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Type: Journal article
Title: Implementation strategies to improve preconception and antenatal care for tobacco smoking, alcohol consumption and weight management: a systematic review protocol
Author: Doherty, E.
Kingsland, M.
Wolfenden, L.
Wiggers, J.
Dray, J.
Hollis, J.
Elliott, E.J.
Daly, J.B.
Bailey, K.A.
Attia, J.
Hunter, M.
Symonds, I.
Tully, B.
Tremain, D.
Hodder, R.K.
Citation: Systematic Reviews, 2019; 8(1):285-1-285-8
Publisher: BioMed Central; Springer Nature
Issue Date: 2019
ISSN: 2046-4053
Statement of
Emma Doherty, Melanie Kingsland, Luke Wolfenden, John Wiggers, Julia Dray, Jenna Hollis, Elizabeth J. Elliott, Justine B. Daly, Kylie A. Bailey, John Attia, Mandy Hunter, Ian Symonds, Belinda Tully, Danika Tremain, and Rebecca K. Hodder
Abstract: Background: Despite existing best practice care recommendations for addressing tobacco smoking, alcohol consumption and weight management in preconception and antenatal care, such recommendations are often not implemented into routine practice. Effective strategies that target known barriers to implementation are key to reducing this evidence to practice gap. The aim of this review is to synthesise the evidence on the effectiveness of implementation strategies in improving the provision of preconception and antenatal care for these modifiable risk factors. Methods: Randomised and non-randomised study designs will be eligible for inclusion if they have a parallel control group. We will include studies that either compare an implementation strategy to usual practice or compare two or more strategies. Participants may include any health service providing preconception or antenatal care to women and/or the health professionals working within such a service. The primary outcome will be any measure of the effectiveness of implementation strategies to improve preconception and/or antenatal care for tobacco smoking, alcohol consumption and/or weight management (including care to improve nutrition and/or physical activity). Secondary outcomes will include the effect of the implementation strategy on women's modifiable risk factors, estimates of absolute costs or cost-effectiveness and any reported unintentional consequences. Eligible studies will be identified via searching Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, ProQuest Dissertations and Theses and other sources (e.g. contacting experts in the field). Study selection, data extraction and risk of bias will be assessed independently by two review authors and differences resolved by a third reviewer. If data permits, we will conduct fixed-effects or random-effects meta-analysis where appropriate. If studies do not report the same outcome or there is significant heterogeneity, results will be summarised narratively. Discussion: This review will identify which implementation strategies are effective in improving the routine provision of preconception and antenatal care for tobacco smoking, alcohol consumption and weight management. Such a review will be of interest to service providers, policy makers and implementation researchers seeking to improve women's modifiable risk factors in preconception and antenatal care settings.
Keywords: Implementation; antenatal; preconception; modfiable risk factors
Rights: © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
RMID: 1000007900
DOI: 10.1186/s13643-019-1193-3
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Appears in Collections:Medicine publications

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