Abstract

BackgroundDuring pregnancy and postnatally, women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. In 2014–2016, UK-based charity Best Beginnings used an embedding model to embed three of their resources – the Baby Buddy app, Baby Express magazine, and ‘From Bump to Breastfeeding’ DVD – into maternity and early years care pathways at three sites in the north of England. A mixed-methods evaluation comprising an impact evaluation and a process evaluation was undertaken. Here we report findings from the process evaluation that aimed to understand the embedding process, explore maternity and early years’ professionals’ views and use of the resources, explore women’s engagement with and views of the resources, and identify barriers and facilitators to the embedding process.MethodsWe carried out semi-structured interviews with stakeholders (professionals involved in embedding) and observations of embedding activities to understand how embedding worked. Surveys of postnatal women were conducted over a two-month period both prior to, and after, the resources had been embedded, to ascertain engagement with and views of the resources. A survey of professionals was carried out post-embedding to understand how, where and when the resources were used in practice, and professionals’ views. Descriptive and thematic analyses were undertaken.ResultsThirty stakeholders took part in interviews. Surveys were completed by 146 professionals, and by 161 and 192 women in the pre and post-embedding phases respectively. Themes derived from analysis of qualitative data were ‘Implementation of the embedding model’, ‘Promotion and distribution of, and engagement with, the resources’, ‘Fit with care pathways’, and ‘Perceptions of the resources’. While survey responses indicated that embedding of the resources into practice was not yet complete, those who had used the resources believed that they had helped increase knowledge, build confidence and support relationship-building.ConclusionsIncorporating supportive parenting resources into maternity and early years’ care pathways requires a planned embedding approach, committed champions, and senior management support. Findings indicate largely positive views of women and professionals, and suggest the resources can be a beneficial aid for families.

Highlights

  • During pregnancy and postnatally, women seek information from a variety of sources

  • Birth, infant development and advice about infant care is offered to women by health providers, family, friends, wider society, and commercial sources, but information alone is not necessarily supportive for women, who may have difficulties accessing, understanding or utilising information, or who may feel overwhelmed by the sheer volume of information available [3]. mHealth, the use of mobile communications to deliver health information and services, has gathered much interest in recent years, and there has been vast increase in the number of digital and mHealth applications aimed at pregnant women and new parents [4]

  • Study design We carried out a mixed-methods process evaluation involving: (i) observations of key embedding events; (ii) interviews with stakeholders; (iii) post-embedding survey of maternity and early years’ professionals; (iv) pre- and post-embedding surveys of postnatal women; and (v) a review of data on the numbers of Baby Buddy app registrations supplied by Best Beginnings

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Summary

Introduction

Women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. A qualitative study by Wilcox and colleagues investigating women’s and professionals’ views of mHealth information sources to support a healthy lifestyle in pregnancy found that the health professionals envisaged mHealth operating in parallel to conventional services, women were more likely to want mHealth to be integrated into conventional care [7]. Another recent qualitative study found that pregnant women favoured the integration of eHealth and mHealth applications into usual healthcare [8]. A further study exploring pregnant women’s experiences of using a smartphone app to help manage gestational diabetes reported that women found the app to be a useful source and reminder of information, but that health professionals often did not engage with the app [9]

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