Using health promotion to reduce the burden of obesity before and in pregnancy
Project title: Generating and translating knowledge in health promotion and lifestyle improvement prior to and during pregnancy to reduce the burden of maternal obesity
Start date: March 2018
Estimated end date: August 2020
What is the issue?
Two-thirds of Australian adults are overweight or obese. Women in their reproductive years are leading this trend, gaining more weight yearly than older women and progressing more rapidly to obesity than men. Over half of women in Australia and other developed countries enter pregnancy overweight or obese. A higher body mass index (BMI) prior to pregnancy increases the risk of complications during pregnancy including gestational diabetes mellitus, pre-eclampsia, caesarean section, and large-for-gestational-age (LGA) infants.
There is a clear imperative to reduce obesity, yet treating established obesity is intensive, costly, largely ineffective and unsustainable at a population level. This leading team has developed effective lifestyle interventions for reproductive aged women and pregnancy, however, to date, no country has implemented such interventions and scaled them as a systems level- and policy-level evidence-based strategies targeting women pre-conception and pregnancy to prevent obesity.
How is the project addressing the issue?
The aim of this project is to create, capture and deliver health promotion, lifestyle improvement and obesity prevention strategically targeting women during pre-conception and pregnancy, to improve the health of women and the next generation.
Taking a systems implementation approach, the project team will engage with stakeholders, generate and translate new knowledge in implementation of effective interventions and strategies at scale.
Relevance of the project for policy and practice
The delivery of effective interventions and tool kits will support women through pre-conception and pregnancy to live active and healthy lives.
This is the first project, nationally or internationally, to take such a systems approach in the maternal obesity space, and it will have flow on effects on childhood obesity. If we tackle obesity prevention from before conception, through pregnancy and into the postpartum, we will build effective and population level support for women and help prevent childhood obesity.
What are the expected outcomes?
The project will implement low cost, translatable and scalable solutions to reduce the burden of maternal and childhood obesity including:
- Designing an innovative and engaging pre-conception health promotion program targeting reproductive aged women
- Developing evidence-based resources and an implementation strategy ready for translation and scale of pre-conception health promotion programs
- Mapping current practice, scope implementation enablers and barriers in pregnancy
- Co-designing implementation strategies and resources for integration of lifestyle interventions into routine antenatal care
- Identifying gaps in the training of medical doctors and nurses/midwives to support lifestyle modification pre-conception and in pregnancy
- Co-designing an accessible, low-cost, capacity building intervention to up-skill health professionals to support lifestyle modification and deliver pre-conception and antenatal lifestyle interventions effectively.
Professor Helena Teede, Monash University
Professor Helen Skouteris, Monash University
Associate Professor Jacqueline Boyle, Monash University
Tracy Taylor (Project Manager), Monash University
Josie Johnson, Monash University
Cheryce Harrison, Monash University
Briony Hill, Monash University
Cate Bailey, Monash University
Emily Gilbert, Monash University
Rebeccah Bartlett, Monash University
Heidi Bergmeier, Monash University
Grace Xie, Monash University
Ruth Walker, Monash University
Siew Lim, Monash University
Funding for this research has been provided from the Australian Government’s Medical Research Future Fund (MRFF). The MRFF provides funding to support health and medical research and innovation, with the objective of improving the health and wellbeing of Australians. MRFF funding has been provided to The Australian Prevention Partnership Centre under the MRFF Boosting Preventive Health Research Program. Further information on the MRFF is available at www.health.gov.au/mrff.
