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  4. Participant and provider views and experiences of the ESTEEM dietary intervention for pregnant women with metabolic risk factors




Participant and provider views and experiences of the ESTEEM dietary intervention for pregnant women with metabolic risk factors



Public, Staff, Students, Alumni

Speaker: Adela Hamilton

The Centre for Maternal & Child Health at the School of Health Science, City, University of London welcomes Adela Hamilton to discuss her doctoral research as part of the research seminar series.


ESTEEM (Effect of Simple, Targeted diEt in prEgnant women with Metabolic risk factors on pregnancy outcomes), was a randomised controlled trial of a dietary intervention based on the Mediterranean diet. Intervention programmes like this are recognised in the literature as complex to evaluate. Engagement and adherence are problematic as most dietary interventions are complex and demanding. There is a need for dietary interventions in pregnancy which are simple and effective.

Aim: The aim of this study was to explore the views and experiences of the ESTEEM dietary intervention in a pregnant cohort with metabolic risk factors. The concept of engagement with the ESTEEM dietary intervention in at risk women was explored.

Methods: Qualitative methods using interviews with women, partners (separately) and focus groups with health care professionals were carried out. Data were analysed using thematic analysis.

Findings: Women were able to plan and adapt their food and use the ESTEEM diet to their own and their family’s advantage. However, some of the information provided during the ESTEEM intervention made women more aware of their metabolic risk factors and more anxious. Women found solutions to their individual concerns during the ESTEEM intervention, by sharing information and ideas, and by supporting each other. Partners perceived the dietary intervention as having benefits for themselves, the mother as well as their children. Men appeared to hold mothers to be mainly responsible for feeding the children and ensuring that what they ate was healthy. Health care professionals thought that food must be viewed within the family context to enable change in dietary behaviours.

Conclusion: Interventions must seek to understand the individual as a decision-maker within the wider social context in which they live. Diet and lifestyle intervention will become truly effective if they are co-designed with women and families and health care is co-produced with people.

About the speaker

Adela Hamilton is a midwife, a former senior lecturer, the first Darzi Fellow (Midwifery). The Darzi fellowship is a leadership training programme set up about 10 years ago by Lord Darzi, former Minister for health. Her career has been varied and she has worked as a midwife, manager, lecturer and researcher. She have also been involved in project in India, educating midwives and written chapters for Myles textbook for midwives.

A light lunch with refreshments will be provided. Further information and event timings can be found on our website.

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When and where

12.45pm - 2.00pmMonday 4th February 2019

MG26 Myddelton Street Building City, University of London 1 Myddelton Street London EC1R 1UW United Kingdom