Background
Methods
Study design
The intervention
Study population
Recruitment and study conduct
Data collection
Outcomes
Historical control group
Sample size calculation
Statistical analysis
Results
Variables | Subcategories (If applicable) | Knowledge tool group (n = 131) N (%)*, unless otherwise indicated | Control group (n = 310) [9]† N (%)*, unless otherwise indicated | p-value |
---|---|---|---|---|
Maternal age
| Mean (±SD), years | 30.1 (5.5) | 29.5 (5.7) | 0.365 |
Gestational age at enrolment
| Mean (±SD), years | 17.2 (5.5) | 30.9 (7.5) | <0.001‡ |
Ethnicity
| Caucasian | 96 (75.6) | 229 (74.1) | 0.747 |
Marital status
| Married | 95 (74.8) | 203 (65.5) | 0.156 |
Common-law | 17 (13.4) | 53 (17.1) | ||
Other | 15 (11.8) | 54 (17.4) | ||
Education
| Secondary or less | 19 (14.7) | 72 (23.5) | 0.039‡ |
Any post-secondary | 110 (85.3) | 234 (76.5) | ||
Income
| Low (< $20,000) | 19 (15.7) | 52 (19.8) | 0.115 |
Middle ($20,000 to $80,000) | 40 (33.1) | 106 (40.3) | ||
High (> $80 000) | 62 (51.2) | 105 (39.9) | ||
Current smoker
| 14 (10.8) | 32 (10.4) | 0.897 | |
Chronic health conditions
§
| 39 (29.8) | 56 (19.1) | 0.015‡ | |
Pregnancy history
| First time giving birth | 62 (47.7) | 132 (44.7) | 0.437 |
One previous birth | 50 (38.5) | 107 (36.3) | ||
Two or more previous births | 18 (13.9) | 56 (19.0) | ||
Prepregnancy BMI
| Mean (±SD), kg/m2 | 24.7 (5.7) | 25.1 (6.7) | 0.492 |
Underweight (BMI <18.5 kg/m2) | 11 (8.5) | 20 (6.8) | 0.789 | |
Normal weight (BMI 18.5-24.9 kg/m2) | 67 (51.4) | 164 (56.2) | ||
Overweight (BMI 25.0-29.9 kg/m2) | 33 (25.4) | 65 (22.3) | ||
Obese (BMI >30 kg/m2) | 19 (14.6) | 43 (14.7) |
Univariate analysis on knowledge outcomes between knowledge tool and control groups
Variables | Subcategories (If applicable) | Knowledge tool group (n = 131) N (%)*, unless otherwise indicated | Control group (n = 310) [9]† N (%)*, unless otherwise indicated | p-value |
---|---|---|---|---|
Reported receiving GWG counseling from HCP
| To gain a specific amount or range‡ | 78 (60.5) | 90 (29.2) | <0.001§ |
To gain within IOM guidelines | 32 (51.6) | 31 (48.4) | 0.722 | |
Discussed GWG topics with HCP** | 108 (85.7) | 142 (47.2) | <0.001§ | |
Believed that there were risks in gaining excess GWG
| To themselves | 95 (79.2) | 50 (63.3) | 0.014§ |
To their infants | 75 (63.6) | 42 (56.0) | 0.295 | |
Believed that there were risks in gaining inadequate GWG
| To themselves | 42 (34.4) | 17 (21.3) | 0.044§ |
To their infants | 73 (62.4) | 28 (37.8) | 0.001§ | |
Reported receiving counsel to consume an amount or range of additional calories each day by HCP
| 31 (24.0) | 55 (17.9) | 0.139 | |
Amount or range of additional calories recommended each day for those counseled to do so by HCP | 0-100 calories | 0 (0.0) | 2 (3.7) | 0.007§ |
100-300 calories | 23 (76.7) | 23 (42.6) | ||
300-500 calories | 5 (16.7) | 6 (11.1) | ||
>500 calories | 0 (0.0) | 2 (3.7) | ||
Could not recall how many calories | 2 (6.7) | 21 (38.9) | ||
Reported receiving counsel to take vitamins by HCP
| 12 (98.4) | 301 (97.7) | 0.628 | |
Reported discussing nutrition/healthy eating with HCP
††
