ArticleBMC health services research2025
Implementing clinical guidelines for gestational weight gain care: a novel application of best-worst scaling to prioritise barriers.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundAntenatal clinical guidelines recommending the provision of care for gestational weight gain (GWG) are not routinely delivered by antenatal care providers (ACPs). Determining barriers to such care delivery can inform the development of targeted strategies to improve implementation. However, no previous studies have identified which barriers are most important.
methodsA best-worst scaling (BWS) survey was developed to estimate the magnitude and rank the importance of barriers to the delivery of recommended GWG care. The survey was conducted between December 2020 and November 2021 with ACPs (medical, midwifery, and Aboriginal health workers) who provided care in public maternity services within three sites in New South Wales, Australia. ACPs were asked to select which of four barriers were most and least likely to inhibit five recommended GWG care practices (assessment of GWG; advice on GWG, diet and physical activity; and referral to specialist GWG services). Rankings of barriers were determined through choice frequency analysis for ACPs at each site.
resultsA total of 143 ACPs completed the survey (64.4% response rate). For each of the five recommended GWG care practices, the most important barrier across all health sites and for both midwives and medical ACPs was 'compared to other aspects of my job, the guideline care is not a high priority.' There was some variation in the importance of barriers between sites. Across all sites, medical staff were more likely than midwives to report 'I forget' as a barrier to weighing and providing weight tracking and dietary advice and 'I don't feel confident (providing this GWG care practice)' as a barrier to providing referrals to a specialist GWG service.
conclusionsBest-worst scaling was a valuable method to rank the influence of barriers and to prioritise site-specific and profession-based barriers to ACP provision of guideline-recommended care for GWG. Not all barriers were equally important, and this 'hierarchy' differed across ACPs and sites. Implementation strategies should be developed to address the highest priority barriers, tailored to site and professional needs.
trial registrationAustralian and New Zealand Clinical Trials Registry, ACTRN12621000054819 (22/01/2021). http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380680&isReview=true.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.