P74 Barriers and facilitators for preconception planning among women in the United Kingdom: a rapid review
P74 Barriers and facilitators for preconception planning among women in the United Kingdom: a rapid review
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P74 英国妇女孕前计划的障碍和促进因素：快速回顾
DOI：
10.1136/jech-2020-ssmabstracts.166
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发表时间：
2020
影响因子：
6.3
通讯作者：
O. Oyebode
中科院分区：
文献类型：
--
作者：
A. Ayorinde;F. Boardman;B. Alzouebi;L. Porter;A. Hadley;M. Ludeke;A. Sallis;S. Mann;O. Oyebode
背景 孕前计划使妇女能够优化孕前健康，从而降低孕产妇和新生儿不良结局的风险。对孕前计划的认识和实践普遍较低。在这次快速证据审查中，我们研究了女性选择计划和准备健康怀孕的障碍和促进因素。方法我们检索了2009年至2019年10月的MEDLINE、PsycINFO和CINAHL，且仅限于英语。我们收录了所有为女性选择计划和准备怀孕提供便利和障碍的出版物。我们还收录了一些论文，介绍了支持这种行为的医疗保健专业人员的障碍和促进因素，以及有关相关干预措施的文章，尽管这些数据未在此提供。我们联系了专家来识别灰色文献。我们使用预先试验的数据提取表格提取研究特征，并使用混合方法评估工具评估个别研究的质量。一名评审员进行了标题和摘要筛选、数据提取和质量评估，并由第二名评审员检查了样本。两位审稿人独立筛选全文。使用 NVivo，我们将每项研究中有关障碍和促进因素的信息编码为两个小标题下的主题； a) 信息查找和 b) 为健康怀孕做好准备。结果 我们筛选了 2679 条引用，54 篇全文文章，并纳入 24 篇文章进行分析。 18 篇文章报道了女性面临的障碍和促进因素。最常报告的受孕前信息寻求障碍是意外怀孕、引发焦虑的信息以及认为不需要孕前护理的信念。协调员包括医疗保健机构中的临时提示以及讨论怀孕意图的机会（例如作为慢性病护理的一部分）。为健康怀孕做准备的最常见障碍是：不知道建议的行为是什么、缺乏理解或不正确的信念、不适合女性背景的信息以及似乎与健康建议相矛盾的生活经历（自我或社交圈）。促进因素包括对建议行为的了解、对潜在婴儿的责任感以及对在怀孕前实现健康目标的能力的信心。结论 我们将进行行为分析，并将已识别的障碍和促进因素分类为理论和技术工具 (TaTT) 行动机制 (MoAs)。然后，我们将检查现有干预内容是否符合理论上的适当内容，从而确定改进现有干预措施和新开发的机会，以促进孕前计划并最终改善孕产妇和新生儿的结局。
Background Preconception planning enables women to optimize preconception health thereby reducing the risk of poor maternal and neonatal outcomes. Awareness and practice of preconception planning is generally low. In this rapid evidence review, we examined the barriers and facilitators to women choosing to plan and prepare for a healthy pregnancy. Methods We searched MEDLINE, PsycINFO and CINAHL from 2009 to October 2019 and limited to English language. We included any publications that presented facilitators and barriers for women choosing to plan and prepare for pregnancy. We also included papers presenting barriers and facilitators to health care professionals supporting this behaviour and articles on relevant interventions although these data are not presented here. We contacted experts to identify grey literature. We extracted study characteristics using a pre-piloted data extraction form and assessed the quality of individual studies using the Mixed Methods Appraisal Tool. One reviewer performed title and abstract screening, data extraction and quality assessment with a sample checked by a second reviewer. Two reviewers screened full texts independently. Using NVivo, we coded information on barriers and facilitators from each study into themes under two subheadings; a) information seeking and b) preparing for a healthy pregnancy. Results We screened 2679 citations, 54 full-text articles and included 24 articles for analysis. 18articles reported barriers and facilitators for women. The most frequently reported barriers to information seeking prior to conception were unintended pregnancy, information provoking anxiety, and belief that there is no need for preconception care. Facilitators included ad hoc prompts in health care settings, and opportunities to discuss pregnancy intentions (e.g. as part of care for a chronic condition). The most frequent barriers to preparing for a healthy pregnancy were: not knowing what recommended behaviours might be, lack of understanding or incorrect beliefs, information not appropriate for woman’s context, and lived experience (of self or in social circle) that appears to contradict health advice. Facilitators included knowledge of recommended behaviours, feelings of responsibility towards a potential baby, and confidence in ability to achieve health goals prior to conceiving. Conclusion We will conduct a behavioural analysis and categorise the identified barriers and facilitators into the Theory and Techniques Tool (TaTT) mechanisms of actions (MoAs). We will then examine whether existing intervention content matches what is theoretically appropriate, therefore identifying opportunities for improvement of existing interventions and novel development to promote preconception planning and ultimately, better maternal and neonatal outcomes.