| 77 (61.1) | 210 (69.1) | 0.110 | |
Reported discussing appropriate weight gain with HCP
††
| 82 (65.1) | 142 (47.2) | 0.001§ | |
Reported discussing risks of gaining too much weight with HCP
††
| 38 (30.4) | 79 (26.5) | 0.415 | |
Reported discussing exercise with HCP
††
| Discussed | 70 (55.6) | 162 (53.8) | 0.743 |
Planned GWG
| Below IOM guidelines | 43 (33.9) | 66 (24.3) | 0.124 |
Within IOM guidelines | 43 (33.9) | 100 (36.8) | ||
Above IOM guidelines | 41 (32.3) | 106 (39.0) | ||
Difference between planned GWG and reported weight gain recommendation by HCP, kg
‡‡
| Mean of differences (SD) | 0.5 (4.5) | 0.9 (3.0) | 0.536 |
Univariate and multivariable logistic regression on knowledge outcomes
Variable | Comparison groups | Crude odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | P-value |
---|---|---|---|---|---|
Study group
| KT group vs. control group [9] (reference) | 3.70 (2.38-5.56) | <0.001* | 3.45 (2.22-5.37) | <0.001† |
Maternal age
| Age as a continuous variable (per year) | 1.00 (0.96-1.03) | 0.865 | - | - |
Ethnicity
| Caucasian vs. non-Caucasian (reference) | 1.16 (0.74-1.82) | 0.526 | - | - |
Education
| Any post-secondary education vs. secondary education or less (reference) | 1.21 (0.74-1.97) | 0.440 | - | - |
Income
| Low vs. middle income (reference) | 1.06 (0.59-1.92) | 0.845 | - | - |
High vs. middle income (reference) | 1.24 (0.78-1.95) | 0.364 | - | - | |
Smoking
| Current smoker vs. non-smoker (reference) | 1.19 (0.63-2.22) | 0.592 | - | - |
Chronic health condition
| Has chronic health condition vs. does not have chronic health condition (reference) | 1.00 (0.62-1.59) | 0.988 | - | - |
Pregnancy history
| First birth vs. one or more previous birth (reference) | 1.73 (1.17-2.57) | O0.006* | 1.75 (1.15-2.67) | 0.010† |
Prepregnancy BMI
| Underweight vs. normal weight (reference) | 1.42 (0.66-3.08) | 0.369 | 1.42 (0.64-3.17) | 0.392 |
Overweight vs. normal weight (reference) | 1.72 (1.06-2.78) | 0.028* | 1.80 (1.08-3.01) | 0.024† | |
Obese vs. normal weight (reference) | 1.26 (0.71-2.24) | 0.434 | 1.32 (0.71-2.46) | 0.378 |
Variable | Comparison groups | Crude odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | P-value |
---|---|---|---|---|---|
Study group
| KT group vs. control group [9] (reference) | 6.67 (3.85-11.11) | <0.001* | 7.96 (4.41-14.37) | <0.001† |
Maternal age
| Age as a continuous variable (per year) | 0.99 (0.95-1.02) | 0.467 | - | - |
Ethnicity
| Caucasian vs. non-Caucasian (reference) | 0.67 (0.42-1.06) | 0.091* | 0.52 (0.31-0.89) | 0.018† |
Education
| Any post-secondary education vs. secondary education or less (reference) | 1.52 (0.95-2.43) | 0.083* | 1.43 (0.83-2.47) | 0.196 |
Income
| Low vs. middle income (reference) | 0.81 (0.45-1.43) | 0.462 | - | - |
High vs. middle income (reference) | 1.32 (0.83-2.08) | 0.239 | - | - | |
Smoking
| Current smoker vs. non-smoker (reference) | 0.74 (0.40-1.37) | 0.344 | - | - |
Chronic health condition
| Has chronic health condition vs. does not have chronic health condition (reference) | 1.00 (0.63-1.61) | 0.987 | - | - |
Pregnancy history
| First birth vs. one or more previous birth (reference) | 2.24 (1.49-3.35) | 0.001* | 2.60 (1.66-4.07) | <0.001† |
