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Randomized Controlled Trial
. 2021 Jan 8:8:589870.
doi: 10.3389/fpubh.2020.589870. eCollection 2020.

An Opportunity During Antenatal Services to Strengthen Nurturing Care: Global and National Recommendations for Routine Ultrasound Before 24 Weeks Gestation

Wiedaad Slemming  1 , Roisin Drysdale  2 , Linda M Richter  2
Affiliations
Randomized Controlled Trial

An Opportunity During Antenatal Services to Strengthen Nurturing Care: Global and National Recommendations for Routine Ultrasound Before 24 Weeks Gestation

Wiedaad Slemming et al. Front Public Health. .

Abstract

Introduction: The Healthy Pregnancy, Healthy Baby study (HPHB) augments a routine service (pregnancy ultrasound) with information about fetal and infant development and the importance of parent wellbeing and infant care, to assess whether it will improve child development and growth, parent-infant attachment, parental wellbeing and routine clinic attendance. This paper outlines the process of intervention development and implementation in a complex environment with multiple stakeholders. Methods: Study participants were recruited from pregnant women attending fetal ultrasound (US) at Chris Hani Baragwanath Hospital (CHBH), Soweto, South Africa. Partners were invited to attend all sessions. The HPHB intervention, a novel combination of a health and a parenting intervention that augments a routine service (US), is being tested through a randomized controlled trial with outcome assessments at 6 weeks and 6 months follow-up. The current study outlines the process of moving from intervention design to full implementation in a high-risk clinical setting. Results: Formative research informed the design and content of the intervention materials. Implementation is monitored through weekly reports and team meetings as well as formal and informal feedback received from staff and participants. Close collaborations with clinicians enhanced recruitment practices and provided clinical oversight of the trial procedures. Ongoing stakeholder engagement informed intervention procedures and strategies to address challenges that arise during implementation. Conclusion: This study emphasizes the importance of dynamic, inclusive and interactive approaches to intervention development and implementation, as well as the purposeful use of varied information from diverse sources in decision-making for effective implementation.

Keywords: antenatal; development; fetal; parenting; pregnancy; ultrasound.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Reflections on specific stages of the implementation process.
Figure 2
Figure 2
Intervention components.
Figure 3
Figure 3
Implementation framework for the Healthy Pregnancy, Healthy Baby study.
See this image and copyright information in PMC

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