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dc.contributor.authorSalmon, VE
dc.contributor.authorHay-Smith, EJC
dc.contributor.authorJarvie, R
dc.contributor.authorDean, S
dc.contributor.authorOborn, E
dc.contributor.authorBayliss, SE
dc.contributor.authorBick, D
dc.contributor.authorDavenport, C
dc.contributor.authorIsmail, KM
dc.contributor.authorMacArthur, C
dc.contributor.authorPearson, M
dc.contributor.authorAPPEAL study
dc.date.accessioned2017-02-06T10:32:57Z
dc.date.issued2017-01-25
dc.description.abstractBACKGROUND: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. METHODS: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. DISCUSSION: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42016042792.en_GB
dc.description.sponsorshipThe APPEAL project is funded by a National Institute for Health Research (NIHR) programme grant for applied research (RP-PG-0514-20002). MP and SD were supported in their contribution to the development of the research proposal by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula. CM is part-funded by the CLAHRC West Midlands, and DB is part-funded by the CLAHRC South London.en_GB
dc.identifier.citationVol. 6, 18en_GB
dc.identifier.doi10.1186/s13643-017-0420-z
dc.identifier.urihttp://hdl.handle.net/10871/25603
dc.language.isoenen_GB
dc.publisherBioMed Centralen_GB
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pubmed/28122608en_GB
dc.rights© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stateden_GB
dc.subjectAntenatal educationen_GB
dc.subjectCritical interpretive synthesisen_GB
dc.subjectImplementationen_GB
dc.subjectMaternity servicesen_GB
dc.subjectMidwifery practiceen_GB
dc.subjectPelvic floor muscle exerciseen_GB
dc.subjectPelvic floor muscle trainingen_GB
dc.subjectPostpartumen_GB
dc.subjectPregnancyen_GB
dc.subjectUrinary incontinenceen_GB
dc.titleOpportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesisen_GB
dc.typeArticleen_GB
dc.date.available2017-02-06T10:32:57Z
dc.identifier.issn2046-4053
exeter.place-of-publicationEnglanden_GB
dc.descriptionThis is the final version of the article. Available from the publisher via the DOI in this record.en_GB
dc.identifier.journalSystematic Reviewsen_GB
dc.identifier.pmcidPMC5267404
dc.identifier.pmid28122608


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