Prenatal Nutrition in Team-Based Care: Current Practices and Opportunities for Optimization of Care
Publication: Canadian Journal of Dietetic Practice and Research
7 February 2019
Abstract
Purpose: To describe prenatal nutrition care currently delivered by Family Health Teams (FHTs) and Community Health Centres (CHCs) in Ontario, from the perspectives of health care providers, and to identify opportunities for improving care.
Methods: Ten 1-hour, interdisciplinary focus groups were conducted in FHTs and CHCs, involving a total of 73 health care providers. Focus groups ranged in size from 3 to 11 team members, and at least 3 different professions participated in each group. The shared perspectives and experiences on prenatal nutrition care were collected using a semi-structured interview guide and analyzed using thematic analysis.
Results: Limited time was spent on prenatal nutrition education and counselling. Two themes emerged describing gaps in care: (i) providing care in “borderline” high-risk pregnancies (i.e., impaired glucose tolerance) and (ii) providing care around gestational weight gain. Providers envisioned improving services offered by increasing preventative care, empowering providers to provide more nutrition care, facilitating patient self-care, and building a 1-stop shop “medical home”.
Conclusions: This study’s findings can guide strategies to mobilize current nutritional knowledge into routine prenatal care, and the shared vision for improvement will inform the routes for new practice that are supported by health care professionals.
Résumé
Objectif. Décrire les soins en nutrition prénataux actuellement offerts par les équipes de santé familiale (ESF) et les centres de santé communautaire (CSC) de l’Ontario, du point de vue des fournisseurs de soins de santé, et recenser les possibilités d’améliorer les soins.
Méthodes. Dix groupes de discussion interdisciplinaires d’une heure ont été menés dans les ESF et les CSC, pour un total de 73 fournisseurs de soins de santé. La taille des groupes variait de 3 à 11 membres, et au moins 3 professions différentes étaient représentées dans chaque groupe. Les perspectives et expériences sur les soins en nutrition prénataux ont été recueillies à l’aide d’un guide d’entrevue semi-structurée puis analysées au moyen d’une analyse thématique.
Résultats. Peu de temps était consacré au counseling et à l’éducation en matière de nutrition prénatale. Deux thèmes sont ressortis et décrivent des lacunes dans les soins : (i) la prestation de soins dans les « cas limite » de grossesse à haut risque (c.-à-d. intolérance au glucose) et (ii) la prestation de soins liés au gain de poids gestationnel. Les professionnels envisageaient d’améliorer les services offerts en augmentant les soins préventifs, en donnant aux prestataires les moyens d’offrir davantage de soins en nutrition, en aidant les patients à se prendre eux-mêmes en charge et en instaurant un guichet unique pour les soins médicaux.
Conclusions. Les résultats de cette étude peuvent orienter les stratégies visant à intégrer les connaissances actuelles sur la nutrition dans les soins prénataux courants. De plus, l’objectif commun d’améliorer ces soins ouvrira la voie à de nouvelles pratiques appuyées par les professionnels de la santé.
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Financial support: Canadian Foundation for Dietetic Research.
Conflicts of interest: The authors declare that they have no competing interests.
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Information & Authors
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Published In
Canadian Journal of Dietetic Practice and Research
Volume 80 • Number 3 • September 2019
Pages: 96 - 103
History
Version of record online: 7 February 2019
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© 2019.
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MartinaTownMSc, RD, OlgaSmoliakPhD, PaulaBrauerPhD, RD, FDC, and LauraForbesPhD, RD. 2019. Prenatal Nutrition in Team-Based Care: Current Practices and Opportunities for Optimization of Care. Canadian Journal of Dietetic Practice and Research.
80(3): 96-103. https://doi.org/10.3148/cjdpr-2018-043
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1. Prenatal Nutrition Care in Alberta: The Perspectives of Pregnant Women and Registered Dietitians
2. Identifiable Dietary Patterns of Pregnant Women: A Canadian Sample
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