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BackgroundEvidence suggests that women are failing to meet guidelines for nutrition, physical activity, and weight gain during pregnancy. Interventions to promote a healthy lifestyle in pregnancy demonstrate mixed results and many are time and resource intensive. mHealth-delivered interventions offer an opportunity to provide trusted source information in a timely and cost-effective manner. Studies regarding women’s and health professionals’ views of mHealth in antenatal care are limited. ObjectiveThis study aimed to explore women’s and health professionals’ views regarding mHealth information sources and interventions to assist women to eat well, be physically active, and gain healthy amounts of weight in pregnancy. MethodsA descriptive qualitative research approach employed focus groups and in-depth interviews with 15 pregnant or postpartum women and 12 in-depth interviews with health professionals including two from each category: obstetricians, general practitioners, midwives, dietitians, physiotherapists, and community pharmacists. All interviews were transcribed verbatim and thematically analyzed. ResultsWomen uniformly embraced the concept of mHealth information sources and interventions in antenatal care and saw them as central to information acquisition and ideally incorporated into future antenatal care processes. Health professionals exhibited varied views perceiving mHealth as an inevitable, often parallel, service rather than one integrated into the care model. Four key themes emerged: engagement, risk perception, responsibility, and functionality. Women saw their ability to access mHealth elements as a way to self-manage or control information acquisition that was unavailable in traditional care models and information sources. The emergence of technology was perceived by some health professionals to have shifted control of information from trusted sources, such as health professionals and health organizations, to nontrusted sources. Some health professionals were concerned about the medicolegal risks of mHealth (incorrect or harmful information and privacy concerns), while others acknowledged that mHealth was feasible if inherent risks were addressed. Across both groups, there was uncertainty as to who should be responsible for ensuring high-quality mHealth. The absence of a key pregnancy or women’s advocacy group, lack of health funds for technologies, and the perceived inability of maternity hospitals to embrace technology were seen to be key barriers to provision. Women consistently identified the functionality of mHealth as adding value to antenatal care models. For some health professionals, lack of familiarity with and fear of mHealth limited their engagement with and comprehension of the capacity of new technologies to support antenatal care. ConclusionsWomen exhibited positive views regarding mHealth for the promotion of a healthy lifestyle in antenatal care. Conversely, health professionals expressed a much wider variation in attitudes and were more able to identify potential risks and barriers to development and implementation. This study contributes to the understanding of the opportunities and challenges in developing mHealth lifestyle interventions in antenatal care.

Background: Gestational diabetes mellitus (GDM) is a common and costly condition of pregnancy. The Healthy Gut Diet for Preventing Gestational Diabetes study is a novel randomised controlled trial that aims to prevent GDM through a diet that modulates the gut microbiota for pregnant women with GDM risk factors. Despite increasing interest in co‐designing interventions with consumers (lived experience experts), co‐design methods and outcomes are often poorly reported. The present study aims to report on the co‐design process used to develop The Healthy Gut Diet intervention. Methods: Co‐design occurred across three online workshops with consumer participants (women with a lived experience of GDM, n = 11), researchers (n = 6) and workshop co‐facilitators (including a consumer co‐facilitator, n = 2). The workshops explored women's preferences for the mode and length of education sessions, as well as the types of information and supportive resources women wanted to receive, and undertook a "behaviour diagnosis" to understand barriers and enablers to the target behaviours (eating for gut health). The final intervention is reported according to the Template for Intervention Description and Replication. Results: A co‐designed dietary intervention (The Healthy Gut Diet), delivered via telehealth, with a suite of educational and supportive resources that integrates published behaviour change techniques, was developed. Generally, the co‐design process was reported as a positive experience based on participant feedback and evidenced by no participant dropouts over the 3‐month study period. Conclusions: Co‐design is recognised as a process that creates a partnership between lived experience experts and researchers who can engage and empower research recipients and improve health behaviours. Highlights: Co‐designing dietary interventions with consumers can reduce research waste, improve applicability and intervention adherence, and enable selection of behaviour change techniques.Although increasing in popularity, co‐design methods, processes and outcomes are minimally described in diet research.Co‐design for The Healthy Gut Diet for Preventing Gestational Diabetes study involved 12 consumers with a lived experience of gestational diabetes and six researchers.Three online co‐design workshops were used to explore and decide on educational formats, content and delivery for the intervention, communication methods and a "behavioural diagnosis".The result was a dietary and behaviour change intervention (The Healthy Gut Diet), which is reported using the Template for Intervention Description and Replication. [ABSTRACT FROM AUTHOR]