Prepregnancy BMI
| Underweight vs. normal weight (reference) | 1.76 (0.77-4.02) | 0.178 | - | - |
Overweight vs. normal weight (reference) | 1.40 (0.85-2.30) | 0.182 | - | - | |
Obese vs. normal weight (reference) | 0.86 (0.49-1.53) | 0.616 | - | - |
Variable | Comparison groups | Crude odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | P-value |
---|---|---|---|---|---|
Study group
| KT group vs. control group [9] (reference) | 2.22 (1.16-4.17) | 0.015* | 1.53 (0.66-3.53) | 0.323 |
Maternal age
| Age as a continuous variable (per year) | 1.09 (1.02-1.16) | 0.008* | 0.95 (0.87-1.04) | 0.285 |
Ethnicity
| Caucasian vs. non-Caucasian (reference) | 1.15 (0.54-2.44) | 0.718 | - | - |
Education
| Any post-secondary education vs. secondary education or less (reference) | 12.32 (5.19-29.25) | <0.001* | 13.47 (4.03-44.97) | <0.001† |
Income
| Low vs. middle income (reference) | 0.50 (0.20-1.26) | 0.141 | 0.76 (0.25-2.30) | 0.632 |
High vs. middle income (reference) | 4.25 (1.83-9.90) | 0.001* | 3.63 (1.38-9.52) | 0.009† | |
Smoking
| Current smoker vs. non-smoker (reference) | 0.18 (0.07-0.47) | 0.001* | 0.95 (0.23-3.91) | 0.947 |
Chronic health condition
| Has chronic health condition vs. does not have chronic health condition (reference) | 2.43 (1.01-1.16) | 0.009* | 2.34 (0.78-7.04) | 0.132 |
Pregnancy history
| First birth vs. one or more previous birth (reference) | 1.65 (0.88-3.11) | 0.122 | - | - |
Prepregnancy BMI
| Underweight vs. normal weight (reference) | 0.48 (0.17-1.39) | 0.175 | - | - |
Overweight vs. normal weight (reference) | 0.92 (0.42-1.98) | 0.825 | - | - | |
Obese vs. normal weight (reference) | 0.58 (0.24-1.43) | 0.238 | - | - |
Variable | Comparison groups | Crude odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | P-value |
---|---|---|---|---|---|
Study group
| KT group vs. control group [9] (reference) | 1.96 (1.01-3.70) | 0.046* | 1.99 (0.92-4.30) | 0.080 |
Maternal age
| Age as a continuous variable (per year) | 1.00 (0.94-1.06) | 0.991 | - | - |
Ethnicity
| Caucasian vs. non-Caucasian (reference) | 0.78 (0.38-1.64) | 0.522 | - | - |
Education
| Any post-secondary education vs. secondary education or less (reference) | 2.11 (0.82-5.42) | 0.121 | - | - |
Income
| Low vs. middle income (reference) | 1.07 (0.36-3.19) | 0.910 | 1.06 (0.33-3.40) | 0.916 |
High vs. middle income (reference) | 2.18 (1.01-4.70) | 0.046* | 2.18 (0.97-4.93) | 0.061 | |
Smoking
| Current smoker vs. non-smoker (reference) | 0.54 (0.17-1.68) | 0.286 | - | - |
Chronic health condition
| Has chronic health condition vs. does not have chronic health condition (reference) | 1.06 (0.52-2.17) | 0.874 | - | - |
Pregnancy history
| First birth vs. one or more previous birth (reference) | 1.46 (0.79-2.70) | 0.229 | - | - |
Prepregnancy BMI
| Underweight vs. normal weight (reference) | 0.27 (0.07-0.99) | 0.048* | 0.34 (0.09-1.30) | 0.115 |
Overweight vs. normal weight (reference) | 0.44 (0.21-0.90) | 0.025* | 0.44 (0.19-0.98) | 0.044† | |
Obese vs. normal weight (reference) | 0.05 (0.01-0.37) | 0.003* | 0.05 (0.01-0.36) | 0.003† |
