Background

Obesity and excessive weight gain during pregnancy are associated with an increased risk of complications as well as maternal and neonatal mortality. Excessive weight gain during pregnancy can also lead to further development of obesity in women and their offspring, therefore effective strategies are required to tackle this important health issue.

National Institute for Health and Clinical Excellence (NICE 2010) has identified the need for more research on the management of maternal obesity. With an initial funding from the Engineering for Life (EFL) and support from CLAHRC (UCHD, Obesity and TaCT themes) we have completed the preclinical stages of developing a complex intervention to evaluate the use of text messaging in the management of maternal obesity. 

Project Summary

This project links with existing
care pathways and will provide technological advances on previous projects. The development of an e-health platform, delivered through a portable device, can optimise access and promote effectiveness by overcoming challenges associated with the stigma and other face-to-face barriers.

A phased approach was taken to develop and evaluate this complex intervention. The results of the preclinical and phase I are presented here. Through a structured literature search and focus groups of women and midwives a preliminary prototype was developed. Additional focus groups were carried out to verify acceptability of the intervention components. This was followed by a usability testing to explore implementation of the intervention into the practical setting. The results of the focus groups were analysed thematically.

Women and midwives welcomed an additional support particularly text messaging for maternal obesity management as a modern and discrete service. A message delivery platform, 96 motivational text messages, and diaries were developed to enable goal setting for diet and physical activity behaviour change and self-monitoring purposes. The verification process identified several areas for improvement. Participants felt that consultations went well, some text messages needed rewording, one message a day was ideal, and the diary layout and colours needed changing. A few minor software improvements were also identified.
The intensive engagement of service users and care providers through an iterative process has led to development of the MOMTech prototype for further evaluation. Amendments will be made, prior to piloting with pregnant women.

The team has been successful in obtaining a small funding from BUPA to examine practicality of the intervention and its implementation into practice prior to a pilot study.

Professor Hora Soltani (Chair in Maternal and Infant Health at Sheffield Hallam University-project lead) says "This project is an excellent example of academic and clinical networking. The need for the study was identified as a result of a gap analysis by clinicians leading the maternal obesity clinic in Doncaster and their communications with myself."

The multidisciplinary team includes experts from User Centred Healthcare Design (led by Professor Andy Dearden), health psychologists (Dr Maddy Arden and Dr Penny Furness) and a research assistant (Alex Scott) who has recently joined the team, initially supported by the CLAHRC SY. Dr Kerry McSeveny from Cultural, Communication and Computing Research Institute, contributed to the early stage of the study supported by EFL. In addition our clinical colleagues Carolyn Garland and Alison Williams from Doncaster maternity unit have been instrumental in taking this project forward. We have had discussions with market leading industrial partners for a wider evaluation and application of these services.

Support from BUPA allows examining the practicality of the intervention prior to the next step which we are currently designing to conduct a pilot multi-centre randomized controlled trial.

For further information, please contact Hora Soltani

CLAHRC Themes involved in the Project

UCHD, TaCT

CLAHRC project partners

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Supported by BUPA for feasibility testing