Aim: Optimising preconception health increases the likelihood of conception, positively influences short‐ and long‐term pregnancy outcomes and reduces intergenerational chronic disease risk. Our aim was to synthesise study characteristics and maternal outcomes of digital or blended (combining face to face and digital modalities) interventions in the preconception period. Methods: We searched six databases (PubMed, Cochrane, Embase, Web of Science, CINHAL and PsycINFO) from 1990 to November 2022 according to the PRISMA guidelines for randomised control trials, quasi‐experimental trials, observation studies with historical control group. Studies were included if they targeted women of childbearing age, older than 18 years, who were not currently pregnant and were between pregnancies or/and actively trying to conceive. Interventions had to be delivered digitally or via digital health in combination with face‐to‐face delivery and aimed to improve modifiable behaviours, including dietary intake, physical activity, weight and supplementation. Studies that included women diagnosed with type 1 or 2 diabetes were excluded. Risk of bias was assessed using the Academy of Nutrition and Dietetics quality criteria checklist. Study characteristics, intervention characteristics and outcome data were extracted. Results: Ten studies (total participants n=4,461) were included, consisting of nine randomised control trials and one pre–post cohort study. Seven studies received a low risk of bias and two received a neutral risk of bias. Four were digitally delivered and six were delivered using blended modalities. A wide range of digital delivery modalities were employed, with the most common being email and text messaging. Other digital delivery methods included web‐based educational materials, social media, phone applications, online forums and online conversational agents. Studies with longer engagement that utilised blended delivery showed greater weight loss. Conclusion: More effective interventions appear to combine both traditional and digital delivery methods. More research is needed to adequately test effective delivery modalities across a diverse range of digital delivery methods, as high heterogeneity was observed across the small number of included studies. [ABSTRACT FROM AUTHOR]

In high‐income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study. Maternal characteristics, nutrient intake from food and supplements, and biochemical nutrient status were assessed in the second trimester (n = 127). Supplement use was reported by 89% of participants, of whom 91% reported taking an MMN supplement. Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use. Private obstetric care and general practitioner shared care were associated with higher daily dose of supplemental nutrients consumed compared with midwifery group practice. There was high reliance on supplements to meet nutrient reference values for folate, iodine and iron, but only plasma folate concentrations were higher in MMN supplement versus nonsupplement users. Exceeding the upper level of intake for folic acid and iron was more likely among combined MMN and individual supplement/s users, and associated with higher plasma concentrations of the respective nutrients. Given the low alignment with food group recommendations and potential risks associated with high MMN supplement use, whole food diets should be emphasized. This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, especially among those most vulnerable where MMN supplement use may be appropriate. Key messages: Multiple micronutrient (MMN) supplementation during pregnancy is a common practice in high‐income countries.Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use.There was high reliance on supplements to meet intake guidelines for folate, iodine and iron, which also raised concern for excess nutrient intake.This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, including the promotion of whole food diets and appropriate use of MMN supplements. [ABSTRACT FROM AUTHOR]

Background: There is little known about nutrition intervention research involving consumer co‐design. The aim of this scoping review was to identify and synthesise the existing evidence on the current use and extent of consumer co‐design in nutrition interventions. Methods: This scoping review is in line with the methodological framework developed by Arksey and O'Malley and refined by the Joanna Briggs Institute using an adapted 2weekSR approach. We searched Medline, EMBASE, PsycInfo, CINAHL and Cochrane. Only studies that included consumers in the co‐design and met the 'Collaborate' or 'Empower' levels of the International Association of Public Participation's Public Participation Spectrum were included. Studies were synthesised according to two main concepts: (1) co‐design for (2) nutrition interventions. Results: The initial search yielded 8157 articles, of which 19 studies were included (comprising 29 articles). The studies represented a range of intervention types and participants from seven countries. Sixteen studies were published in the past 5 years. Co‐design was most often used for intervention development, and only two studies reported a partnership with consumers across all stages of research. Overall, consumer involvement was not well documented. No preferred co‐design framework or approach was reported across the various studies. Conclusions: Consumer co‐design for nutrition interventions has become more frequent in recent years, but genuine partnerships with consumers across all stages of nutrition intervention research remain uncommon. There is an opportunity to improve the reporting of consumer involvement in co‐design and enable equal partnerships with consumers in nutrition research. Key points: Of the approximately 5000 abstracts screened, only 19 studies met the criteria of co‐design at the 'Collaborate' or 'Empower' levels of Public Participation (IAP2 Public Participation Specturm), and there is high variability in co‐design approaches and definitions within health research.Similarly, there is no singular co‐design framework or theoretical approach that is commonly used, although intervention mapping and integrated knowledge translation approaches were most common.Co‐designing dietary interventions typically occurs after a research question and direction has already been predetermined, and often, researchers 'overrule' consumers' recommendations and decisions.Our scoping review included a consumer as a co‐author, which was a strength of this paper. Based on our consumer co‐author's recommendation, we developed an 'ideal co‐design' checklist to capture key elements of co‐design that should be considered in research projects – about one quarter of included studies met all or most of these elements.Although co‐design for dietary interventions has become more common in the past 5 years, consumers are rarely engaged across the entire research process, which could help improve research impact and reduce research waste. [ABSTRACT FROM AUTHOR]