背景:怀孕期间的粮食不安全和饥饿对母亲和婴儿的健康有重大影响。在怀孕期间遇到饥饿或粮食不安全的妇女时,协助临床医生将增加更好的分娩和妊娠结局的机会。目前,澳大利亚临床医生没有关于如何做到这一点的指南。
方法:本研究采用改良的Delphi技术,允许不同的参与这个过程,就如何解决和应对怀孕期间的粮食不安全问题达成共识。该改良的Delphi通过两轮共识收集数据。从第一轮收集的意见进行了主题分类和分组。这些主题已纳入第二轮调查,并分发给参与者。在第二轮中,对被认为最重要的主题给予5分,对优先事项进行评分,最不重要的一点。
结果:通过两轮咨询,小组就如何识别怀孕期间的粮食不安全问题达成了共识,一些明确的共识项目涉及可以实施的干预措施,以解决怀孕期间的粮食不安全问题。专家们就在机构和政策层面具有重要性的项目达成共识,以及社区中存在的服务。关于各种援助机会的共识,从临床,社区提供的援助,政府的政策和实践证明了这个问题的复杂性,以及解决这一问题所需的多管齐下的方法。
结论:这是澳大利亚首次与专家就怀孕期间的饥饿和粮食不安全问题进行磋商。达成共识的项目和问题的重要性提出了在与饥饿和/或粮食不安全的孕妇合作时的几种方法。
BACKGROUND: Food insecurity and hunger during pregnancy have significant implications for the health of the mother and baby. Assisting clinicians when they encounter women who are experiencing hunger or food insecurity during their pregnancy will increase the opportunity for better birth and pregnancy outcomes. At present there are no
guidelines for Australian clinicians on how to do this.
METHODS: This study uses a modified Delphi technique, allowing diverse participation in the process, to create consensus on the ways to address and respond to food insecurity during pregnancy. This modified Delphi collected data via two rounds of
consensus. The opinions collected from the first round were thematically categorised and grouped. The topics were integrated into the survey for the second round and circulated to participants. During the second round, priorities were scored by giving five points to the topic considered most important, and one point to the least important.
RESULTS: Through two rounds of consultation, the panel achieved
consensus on how to identify food insecurity during pregnancy, with some clear items of consensus related to interventions that could be implemented to address food insecurity during pregnancy. Experts achieved
consensus on items that have importance at the institution and policy level, as well as services that exist in the community. The consensus across the spectrum of opportunities for assistance, from the clinical, to community-provided assistance, and on to government policy and practice demonstrate the complexity of this issue, and the multipronged approach that will be required to address it.
CONCLUSIONS: This is the first time such a consultation with experts on hunger and food insecurity during pregnancy has been conducted in Australia. Items that achieved
consensus and the importance of the issue suggest several ways forward when working with pregnant women who are hungry and/or food insecure.