Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: Protocol for a critical interpretive synthesis

Victoria E. Salmon; E. Jean C Hay-Smith; Rachel Jarvie; Sarah Dean; Eivor Oborn; Susan E. Bayliss; Debra Bick; Clare Davenport; Khaled M. Ismail; Christine MacArthur; Mark Pearson

doi:10.1186/s13643-017-0420-z

Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: Protocol for a critical interpretive synthesis

Victoria E. Salmon, E. Jean C Hay-Smith, Rachel Jarvie, Sarah Dean, Eivor Oborn, Susan E. Bayliss, Debra Bick, Clare Davenport, Khaled M. Ismail, Christine MacArthur, Mark Pearson^*

^*Corresponding author for this work

Midwifery

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Abstract

Background: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. Methods: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. Discussion: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. Systematic review registration: PROSPERO: CRD42016042792

Original language	English
Article number	18
Journal	Systematic Reviews
Volume	6
Issue number	1
DOIs	https://doi.org/10.1186/s13643-017-0420-z
Publication status	Published - 25 Jan 2017

Keywords

Antenatal education
Critical interpretive synthesis
Implementation
Maternity services
Midwifery practice
Pelvic floor muscle exercise
Pelvic floor muscle training
Postpartum
Pregnancy
Urinary incontinence

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10.1186/s13643-017-0420-z

Opportunities, challenges and concerns_SALMON_Published25January2017_GOLD VoR (CC-BY)Final published version, 390 KBLicence: CC BY

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Salmon, V. E., Hay-Smith, E. J. C., Jarvie, R., Dean, S., Oborn, E., Bayliss, S. E., Bick, D., Davenport, C., Ismail, K. M., MacArthur, C., & Pearson, M. (2017). Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: Protocol for a critical interpretive synthesis. Systematic Reviews, 6(1), Article 18. https://doi.org/10.1186/s13643-017-0420-z

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abstract = "Background: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. Methods: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. Discussion: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. Systematic review registration: PROSPERO: CRD42016042792",

keywords = "Antenatal education, Critical interpretive synthesis, Implementation, Maternity services, Midwifery practice, Pelvic floor muscle exercise, Pelvic floor muscle training, Postpartum, Pregnancy, Urinary incontinence",

author = "Salmon, {Victoria E.} and Hay-Smith, {E. Jean C} and Rachel Jarvie and Sarah Dean and Eivor Oborn and Bayliss, {Susan E.} and Debra Bick and Clare Davenport and Ismail, {Khaled M.} and Christine MacArthur and Mark Pearson",

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Salmon, VE, Hay-Smith, EJC, Jarvie, R, Dean, S, Oborn, E, Bayliss, SE, Bick, D, Davenport, C, Ismail, KM, MacArthur, C & Pearson, M 2017, 'Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: Protocol for a critical interpretive synthesis', Systematic Reviews, vol. 6, no. 1, 18. https://doi.org/10.1186/s13643-017-0420-z

Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: Protocol for a critical interpretive synthesis. / Salmon, Victoria E.; Hay-Smith, E. Jean C; Jarvie, Rachel et al.
In: Systematic Reviews, Vol. 6, No. 1, 18, 25.01.2017.

Research output: Contribution to journal › Article › peer-review

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T1 - Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years

T2 - Protocol for a critical interpretive synthesis

AU - Salmon, Victoria E.

AU - Hay-Smith, E. Jean C

AU - Jarvie, Rachel

AU - Dean, Sarah

AU - Oborn, Eivor

AU - Bayliss, Susan E.

AU - Bick, Debra

AU - Davenport, Clare

AU - Ismail, Khaled M.

AU - MacArthur, Christine

AU - Pearson, Mark

PY - 2017/1/25

Y1 - 2017/1/25

N2 - Background: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. Methods: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. Discussion: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. Systematic review registration: PROSPERO: CRD42016042792

AB - Background: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. Methods: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. Discussion: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. Systematic review registration: PROSPERO: CRD42016042792

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KW - Implementation

KW - Maternity services

KW - Midwifery practice

KW - Pelvic floor muscle exercise

KW - Pelvic floor muscle training

KW - Postpartum

KW - Pregnancy

KW - Urinary incontinence

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DO - 10.1186/s13643-017-0420-z

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ER -

Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: Protocol for a critical interpretive synthesis

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