Variable | Comparison groups | Crude odds ratio (95% CI) | P-value | Adjusted odds ratio (95% CI) | P-value |
---|---|---|---|---|---|
Study group
| KT group vs. control group [9] (reference) | 2.70 (1.49-5.00) | 0.001* | 2.48 (1.14-5.37) | 0.021† |
Maternal age
| Age as a continuous variable (per year) | 0.98 (0.93-1.04) | 0.565 | - | - |
Ethnicity
| Caucasian vs. non-Caucasian (reference) | 1.82 (0.89-3.70) | 0.105 | - | - |
Education
| Any post-secondary education vs. secondary education or less (reference) | 4.43 (1.79-10.97) | 0.001* | 5.36 (1.50-19.17) | 0.010† |
Income
| Low vs. middle income (reference) | 0.53 (0.20-1.40) | 0.199 | 0.56 (0.17-1.88) | 0.350 |
High vs. middle income (reference) | 1.96 (1.00-3.85) | 0.050* | 1.52 (0.67-3.45) | 0.315 | |
Smoking
| Current smoker vs. non-smoker (reference) | 0.34 (0.11-1.00) | 0.051* | 0.87 (0.18-4.15) | 0.866 |
Chronic health condition
| Has chronic health condition vs. does not have chronic health condition (reference) | 3.02 (1.44-6.32) | 0.003* | 3.39 (1.32-8.69) | 0.011† |
Pregnancy history
| First birth vs. one or more previous birth (reference) | 2.43 (1.36-4.36) | 0.003* | 2.10 (1.00-4.42) | 0.051 |
Prepregnancy BMI group
| Underweight vs. normal weight (reference) | 0.50 (0.17-1.46) | 0.206* | 0.82 (0.21-3.14) | 0.775 |
Overweight vs. normal weight (reference) | 0.45 (0.23-0.89) | 0.022* | 0.45 (0.20-1.05) | 0.064 | |
Obese vs. normal weight (reference) | 0.14 (0.05-0.37) | <0.001* | 0.09 (0.03-0.31) | <0.001† |
Knowledge translation tool evaluation
Variables | Subcategories (if applicable) | N (%)*, unless otherwise indicated |
---|---|---|
Would recommend the KT tool to a friend
| Definitely not | 0 (0.0) |
Probably not | 25 (25.3) | |
Don’t know | 25 (25.3) | |
Probably yes | 42 (42.4) | |
Definitely yes | 7 (7.1) | |
Suggested improvements to KT tool
| Bigger graph | 57 (54.3) |
More information on food servings | 46 (43.8) | |
More information on exercise | 32 (30.5) | |
Other | 15 (14.3) | |
Should remain unchanged | 15 (14.3) | |
HCP showed KT tool
| Never | 35 (35.4) |
Occasionally | 18 (18.2) | |
About half the time | 9 (9.1) | |
Usually | 13 (13.1) | |
Always | 24 (24.2) | |
Marker of KT tool
| Participant (pregnant woman) | 40 (40.4) |
Nurse/Nurse Practitioner | 15 (15.2) | |
Doctor | 11 (11.1) | |
Midwife | 23 (23.2) | |
Other | 10 (10.1) | |
Preference if using knowledge KT in the future
| Only mark weight on the tool themselves | 11 (11.1) |
Only have HCP mark weight on the tool | 28 (28.3) | |
Have HCP mark their weight on the tool in their chart, and mark their weight on their own copy of the tool themselves | 60 (60.6) | |
Preference in marking weight
| On their own paper copy of tool | 39 (54.9) |
On an “app” (application) for their hand-held electronic device | 22 (31.0) | |
Online on a website on a computer | 9 (12.7) | |
Other | 1 (1.4) | |
Were given a copy of KT tool
| No | 16 (16.2) |
Yes | 83 (83.8) | |
Checked their weight gain on KT tool
| About once a week | 4 (4.8) |
About every two weeks | 9 (10.8) | |
About once per month | 17 (20.5) | |
Before (or at) every clinic visit | 41 (49.4) | |
Other | 12 (14.5) |