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Innovation Poster Session HRT1104b – Maternity Melbourne 10 th & 11 th March 2011. Healthy Start to Pregnancy: the Personalised Pregnancy Weight Tracker Presenter: Dr Shelley Wilkinson, Dr Di Poad, Marlene Redelinghuys. Hospital Code Name:. KEY PROBLEM. Complications exist with

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Hospital Code Name:

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  1. Innovation Poster Session HRT1104b – Maternity Melbourne 10th & 11th March 2011 Healthy Start to Pregnancy:the Personalised Pregnancy Weight TrackerPresenter: Dr Shelley Wilkinson, Dr Di Poad, Marlene Redelinghuys Hospital Code Name:

  2. KEY PROBLEM Complications exist with high BMI pregnancies excessive weight gain 35% of our women overweight/obese pre-pregnancy (see graphs) ‘Diet quality’ deteriorates with increasing BMI Low Nutrition & Dietetic staffing levels at our site Knowledge of weight gain guidelines increases likelihood of correct weight gain, but no advice given

  3. BMI range year

  4. AIM OF THIS INNOVATION To improve pregnant women’s nutrition knowledge and behaviours and to meet women’s nutrition-related needs by providing evidence-based nutrition educationand advice, and appropriate and timely access to dietitians during pregnancy according to a self-management framework (The 5As): Assess/Advise/Agree/Assist/Arrange.

  5. BASELINE DATA Our women had: Poor access to and awareness of Dietetic service Very poor knowledge of weight gain guidelines Poor dietary behaviours Excessive weight gain 50% of women with BMI > 25kg/m² 75% of women with BMI > 30kg/m² 100% of women with BMI > 40kg/m² > 60% interested in nutrition education & support 50% when find out pregnant, 29.9% @ 1st ANC visit, 15.9% either

  6. KEY CHANGES IMPLEMENTED New Nutrition & Maternal Health Model of Care (MOC) Evidence-based (EB) nutrition resource (given by midwives@1st visit) ‘Healthy Start to Pregnancy’ (Dietitian’s EB behaviour-change group) 1 hour, dietitian-facilitated workshop, delivery of evidence-based content, based on behaviour change theory Integrated ‘healthy weight gain for a healthy pregnancy’ message through out service Reinforced by ‘personalised pregnancy weight tracker’ With advice on “what to do when track outside the shading” + Offer of phone or face to face reviews, esp. high BMI women Evidence-based nutrition booklet

  7. Evidence based pregnancy weight tracker Assess: Work out pre-pregnancy BMI Advise & agree: Discuss weight gain range for a healthy pregnancy Assist: Track (your) weight every week or so; if you track high or low, make diet and lifestyle changes according to the information in your booklet Arrange: If you continue to track high or low, contact the dietitian for an appointment Write your pre-pregnancy weight at the bottom and then in the box above that write a weight that is one kilo higher until you’ve filled all the boxes Weight goes up the side →→→ * * Find your weeks of pregnancy, find your weight and put a cross where the lines meet * * * * Weeks are along the bottom →→→

  8. OUTCOMES SO FAR ‘Process’ evaluation of HSP: 200+ women attended so far > 93.9% rated: ‘good’ or ‘very good’ Increased knowledge and understanding of: Diet – 92.6% (agree/strongly agree) Weight management – 74.2% (agree/strongly agree) Gave practical advice (94.9%) and motivated to make changes (94.7%) to change diet (agree/strongly agree) Many high BMI women attend HSP, but few who have been referred What women liked about the session: Learning what a proper serve size was Knowing what I need to eat and how to apply it to my own habits and preferences I liked the opportunity to use the weight tracker I was a bit worried coming to the group as I’m big and I was worried about what the dietitian would tell me to do —I’ve heard it all before but— the focus on healthy weight gain for pregnancy, whatever weight you start at and the weight tracker was really good. The weight tracker was VERY helpful as my weight has been a main source of stress for me Currently evaluating impact outcomes in an RCT (n=360)

  9. LESSONS LEARNT Our healthy pregnancy nutrition booklet and program, with an integrated ‘healthy weight management’ message, delivered in early pregnancy is well received (and attended) A separate weight management approach may be required to provide a higher level of support to some women This should incorporate the evidence that numerous visits (or contacts) are usually required to support behaviour change Funding of research to examine cost effectiveness of interventions to assist women would be useful

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