Can we train maternity staff in Healthy Conversation Skills to support them to provide care for pregnancy weight gain?

A 2-month multi-component intervention will be implemented across maternity services in three health sectors. The Healthy Conversation Skills intervention will include organisational and clinician-focused implementation strategies to support antenatal care providers to use Healthy Conversation Skills to provide antenatal care for gestational weight gain. Leadership: Existing clinical networks and antenatal clinic leaders will be engaged prior to and during the intervention period to provide authorisation and endorsement of Healthy Conversation Skills. This will include the presence of clinical leaders at training and endorsement through usual communication channels. Service champion: Clinical Midwife Educators and Population Health staff (who are trained to deliver Healthy Conversation Skills training) will train, monitor performance and provide feedback to antenatal care providers in maternity services over the 2-month intervention period. Community of practice meetings: Healthy Conversation Skills Trainers will be supported by community of practice meetings (face-to-face or online) to plan and implement the Healthy Conversation Skills intervention in each maternity service. Clinician training: In pairs, Healthy Conversation Skills Trainers will deliver the group-based (6-16 participants) training to antenatal care providers in their services. Training sessions will be rostered into routine educational sessions, with the delivery of training sessions (e.g. timing; mode (face to face or online); amount of training (6 hours of full training or 3 hours of ‘lite’ training)) decided by each maternity service as per local need. Healthy Conversation Skills training aims to upskill health care workers in an empowering, person-centred approach to support patient health behaviour change by using open discovery questions (i.e. starting with ‘what’ and ‘how’) to help patients to explore the context of their behaviour, identify their own solutions, and plan their first steps to change. Antenatal care providers who participate in the training can use the skills when providing care for gestational weight gain during existing timing in antenatal appointments. Healthy Conversation Skills training was developed by a multidisciplinary research team at the University of Southampton, United Kingdom. It is based on Social Cognitive Theory and the training is underpinned by the Taxonomy of Behaviour Change Techniques. The training uses an interactive, participatory approach to learning built on the pedagogy of active learning, with the trainer modelling the philosophy and skills throughout. The nature of the training means that it is tailored to the context, beliefs and experiences of participants attending the training. The training provides opportunities for participants to reflect on discrepancies between their current and desired communication style, demonstrates an exemplar conversation, supports participants to practise the skills, and sets graded tasks (of increasing difficulty) to progressively increase skill level. The use of group work to provide social support and feedback, sharing of experiences and practising with each other is fundamental to this approach. There is no use of technology, and participants are discouraged from taking notes and encouraged to fully engage with the experiential training. Educational materials: Healthy Conversation Skills Trainers will be provided with a training implementation toolkit (training manual, session guides and resource pack) and printed resources for antenatal care providers to practice and reflect on their communication skills. Prompts and reminders: Physical point of care prompts, including posters, will be provided to each antenatal care provider at the end of training and displayed in each antenatal clinic rooms to remind antenatal care providers to use the skills learnt from the training. All implementation strategies have been co-developed and approved to be implemented in all participating maternity services by the project executive leadership group. The 2-month intervention will be delivered sequentially in each of the three health sectors across a six-month period. Launch of the implementation strategies will commence on day 1 of the intervention period for each health sector, starting with the first training session and with all implementation strategies provided across the 2-month period. This study will be conducted as a single-arm, pre-post study. Study outcome data from antenatal care providers will be collected over nine months, from the first day of the intervention (at the start of training) until 3 months post-intervention in each health sector. Adherence to the implementation strategies (i.e. log of delivery of each implementation strategy, including training completion and resource logs) will also be recorded during the intervention period.