Is a motivational interviewing based lifestyle intervention for obese pregnant women across Europe implemented as planned? Process evaluation of the DALI study
Por:
Jelsma, JGM, Simmons, D, Gobat, N, Rollnick, S, Blumska, K, Jans, G, Galjaard, S, Desoye, G, Corcoy, R, Juarez, F, Kautzky-Willer, A, Harreiter, J, van Assche, A, Devlieger, R, Timmerman, D, Hill, D, Damm, P, Mathiesen, ER, Wender-Ozegowska, E, Zawiejska, A, Lapolla, A, Dalfra, MG, del Prato, S, Bertolotto, A, Dunne, F, Jensen, DM, Andersen, L, Snoek, FJ, van Poppel, MNM
Publicada:
7 sep 2017
Resumen:
Background: Process evaluation is an essential part of designing and assessing complex interventions. The vitamin D and lifestyle intervention study (DALI) study is testing different strategies to prevent development of gestational diabetes mellitus among European obese pregnant women with a body mass index >= 29kg/m(2). The intervention includes guidance on physical activity and/or healthy eating by a lifestyle coach trained in motivational interviewing (MI). The aim of this study was to assess the process elements: reach, dose delivered, fidelity and satisfaction and to investigate whether these process elements were associated with changes in gestational weight gain (GWG).
Methods: Data on reach, dose delivered, fidelity, and satisfaction among 144 participants were collected. Weekly recruitment reports, notes from meetings, coach logs and evaluation questionnaires (n = 110) were consulted. Fidelity of eight (out of twelve) lifestyle coach practitioners was assessed by analysing audio recorded counselling sessions using the MI treatment integrity scale. Furthermore, associations between process elements and GWG were assessed with linear regression analyses.
Results: A total of 20% of the possible study population (reach) was included in this analysis. On average 4.0 (of the intended 5) face-to-face sessions were delivered. Mean MI fidelity almost reached 'expert opinion' threshold for the global scores, but was below 'beginning proficiency' for the behavioural counts. High variability in quality of MI between practitioners was identified. Participants were highly satisfied with the intervention, the lifestyle coach and the intervention materials. No significant associations were found between process elements and GWG.
Conclusion: Overall, the intervention was well delivered and received by the study population, but did not comply with all the principles of MI. Ensuring audio recording of lifestyle sessions throughout the study would facilitate provision of individualized feedback to improve MI skills. A larger sample size is needed to confirm the lack of association between process elements and GWG.
Filiaciones:
Jelsma, JGM:
Vrije Univ Amsterdam, Dept Publ & Occupat Hlth, Med Ctr, Van der Boechorststr 7, NL-1081 BT Amsterdam, Netherlands
Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Med Ctr, Van der Boechorststr 7, NL-1081 BT Amsterdam, Netherlands
Simmons, D:
Addenbrookes Hosp, Inst Metab Sci, Cambridge, England
Univ Western Sydney, Macarthur Clin Sch, Campbelltown, NSW, Australia
Gobat, N:
Cardiff Univ, Sch Med, Cardiff, S Glam, Wales
Rollnick, S:
Cardiff Univ, Sch Med, Cardiff, S Glam, Wales
Blumska, K:
Poznan Univ Med Sci, Med Fac 1, Poznan, Poland
Jans, G:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate Gy, Univ Hosp Leuven, Leuven, Belgium
Galjaard, S:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate Gy, Univ Hosp Leuven, Leuven, Belgium
Univ Med Ctr Rotterdam, Dept Obstet & Gynaecol, Div Obstet & Prenatal Med, Erasmus MC, Rotterdam, Netherlands
Desoye, G:
Med Univ Graz, Dept Obstet & Gynecol, Graz, Austria
Corcoy, R:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Inst Salud Carlos III, CIBER Bioengn Biomat & Nanotechnol, Madrid, Spain
Juarez, F:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Kautzky-Willer, A:
Med Univ Vienna, Vienna, Austria
Harreiter, J:
Med Univ Vienna, Vienna, Austria
van Assche, A:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate Gy, Univ Hosp Leuven, Leuven, Belgium
Devlieger, R:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate Gy, Univ Hosp Leuven, Leuven, Belgium
Timmerman, D:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate Gy, Univ Hosp Leuven, Leuven, Belgium
Hill, D:
Rech Sante Lawson SA, St Gallen, Switzerland
Damm, P:
Univ Copenhagen, Fac Hlth Sci, Ctr Pregnant Women Diabet, Dept Endocrinol,Rigshosp, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth Sci, Ctr Pregnant Women Diabet, Dept Obstet,Rigshosp, Copenhagen, Denmark
Mathiesen, ER:
Univ Copenhagen, Fac Hlth Sci, Ctr Pregnant Women Diabet, Dept Endocrinol,Rigshosp, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth Sci, Ctr Pregnant Women Diabet, Dept Obstet,Rigshosp, Copenhagen, Denmark
Wender-Ozegowska, E:
Poznan Univ Med Sci, Med Fac 1, Poznan, Poland
Zawiejska, A:
Poznan Univ Med Sci, Med Fac 1, Poznan, Poland
Lapolla, A:
Univ Padua, Padua, Italy
Dalfra, MG:
Univ Padua, Padua, Italy
del Prato, S:
Univ Pisa, Pisa, Italy
Bertolotto, A:
Univ Pisa, Pisa, Italy
Dunne, F:
Natl Univ Ireland, Galway, Ireland
Jensen, DM:
Odense Univ Hosp, Odense, Denmark
Andersen, L:
Odense Univ Hosp, Odense, Denmark
Snoek, FJ:
Vrije Univ Amsterdam, Med Ctr, Dept Med Psychol, Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands
Acad Med Ctr, Dept Med Psychol, Amsterdam, Netherlands
van Poppel, MNM:
Vrije Univ Amsterdam, Dept Publ & Occupat Hlth, Med Ctr, Van der Boechorststr 7, NL-1081 BT Amsterdam, Netherlands
Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Med Ctr, Van der Boechorststr 7, NL-1081 BT Amsterdam, Netherlands
Graz Univ, Inst Sport Sci, Graz, Austria
Gold, Green Published, Green Accepted
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