Use of people-first language with regard to obesity

Palad, Carl J.; Stanford, Fatima Cody

doi:10.1093/ajcn/nqy076

Cited by 15 publications

(9 citation statements)

References 4 publications

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“…There were insufficient numbers to form the prepregnancy underweight group, these women ( n = 6) were grouped with those having a prepregnancy healthy weight ( n = 95); thus, herein “healthy weight” refers to BMI ≤ 24.9 kg/m 2 . In line with people-first language, “with obesity” was used herein instead of “obese” [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

Factors Affecting BMI Changes in Mothers during the First Year Postpartum

et al. 2023

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We tested the hypotheses that mothers of infants who exclusively breastfed would differ in the trajectories of postpartum BMI changes than mothers of infants who exclusively formula fed, but such benefits would differ based on the maternal BMI status prepregnancy (primary hypothesis) and that psychological eating behavior traits would have independent effects on postpartum BMI changes (secondary hypothesis). To these aims, linear mixed-effects models analyzed measured anthropometric data collected monthly from 0.5 month (baseline) to 1 year postpartum from two groups of mothers distinct in infant feeding modality (Lactating vs. Non-lactating). While infant feeding modality group and prepregnancy BMI status had independent effects on postpartum BMI changes, the benefits of lactation on BMI changes differed based on prepregnancy BMI. When compared to lactating women, initial rates of BMI loss were significantly slower in the non-lactating women who were with Prepregnancy Healthy Weight (β = 0.63 percent BMI change, 95% CI: 0.19, 1.06) and with Prepregnancy Overweight (β = 2.10 percent BMI change, 95% CI: 1.16, 3.03); the difference was only a trend for those in the Prepregnancy Obesity group (β = 0.60 percent BMI change, 95% CI: −0.03, 1.23). For those with Prepregnancy Overweight, a greater percentage of non-lactating mothers (47%) gained ≥ 3 BMI units by 1 year postpartum than did lactating mothers (9%; p < 0.04). Psychological eating behavior traits of higher dietary restraint, higher disinhibition, and lower susceptibility to hunger were associated with greater BMI loss. In conclusion, while there are myriad advantages to lactation, including greater initial rates of postpartum weight loss regardless of prepregnancy BMI, mothers who were with overweight prior to the pregnancy experienced substantially greater loss if they breastfed their infants. Individual differences in psychological eating behavior traits hold promise as modifiable targets for postpartum weight management.

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Section: Methodsmentioning

confidence: 99%

Factors Affecting BMI Changes in Mothers during the First Year Postpartum

et al. 2023

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“…As the guideline recommendations were not written as explicit behaviours, they were adapted to define the Target population, Action, Context and Time (TACT) [29]. Additionally, the adaptations used people-first language to describe the target population as women with obesity rather than obese women [30]. We also incorporated additional behaviours relating to GWG that were not included in the UK guidelines, as the evidence-base suggested health professionals' lack of knowledge about GWG was a barrier to providing weight management support during pregnancy [20].…”

Section: Data Collectionmentioning

confidence: 99%

Midwives’ survey of their weight management practice before and after the GLOWING guideline implementation intervention: A pilot cluster randomised controlled trial

et al. 2023

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Background Maternal weight management is a priority due to pregnancy risks for women and babies. Interventions significantly improve maternal diet, physical activity, weight, and pregnancy outcomes. There are complex barriers to midwives’ implementation of guidelines; low self-efficacy is a core implementation barrier. The GLOWING intervention uses social cognitive theory (SCT) to address evidence-based barriers to practice. The intervention aimed to support midwives’ implementation of guidelines. Methods An external rehearsal pilot cluster randomised controlled trial in four NHS Trusts (clusters) in England, UK. Clusters were randomised to intervention (where all eligible midwives received the intervention) or control (no intervention delivered) arms. A random sample of 100 midwives were invited to complete questionnaires pre- and post-intervention. UK guideline recommendations relating to midwives’ practice were categorised into: 1) communication-related behaviours (including weight- and risk-communication), and 2) support/intervention-related behaviours (including diet/nutrition, physical activity, weight management, referrals/signposting). Questionnaires were developed using SCT constructs (self-efficacy, outcome expectancies, intentions, behaviours) and 7-point Likert scale, converted to a 0–100 scale. Higher scores were more positive. Descriptive statistics compared intervention and control arms, pre- and post-intervention. Results Seventy-four midwives consented and 68 returned questionnaires. Pre-intervention, self-efficacy for support/intervention-related behaviours scored lowest. In controls, there was limited difference between the pre- and post-intervention scores. Post-intervention, mean (SD) scores were consistently higher among intervention midwives than controls, particularly for support/intervention self-efficacy (71.4 (17.1) vs. 58.4 (20.1)). Mean (SD) self-efficacy was higher post-intervention than pre-intervention for all outcomes among intervention midwives, and consistently higher than controls. Mean differences pre- and post-intervention were greatest for support/intervention self-efficacy (17.92, 95% CI 7.78–28.07) and intentions (12.68, 95% CI 2.76–22.59). Self-efficacy was particularly increased for diet/nutrition and physical activity (MD 24.77, 95% CI 14.09–35.44) and weight management (18.88, 95% CI 7.88–29.88) behaviours, which showed the largest increase in scores. Conclusions This study supports the theoretical models used to develop GLOWING, where low self-efficacy was a core implementation barrier. Results suggest that GLOWING successfully targets self-efficacy, potentially with a positive impact on guideline implementation. A definitive trial is required to determine effectiveness. Trial registration ISRCTN46869894, retrospectively registered 25/05/2016, http://isrctn.com/ISRCTN46869894.