- O’Brien EC, Segurado R, Geraghty AA, Alberdi G, Rogozinska E, Astrup A, et al. Impact of maternal education on response to lifestyle interventions to reduce gestational weight gain: individual participant data meta-analysis. International Weight Management in Pregnancy (i-WIP) Collaborative Group. August 2019. BMJ Open. August 2019;9(8):e025620. doi: 10.1136/bmjopen-2018-025620
- Tay CT, Teede HJ, Hill B, Loxton D, Joham, AE. Increased prevalence of eating disorders, low self-esteem and psychological distress in women with polycystic ovary syndrome: a community-based cohort study. Fertility and Sterility. August 2019;112(2):353–61. doi: 10.1016/j.fertnstert.2019.03.027
- Bennett C, Walker R, Blumfield M, Gwini S, Ma J. Wang F, Wan Y, Truby H. Attenuation of maternal weight gain impacts infant birthweight: systematic review and meta-analysis. Journal of Developmental Origins of Health and Disease. August 2019;10(4):387–405. doi: 10.1017/S2040174418000879
- Lim S, Liang X, Hill B, Teede H, Moran LJ, O’Reilly S. A systematic review and meta‐analysis of intervention characteristic in postpartum weight management using the TIDieR framework: A summary of evidence to inform implementation. Obesity Reviews. 2019;20(7):1045–56. doi: 10.1017/S2040174418000879
- Khan NN, Boyle JA, Lang AY, Harrison CL. Preconception health attitudes and behaviours of women: A qualitative investigation. Nutrients. 2019;11(7):1490. doi: 10.3390/nu11071490
- Hill B, Kothe EJ, Currie S, Danby M, Lang AY, et al. A systematic mapping review of the associations between pregnancy intentions and health-related lifestyle behaviours or psychological wellbeing. Preventive Medicine Reports. June 2019;14. doi: 10.1016/j.pmedr.2019.100869
- Hill B, Hayden M, McPhie, S, Bailey C, Skouteris H. Preconception and antenatal knowledge and beliefs about gestational weight gain. ANZJOG, 2019:1–7. Manuscript ID ANZJOG-2018-0271.R1 (Impact Factor 1.766).
- Kothe E, Lamb M, Bruce L, McPhie S, Klas A, Hill B, Skouteris H. Student midwives’ intention to deliver weight management interventions: A theory of planned behaviour & self-determination theory approach. Nurse Education Today. December 2018:71;10–16 (online publication).
- Lim S. Wheelers Hill Library, Monash City Council Community Talk, August 2019, Wheelers Hill, Vic Australia. Invited speaker – Polycystic Ovary Syndrome (PCOS) Information Session
- Walker R. Department of General Practice, Monash University Research Seminar, July 2019, Melbourne, Australia. Invited speaker – Maternal nutrition: A double-dose of prevention.
- Hill B, Ling B, Skouteris H, Bruce L, Moran L, Teede H, Mishra G. Australasian Society of Lifestyle Medicine Conference, June 2019, Auckland, New Zealand. Poster – Lifestyle and psychological characteristics of women with pregnancy intentions.
- Hill B, Ling B, Skouteris H, Bruce L, Moran L, Teede H, Mishra G. Australasian Society of Lifestyle Medicine Conference, June 2019. Auckland, New Zealand. Oral presentation and poster – Associations between future parenthood aspirations and lifestyle and psychological characteristics in women.
- Skouteris H. Capacity in building healthcare improvement. 16th Healthcare Executive Management Development Programme. Mysuru, India. 2-9 February 2019.
- Bergmeier H. Maternal body image during pregnancy, postpartum and early parenting. Expert panel discussion, PANDA (Perinatal Anxiety and Depression) Australia Professional Training. Richmond, Australia, 5 December 2018.
- Hill B, Moran LJ, Teede H, Skouteris H. Lifestyle intervention to prevent obesity during pregnancy: A view to the future. International Congress of Behavioral Medicine, Santiago, Chile. Oral in symposium, The impact of early environments on maternal and child obesity and overweight.
- Hill B, Kothe EJ, Currie S, Danby M, North M, Lang A, Bailey C, Moran LJ, Teede H, Skouteris H. Pregnancy intentions, health-related lifestyle behaviours, and psychological wellbeing: A systematic mapping review of the literature. International Congress of Behavioral Medicine. Santiago, Chile. November 2018.
- Skouteris H. Maternal body image across pregnancy, postpartum and early parenting, PANDA (Perinatal Anxiety & depression Australia), Victoria, Australia. November 2018.
- Skouteris H. Health in preconception and pregnancy: Prevention of maternal obesity, University of Thessaloniki, Greece. September 2018.
- Skouteris H. Health in preconception and pregnancy: An implementation science approach to reducing the burden of maternal obesity. Warwick University, UK, April 2018.
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