Evidence mapPaperPMID 36688498Full record

Trial reportHealth technology assessment (Winchester, England)2023

Acceptability and feasibility of a planned preconception weight loss intervention in women with long-acting reversible contraception: the Plan-it mixed-methods study.

Susan Channon, Elinor Coulman, Rebecca Cannings-John, Josie Henley, Mandy Lau, Fiona Lugg-Widger, Heather Strange, Freya Davies, Julia Sanders, Caroline Scherf and 2 more

Abstract readClinical Trial
In one paragraph

Trial report in Health technology assessment (Winchester, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Susan ChannonCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0002-5394-1483
Elinor CoulmanCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0002-8854-2140
Rebecca Cannings-JohnCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0001-5235-6517
Josie HenleyCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0002-2709-900X
Mandy LauCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0001-5894-570X
Fiona Lugg-WidgerCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0003-0029-9703
Heather StrangeCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0002-5758-8445
Freya DaviesThe Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK.ORCID 0000-0002-6956-1100
Julia SandersSchool of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.ORCID 0000-0001-5712-9989
Caroline ScherfCardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK.ORCID 0000-0002-0208-6317
Zoë CouzensPublic Health Wales NHS Trust, Public Health Wales, Cardiff, UK.ORCID 0000-0002-2670-9611
Leah Morantz

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen with overweight (a body mass index of ≥ 25 kg/m

objectivesThe objectives were to understand if routine NHS data captured the pathway from long-acting reversible contraception removal to pregnancy and included body mass index; to identify the suitable components of a preconception weight loss intervention; and to engage with key stakeholders to determine the acceptability and feasibility of asking women with overweight/obesity to delay the removal of their long-acting reversible contraception in order to take part in a preconception weight loss intervention.

designThis was a preparatory mixed-methods study, assessing the acceptability and feasibility of a potential intervention, using routine NHS data and purposefully collected qualitative data.

participantsThe NHS routine data included all women with a long-acting reversible contraception code. There were three groups of participants in the surveys and interviews: health-care practitioners who remove long-acting reversible contraception; weight management consultants; and women of reproductive age with experience of overweight/obesity and of using long-acting reversible contraception.

settingUK-based health-care practitioners recruited at professional meetings; and weight management consultants and contraceptive users recruited via social media. DATA SOURCES: Anonymised routine data from UK sexual health clinics and the Clinical Practice Research Datalink, including the Pregnancy Register; and online surveys and qualitative interviews with stakeholders.

resultsThe records of 2,632,871 women aged 16-48 years showed that 318,040 had at least one long-acting reversible contraception event, with 62% of records including a body mass index. Given the identified limitations of the routine NHS data sets, it would not be feasible to reliably identify women with overweight/obesity who request a long-acting reversible contraception removal with an intention to become pregnant. Online surveys were completed by 100 health-care practitioners, four weight management consultants and 243 contraceptive users. Ten health-care practitioners and 20 long-acting reversible contraception users completed qualitative interviews. A realist-informed approach generated a hypothesised programme theory. The combination of weight discussions and the delay of long-acting reversible contraception removal was unacceptable as an intervention to contraceptive users for ethical and practical reasons. However, a preconception health intervention incorporating weight loss could be acceptable, and one potential programme is outlined. LIMITATIONS: There was very limited engagement with weight management consultants, and the sample of participating stakeholders may not be representative.

conclusionsAn intervention that asks women to delay long-acting reversible contraception removal to participate in a preconception weight loss intervention would be neither feasible nor acceptable. A preconception health programme, including weight management, would be welcomed but requires risk communication training of health-care practitioners. FUTURE WORK: Work to improve routine data sets, increase awareness of the importance of preconception health and overcome health-care practitioner barriers to discussing weight as part of preconception care is a priority.

trial registrationThis trial is registered as ISRCTN14733020.

fundingThis project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in

Indexed as

Long-Acting Reversible ContraceptionObesityOverweightAdolescentAdultContraceptive AgentsFeasibility StudiesFemaleHumansMiddle AgedPregnancyWeight LossYoung AdultContraceptive AgentsCONTRACEPTIONINTERVENTIONLONG-ACTING REVERSIBLE CONTRACEPTIVESOBESITYOVERWEIGHTPRECONCEPTIONPREGNANCYROUTINE DATAWEIGHT LOSSWEIGHT MANAGEMENT

Identifiers

PMID36688498
PMCPMC9885302

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.