{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T18:21:59Z","timestamp":1781461319788,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>It is important that midwives discuss good nutrition and optimal weight during antenatal appointments, yet this rarely happens. Earlier research suggests that limited time, plus insufficient knowledge and skills are barriers to this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To engage antenatal midwives in stakeholder discussions to explore their perspectives on the design and delivery of a nutrition resource.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study used a Participatory Action Research (PAR) approach. Twenty\u2010six midwives (19 community\u2010based; 7 hospital\u2010based) were purposely recruited from four NHS sites in Northwest England. Four stakeholder workshops were co\u2010designed and facilitated by researchers. In Phase 1, midwives reflected on current practice and challenges in delivering diet and weight advice. In Phase 2, they co\u2010developed ideas for practical, acceptable nutrition resources. Data collection included participant\u2010generated artefacts, post\u2010it notes, visual maps, field notes, and verbatim reflections. Data were analysed inductively using Reflexive Thematic Analysis, and reflexivity was maintained throughout, recognising researchers' influence within this participatory design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two master themes were developed: (1) \u201cWe Want to Help, But We're Not Trained for This\u201d, highlighting systemic, professional, and emotional barriers to providing support and (2) \u201cMake It Real and Make It Work\u201d, midwives' co\u2010produced recommendations for inclusive tools and training that are realistic, culturally sensitive, and integrated into existing workflows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion<\/jats:title>\n                    <jats:p>Midwives expressed a clear need for improved education and resource support. Despite systemic constraints, they co\u2010produced practical and implementable solutions. Supporting midwives through evidence\u2010based, context\u2010specific tools and training may enhance nutrition conversations in antenatal care and improve maternal and infant health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Three culturally diverse Patient and Public Involvement (PPI) representatives were recruited to assist with the validation of the analytical findings. One was a midwife working in antenatal care; the second was a recent service user (a postnatal woman) with an Eastern European background, and the third was a midwife (currently on maternity leave) with a South American background. Commentary from these PPI representatives was used to validate the analysis and support the interpretation of the data. Additionally, they were invited to provide commentary on the draft manuscript and have been included as co\u2010authors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70633","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:50:48Z","timestamp":1772959848000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring Challenges and Co\u2010Developing a Nutritional Resource for Antenatal Care: A Participatory Stakeholder Engagement Study With Midwives and Public Involvement"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8133-5595","authenticated-orcid":false,"given":"Julie","family":"Abayomi","sequence":"first","affiliation":[{"name":"Health Research Institute Edge Hill University Ormskirk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Richards","sequence":"additional","affiliation":[{"name":"Liverpool Women's Hospital NHS Trust Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Benavides","sequence":"additional","affiliation":[{"name":"Liverpool Women's Hospital NHS Trust Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Reyneke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-8762","authenticated-orcid":false,"given":"Lisa","family":"Newson","sequence":"additional","affiliation":[{"name":"School of Psychology Liverpool John Moores University Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Good Maternal Nutrition: The Best Start in Life","author":"Nutrition, Physical Activity & Obesity (NAO)","year":"2016"},{"key":"e_1_2_10_3_1","unstructured":"National Institute for Health and Care Excellence (NICE). (2025). Maternal and Child Nutrition: Nutrition and Weight Management in Pregnancy and Nutrition in Children up to 5 Years accessed April 14 2025 https:\/\/www.nice.org.uk\/guidance\/ng247."},{"key":"e_1_2_10_4_1","unstructured":"National Institute for Health and Care Excellence (NICE). (2019). Antenatal Care for Uncomplicated Pregnancies accessed April 14 2025 https:\/\/www.nice.org.uk\/guidance\/cg62."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzz081"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13514"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12520"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY17088"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/7698510"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07104-w"},{"key":"e_1_2_10_11_1","unstructured":"INVOLVE. (2012). Briefing Notes for Researchers: Involving the Public in NHS Public Health and Social Care Research."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.028662"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3453"},{"key":"e_1_2_10_16_1","unstructured":"Office for Health Improvement and Disparities. (2024). All Our Health: About the framework. GOV.UK https:\/\/www.gov.uk\/government\/publications\/all-our-health-about-the-framework\/all-our-health-about-the-framework."},{"key":"e_1_2_10_17_1","unstructured":"Department of Health and Social Care (2025) Healthy child programme 0\u201319 years https:\/\/www.gov.uk\/government\/collections\/healthy-child-programme."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.012809.103604"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01083-6"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2014.03.010"},{"key":"e_1_2_10_22_1","unstructured":"British Dietetic Association (BDA) (2020) Dietitians in Maternity Services: Position Statement. British Dietetic Association https:\/\/www.bda.uk.com."},{"key":"e_1_2_10_23_1","unstructured":"Maternity Action. (2025) Maternity Action Cost of Living on Maternity Leave Survey 2025 accessed April 10 2025 https:\/\/maternityaction.org.uk\/wp-content\/uploads\/Interim-findings-summary_-Maternity-Action-Cost-of-Living-on-Maternity-Leave_2025.pdf."},{"key":"e_1_2_10_24_1","unstructured":"DH. (2025) Healthy Start accessed April 10 2025 https:\/\/find-government-grants.service.gov.uk\/grants\/healthy-start#info."},{"key":"e_1_2_10_25_1","unstructured":"Centers for Disease Control and Prevention. (2023). Preconception Health and Health Care. Centers for Disease Control and Prevention https:\/\/www.cdc.gov\/preconception\/index.html."},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0302599"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-015-0153-z"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2008.636"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"e_1_2_10_30_1","unstructured":"National Institute for Health and Care Excellence (NICE). (2014). Glossary: FRAMES accessed on February 19 2025 https:\/\/tinyurl.com\/ybt5tc7u."},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","unstructured":"F. C.Denison P.Norwood S.Bhattacharya A.Duffy T.Mahmood andC.Morris(2018). Care of Women with Obesity in Pregnancy (Green\u2010top Guideline No. 72). Royal College of Obstetricians and Gynaecologists https:\/\/www.rcog.org.uk\/guidance\/browse-all-guidance\/green-top-guidelines\/care-of-women-with-obesity-in-pregnancy-green-top-guideline-no-72\/.","DOI":"10.1111\/1471-0528.15386"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500401"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.012809.103604"},{"key":"e_1_2_10_34_1","volume-title":"Fair society, healthy lives: The Marmot Review \u2013 Strategic review of health inequalities in England post\u20102010","author":"Marmot M.","year":"2010"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m693"},{"key":"e_1_2_10_36_1","unstructured":"House of Lords Food Diet and Obesity Committee. (2024). Recipe for Health: A plan to Fix Our Broken Food System. HL Paper 19 https:\/\/committees.parliament.uk\/publications\/203372\/documents\/170062\/default."}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70633","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hex.70633","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:44:56Z","timestamp":1777459496000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/hex.70633"],"URL":"https:\/\/doi.org\/10.1111\/hex.70633","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]},"assertion":[{"value":"2025-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70633"}}