| 1. |
- Sinclair, Marlene, et al.
(författare)
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A systematic literature review of computer-based behavioural change interventions to inform the design of an online VBAC intervention for the OptiBIRTH European randomized trial.
- 2017
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Ingår i: Evidence Based Midwifery. - 1479-4489. ; 15:1, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this research was o systematically review computer-based, behavior change (BC) interventions during pregnancy and their design components in order to determine their best application within the context of the OptiBIRTH intervention. Design: A systematic literature review was undertaken using the Cochrane collaboration guidelines for systematic reviews of health promotion and public health interventions. Literature searches were conducted in; Ovid MEDLINE, PubMed, Cochrane Library, Embase, PsycINFO, from database inception to June 2015. Cochrane Risk of Bias criteria was applied to assess the methodological quality of the papers and a taxonomy of BC techniques was used to appraise the interventions. PICO. Participants included healthy pregnant women who were ≥18 years old. The types of intervention used were computer-based interventions designed to facilitate a BC approach in a sample of pregnant women. The comparison was routine antenatal care. The primary outcome included improved health behavior(s), as an indicator of the intention behind the intervention design. Results. A total of 343 papers were identified through database-searching and hand- searching methods; 80 duplicates were removed. From the remaining 263, 244 did not explicitly address the subject under review. Therefore, 19 full text articles were assessed for eligibility; 16 did not meet eligibility criteria and were excluded at this stage. This resulted in a total of three studies being selected for inclusion in this review (Jackson et al, 2011; Tzilos et al, 2011; Tsoh et al, 2010). The computer-based interventions were designed to bring about BC in relation to alcohol consumption, smoking or diet and exercise during pregnancy. Interventions delivered varied between two types; purely computer-delivered (Tzilos et al. 2011) or a combination of both computer plus face-to-face input (Jackson et al, 2011; Tsoh et al. 2010). Techniques used included motivational interviewing, problem solving cognitive dissonance and goal setting. Types of measurement outcomes varied but were all self-reported behavioral outcomes. Statistically significant improvements in behavioral outcomes were seen in the interventions by Jackson et al (2011) and Tsoh et al (2011), but not in the intervention by Tzilos et al (2011). The GRADE analysis identified that all studies combined lacked blinding and relied on self-reported data increasing risk of bias. Conclusion. This systematic review reports on the best available evidence and theory to design an online component of a complex intervention for use in an RCT to enhance women´s shared decision-making experience about vaginal births after caesarean (VBAC). The review reports the differences between the observed BC approach and that of a decision-making being focused on a more healthy option. As a result, techniques designed to create dissonance are considered appropriate. Shared decision-making, however, is conceptually different, in that the goal is to facilitate a woman in discovering the best direction of travel for her as person. Therefore, the authors argue that it is crucial for healthcare professionals designing complex healthcare interventions (either BC techniques or shared decision-making) to ensure that a person´s self-determination is respected through having access to relevant and understandable information and healthcare professionals who understand a woman´s motivation. However, it is not possible to draw firm conclusions from three studies and there is a requirement for further research.
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| 2. |
- Smith, Valerie, et al.
(författare)
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Protocol for the development of a salutogenic intrapartum core outcome set (SIPCOS)
- 2017
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Ingår i: BMC Medical Research Methodology. - : Springer Science and Business Media LLC. - 1471-2288. ; 17:61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Maternity intrapartum care research and clinical care more often focus on outcomes that minimise or prevent adverse health rather than on what constitutes positive health and wellbeing (salutogenesis). This was highlighted recently in a systematic review of reviews of intrapartum reported outcomes where only 8% of 1648 individual outcomes, from 102 systematic reviews, were agreed as being salutogenically-focused. Added to this is variation in the outcomes measured in individual studies rendering it very difficult for researchers to synthesise, fully, the evidence from studies on a particular topic. One of the suggested ways to address this is to develop and apply an agreed standardised set of outcomes, known as a ‘core outcome set’ (COS). In this paper we present a protocol for the development of a salutogenic intrapartum COS (SIPCOS) for use in maternity care research and a SIPCOS for measuring in daily intrapartum clinical care. Methods: The study proposes three phases in developing the final SIPCOSs. Phase one, which is complete, involved the conduct of a systematic review of reviews to identify a preliminary list of salutogenically-focused outcomes that had previously been reported in systematic reviews of intrapartum interventions. Sixteen unique salutogenically-focused outcome categories were identified. Phase two will involve prioritising these outcomes, from the perspective of key stakeholders (users of maternity services, clinicians and researchers) by asking them to rate the importance of each outcome for inclusion in the SIPCOSs. A final consensus meeting (phase three) will be held, bringing international stakeholders together to review the preliminary SIPCOSs resulting from the survey and to agree and finalise the final SIPCOSs for use in future maternity care research and daily clinical care. Discussion: The expectation in developing the SIPCOSs is that they will be collected and reported in all future studies evaluating intrapartum interventions and measured/recorded in future intrapartum clinical care, as routine, alongside other outcomes also deemed important in the context of the study or clinical scenario. Using the SIPCOSs in this way, will promote and encourage standardised measurements of positive health outcomes in maternity care, into the future.
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