Bridging the gap between pregnancy loss research and policy and practice: insights from a qualitative survey with knowledge users

Abstract

Background The loss of a pregnancy or the death of baby around the time of their birth can have profound impacts on parents, families and staff involved. There is much opportunity to enhance the systematic uptake of evidence-based interventions to enhance service provision, lived experiences and outcomes. Challenges exist to translating pregnancy loss research evidence into policy and practice, however. Pregnancy loss remains a neglected area of research and resourcing and is steeped in stigma. While barriers and facilitators to the use of research evidence by decision-makers in public health and health services are well documented, we aimed to better understand the factors that influence the translation of pregnancy loss research into practice and policy. Methods We conducted a qualitative online survey of pregnancy loss research knowledge users in Ireland, identified through our clinical and academic networks, between January and March 2022. The survey comprised ten questions, with three closed questions, informed by the Knowledge Translation Planning Template©. Questions included who could benefit from pregnancy loss research, perceived barriers and facilitators to the use of research evidence and preferred knowledge translation strategies. We analysed data using reflexive thematic analysis. Results We included data from 46 participants in our analysis, from which we generated two central themes. The first—‘End the silence; stigma and inequality around pregnancy loss to enhance awareness and understanding, public health and services and supports’—addresses issues related to the stigma, sensitivities and silence, lack of awareness and understanding, and lack of relevance or priority afforded to pregnancy loss. The second theme—‘Use a range of tailored, accessible approaches to engage a large, diverse range of knowledge users’—highlights the need to use relevant, accessible, and engaging information, resources or materials in knowledge translation efforts, and a variety of tailored approaches to suit different audiences, including materials, workshops/webinars, media, knowledge brokers and champions or opinion leaders. Conclusions Our analysis provides rich insights into the barriers and facilitators to knowledge translation in the field of pregnancy loss research. We identified key strategies that can be used to inform knowledge translation planning in Ireland, and which have international applicability.

Methodological and practical guidance for designing and conducting online qualitative surveys in public health

“…They may be fully qualitative or qualitative dominant—mostly qualitative with some quantitative questions ( Terry and Braun, 2017 ). There are also many different ways of conducting these studies—from using a smaller number of questions that engage specific population groups or knowledge users in understanding detailed experiences ( Hennessy and O’Donoghue, 2024 ), to a larger number of questions (which may use market research panel providers to recruit participants), that seek broader opinions and attitudes about public health issues ( Marko et al ., 2022a ; McCarthy et al ., 2023 ; Arnot et al ., 2024a ). However, based on our experiences of applying for grant funding and conducting, publishing and presenting these studies, there are still clear misconceptions and uncertainties about these types of surveys.…”

“…Determining the sample size of online qualitative studies is not an exact science. The sample sizes for recent studies have ranged from n = 46 in a study about pregnancy loss ( Hennessy and O’Donoghue, 2024 ), to n = 511 in a study with young people about the climate crisis ( Arnot et al ., 2023b ). We follow ‘rules of thumb’ [( Braun and Clarke, 2021b ), p. 211] which try to balance the needs of the research and data richness with key practical considerations (such as funding and time constraints), funder expectations, discipline-specific norms and our knowledge and experience of designing and implementing online qualitative surveys.…”

“…A clear record of decision-making about analytical choices (and being reflexive about these) should be kept. In any write-up, we would recommend that researchers are clear about which survey questions they used in the analysis [researchers could consider providing a supplementary file of some or all of the survey questions—see, for example Hennessy and O’Donoghue (2024) ].…”

“…In writing up the results, researchers should still seek to present a rich description of the data, as demonstrated in the presentation of results in the following papers ( Marko et al ., 2022a , 2022b ; McCarthy et al ., 2023 ; Pitt et al ., 2023 ; Hennessy and O’Donoghue, 2024 ). We have found the use of tables with additional examples of quotes as they relate to themes and subthemes can be a practical way of providing the reader with further examples of the data, particularly when constrained by journal word count limits [see, for example, Table 2 in Arnot et al ., (2024c) ].…”