Maternal Obesity Technology
Obesity and excessive weight gain during pregnancy are associated with an increased risk of complications as well as maternal and neonatal mortality. Excessive weight gain during pregnancy can also lead to further development of obesity in women and their offspring, therefore effective strategies are required to tackle this important health issue.

The National Institute for Health and Clinical Excellence (NICE) has identified the need for more research on the management of maternal obesity. With an initial funding from the Engineering for Life (EFL) research network at Sheffield Hallam University and support from CLAHRC SY (User- Centred Healthcare Design, Obesity and Telehealth and Care Technologies themes) we have focused on developing a complex intervention to evaluate the use of text messaging in the management of maternal obesity.

This project links with existing care pathways and will provide technological advances on previous projects. The development of an e-health platform, delivered through a portable device, can optimise access and promote effectiveness by overcoming challenges associated with the stigma and other face-to-face barriers.

A phased approach was taken to develop and evaluate this complex intervention. The results of the preclinical phase and phase one are presented here. Through a structured literature search and focus groups with women and midwives a preliminary prototype was developed. Additional focus groups were carried out to verify acceptability of the intervention components. This was followed by usability testing to explore implementation of the intervention into the practical setting. The results of the focus groups were analysed thermatically.

Women and midwives welcomed additional support, particularly text messaging for maternal obesity management as a modern and discrete service. A message delivery platform, 96 motivational text messages, and diaries were developed to enable goal setting for diet and physical activity behaviour change and selfmonitoring purposes. The verification process identified several areas for improvement. Participants felt that consultations went well, some text messages needed rewording, one message a day was ideal, and the diary layout and colours needed changing.

A few minor software improvements were also identified. The intensive engagement of service users and care providers through an iterative process has led to development of the MOMTech prototype for further evaluation. Amendments will be made prior to piloting with pregnant women. Dr Hora Soltani (Reader in Health and Social Care Research at Sheffield Hallam University-project lead) says: "This project is an excellent example of academic and clinical networking. The need for the study was identified as a result of a gap analysis by clinicians leading the maternal obesity clinic in Doncaster and their communications with myself.

The multidisciplinary team includes experts from User Centred Healthcare Design (led by Professor Andy Dearden), health psychologists (Maddy Arden and Penny Furness), Kerry McSeveny and a research assistant (Alex Scott) who has recently joined the team and is supported by CLAHRC. In addition our clinical colleagues Carolyn Garland and Alison Williams from Doncaster maternity unit have been instrumental in taking this project forward. We have had discussions with market leading industrial partners for a wider evaluation and application of these services.

For further information, please contact:
Dr Hora Soltani