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|Appears in Collections:||Faculty of Health Sciences and Sport Journal Articles|
|Peer Review Status:||Refereed|
|Title:||A realist evaluation of an antenatal programme to change drinking behaviour of pregnant women|
|Citation:||Doi L, Jepson R & Cheyne H (2015) A realist evaluation of an antenatal programme to change drinking behaviour of pregnant women. Midwifery, 31 (10), pp. 965-972. https://doi.org/10.1016/j.midw.2015.06.007|
|Abstract:||Objective: to use realist evaluation to describe and explain how and in what circumstances screening and alcohol brief interventions work in routine antenatal care. Design: a realist evaluation incorporating systematic reviews and qualitative data. Setting: NHS Lothian, which is one of the 14 Scottish health boards. Participants: participants were recruited from two maternity units. In phase one, interviews were conducted with four participants responsible for policy implementation. These data were supported by two systematic reviews. In phase two, 17 pregnant women and 15 midwives participated in interviews, with a further six midwifery team leaders involved in a focus group. Findings: training and resources provided to midwives as part of the programme acted as facilitating mechanisms that improved their skills and confidence to screen and deliver alcohol brief interventions. The programme elicited positive change in attitudes to drinking in pregnancy and possibly stimulated drinking behaviour change amongst pregnant women. However, the small numbers of pregnant women being identified for alcohol brief interventions meant delivery was infrequent and resulted in the programme not working as anticipated. The findings also revealed contextual issues around midwife-pregnant woman relationship and the challenges of negotiating the timing of screening and alcohol brief interventions delivery. Conclusions: Drinking in pregnancy is an emotive issue, therefore delivering alcohol brief interventions at the first antenatal appointment when they are more likely to achieve the most benefits poses challenges. When training midwives to screen and deliver alcohol brief interventions, special attention is needed to improve person-centred communication skills to overcome barriers associated with discussing sensitive prenatal alcohol use and enhance early identification and delivery of alcohol brief interventions at the first antenatal appointment.|
|Rights:||This article is open-access. Open access publishing allows free access to and distribution of published articles where the author retains copyright of their work by employing a Creative Commons attribution licence (CC BY-NC-ND). Proper attribution of authorship and correct citation details should be given. Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.|
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