their HCP (AOR 7.96, 95% CI 4.41-14.37), and believing that there were risks to their infants with inadequate GWG (AOR 2.48, 95% CI 1.14-5.37). Half of women (49.5%) indicated that they would recommend the tool to a friend.


CONCLUSIONS
Women who received the KT tool reported receiving more counseling on GWG from their HCPs and were more aware of the risks of gaining outside appropriate GWG recommendations. The association between GWG education and GWG requires further research.
Department of Obstetrics & Gynecology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. mcdonals@mcmaster.ca.|Department of Radiology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. mcdonals@mcmaster.ca.|Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. mcdonals@mcmaster.ca.
Sarah D
SD
McDonald
Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. parkku2@mcmaster.ca.
Christina K
CK
Park
Child Health Evaluative Sciences Program, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. eleanor.pullenayegum@sickkids.ca.
Eleanor
E
Pullenayegum
Department of Family Medicine, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. bracken@mcmaster.ca.
Keyna
K
Bracken
Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. sword@mcmaster.ca.|School of Nursing, McMaster University, Hamilton, ON, L8S 4L8, Canada. sword@mcmaster.ca.
Wendy
W
Sword
Midwifery Education Program, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. mcdonal@mcmaster.ca.
Helen
H
McDonald
Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. neupanbp@mcmaster.ca.
Binod
B
Neupane
Department of Psychiatry, Women's College Hospital, 76 Grenville St, Toronto, ON, M5S 1B1, Canada. valerie.taylor@wchospital.ca.
Valerie H
VH
Taylor
Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. beyene@mcmaster.ca.
Joseph
J
Beyene
Department of Obstetrics & Gynecology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. muellevm@mcmaster.ca.
Valerie
V
Mueller
Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. mbrouwer@mcmaster.ca.|Department of Oncology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada. mbrouwer@mcmaster.ca.
Melissa
M
Brouwers
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003376:Counseling; D005260:Female; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice; D065386:Historically Controlled Study; D006801:Humans; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011446:Prospective Studies; D057170:Translational Research, Biomedical; D015430:Weight Gain; D055815:Young Adult