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“…As the guideline recommendations were not written as explicit behaviours, they were adapted to de ne the Target population, Action, Context and Time (TACT) (29). Additionally, the adaptations used people-rst language to describe the target population as women with obesity rather than obese women (30). We also incorporated additional behaviours relating to GWG that were not included in the UK guidelines, as the evidence-base suggested health professionals' lack of knowledge about GWG was a barrier to providing weight management support during pregnancy (20).…”

Section: Data Collectionmentioning

confidence: 99%

Midwives’ Survey of Their Weight Management Practice Before and After the GLOWING Guideline Implementation Intervention: A Pilot Cluster Randomised Controlled Trial

Heslehurst

McParlin

Sniehotta

et al. 2021

Preprint

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Background: Weight management is a priority for maternity services due to pregnancy risks and long-term health implications for women and babies. Pregnancy interventions significantly improve maternal diet, physical activity, weight, and some pregnancy outcomes. There are complex barriers, underpinned by self-efficacy, to midwives’ implementation of UK guidelines. The GLOWING intervention uses social cognitive theory (SCT) to address evidence-based barriers to practice, with the aim of supporting midwives’ implementation of guidelines into routine practice.Methods: An external rehearsal pilot cluster randomised controlled trial in four NHS Trusts (clusters) in England, UK. Clusters were randomised to intervention arm where all eligible midwives received the intervention, or control arm which received no intervention. A random sample of 100 midwives were invited to complete questionnaires pre- and post-intervention. UK guideline recommendations were grouped into communication-related behaviours (weight and risk communication) and support/intervention-related behaviours (diet/nutrition, physical activity, weight management, referrals/signposting). Questionnaires were developed using SCT constructs (self-efficacy, outcome expectancies, intentions, behaviours) and 7-point Likert scale. Data were converted to a 0-100 scale, where higher scores were more positive. Descriptive statistics compared intervention and control arms, pre- and post-intervention.Results: Seventy-four midwives consented and 68 returned questionnaires. Pre-intervention, self-efficacy for support/intervention-related behaviours scored lowest. In the control arm, there was limited difference between the pre- and post-intervention scores. Post-intervention, the mean scores were consistently higher in the intervention than control arm, particularly for support/intervention self-efficacy (71.4, SD 17.1 and 58.4, SD 20.1). Mean self-efficacy was higher post-intervention than pre-intervention for all behaviour categories in the intervention arm: weight communication (76.3, SD 16.7 vs. 67.2, SD 21.1), risk communication (79.4, SD 16.4, vs. 68.6, SD 14.9), diet/nutrition/physical activity (76.4, SD 16.0 vs. 49.3, SD 16.5), weight management (72.1, SD 18.3 vs. 48.3, SD 19.8), referrals/signposting (63.3, SD 26.0 vs. 47.9, SD 17.3), and consistently higher than controls.Conclusions: This study supports the theoretical models used to develop GLOWING, particularly that low self-efficacy is core to implementation barriers. Results suggest that the intervention is successfully targeting self-efficacy, which could have a positive impact on guideline implementation. A future definitive trial is required to determine effectiveness and cost-effectiveness. Trial registration: ISRCTN46869894, retrospectively registered 25/05/2016, http://isrctn.com/ISRCTN46869894

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Use of people-first language with regard to obesity

Cited by 15 publications

References 4 publications

Factors Affecting BMI Changes in Mothers during the First Year Postpartum

Factors Affecting BMI Changes in Mothers during the First Year Postpartum

Midwives’ survey of their weight management practice before and after the GLOWING guideline implementation intervention: A pilot cluster randomised controlled trial

Midwives’ Survey of Their Weight Management Practice Before and After the GLOWING Guideline Implementation Intervention: A Pilot Cluster Randomised Controlled Trial

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