RELEVANT
What is the project about?
RELEVANT: REducing stiLlbirth through bEhaViour chAnge iNtervenTions
In high-income countries, the majority of stillbirths occur prior to labour and are associated with placental pathology. However, previous research has shown that stillbirth is associated with a wide range of risk factors, including maternal behavioural risk factors. These including sleep position, smoking, alcohol intake, illicit drug use, high maternal weight and inadequate antenatal care attendance. Considering that some of the mentioned maternal behavioural risk factors have the potential to be modified, there has been an increase in development and implementation of antenatal behavioural interventions targeting those behaviours to reduce the risk of stillbirth.
Phase 1 of the RELEVANT Project was conducted as a doctoral research project funded by Science Foundation Ireland. The overall aim of this PhD was to build the evidence-based to inform the development of a behaviour change intervention to raise awareness of and reduce modifiable risk factors for stillbirth in Ireland.
In Phase 2, we are using all of the evidence generated from the studies undertaken in Phase 1 to develop an intervention, following the Behaviour Change Wheel approach for designing interventions.
What is involved?
Phase 1
- Literature review to examine the available evidence in relation to modifiable risk factors for stillbirth
- An evaluation of the content of 92 websites targeted at the pregnant population in relation to stillbirth and risk factors for stillbirth
- Qualitative evidence syntheses of facilitators and barriers to changing target behaviours (substance use, attendance at antenatal care, weight management)
- Qualitative study exploring first time mum’s experiences and knowledge about behavioural risk factors for stillbirth.
- A systematic review of behaviour change techniques used in the context of stillbirth prevention interventions in high-income countries
- Survey study exploring healthcare professionals’ experiences when communicating with pregnant women about stillbirth to better understand perceived barriers towards addressing these issues in practice.
Phase 2
- Stage 1: Identification of behavioural barriers and facilitators to modifying the behavioural risk factors for stillbirth during pregnancy.
- Stage 2: Identification of behavioural intervention strategies to promote behaviour change during pregnancy.
A stakeholder group will be involved throughout the process of intervention design, and will include health care professionals, and women from different sociodemographic backgrounds, as well as women who have used the currently available supports for behaviour change during pregnancy. Read more about the protocol for Phase 2 in our recently published paper.
Who is involved?
Project team - Phase 2 (March 2023-)
| Tamara Escañuela Sánchez | National Perinatal Epidemiology Centre, UCC; Pregnancy Loss Research Group | Postdoctoral Researcher |
| Professor Keelin O'Donoghue | Pregnancy Loss Research Group | Collaborator |
| School of Public Health, UCC | Collaborator | |
| Professor Richard Greene | National Perintal Epidemiology Centre, UCC | Collaborator |
| Professor Molly Byrne | Health Behaviour Change Reserach Group, School of Psychology, University of Galway | Collaborator |
Project team - Phase 1 (October 2018-March 2023)
| Name | Affiliation | Role |
|---|---|---|
| Tamara Escañuela Sánchez | Pregnancy Loss Research Group; National Perinatal Epidemiology Centre, UCC | PhD Student |
| Professor Keelin O'Donoghue | Pregnancy Loss Research Group | Primary Supervisor |
| School of Public Health, UCC | Co-supervisor | |
| Dr Sarah Meaney | National Perintal Epidemiology Centre, UCC | Co-supervisor |
| Professor Molly Byrne | Health Behaviour Change Reserach Group, School of Psychology, University of Galway | Co-supervisor |
| Dr Laura Linehan | Pregnancy Loss Research Group | Collaborator |
| Caroline O'Connor | Pregnancy Loss Research Group | Collaborator |
| Dr Emily Rutherford | Pregnancy Loss Research Group | Collaborator |
Dissemination activities
Journal articles
- Escañuela Sánchez T, Meaney S, O'Donoghue K. Modifiable risk factors for stillbirth: a literature review. Midwifery. 2019;79:102539. https://doi.org/10.1016/j.midw.2019.102539.
- Escañuela Sánchez T, Meaney S, O’Donoghue K. Stillbirth and risk factors: an evaluation of Irish and UK websites. Journal of Communication in Healthcare. 2021;14(1):68-77. https://doi.org/10.1080/17538068.2020.1807887.
- Escañuela Sánchez T, Linehan L, O’Donoghue K, Byrne M, Meaney S. Facilitators and barriers to seeking and engaging with antenatal care in high-income countries: A meta-synthesis of qualitative research. Health & Social Care in the Community. 2022;1-19. https://doi.org/10.1111/hsc.14072.
- Escañuela Sánchez T, Matvienko-Sikar K, Meaney S, O'Donoghue K. Exploring first-time mothers' experiences and knowledge about behavioural risk factors for stillbirth. Health Expectations. 2022;1-14. https://doi.org/10.1111/hex.13662.
- Escañuela Sánchez T, Matvienko-Sikar K, Linehan L, O’Donoghue K, Byrne M, Meaney S. Facilitators and barriers to substance-free pregnancies in high-income countries: A meta-synthesis of qualitative research. Women and Birth. 2022;35(2):e99-e110. https://doi.org/10.1016/j.wombi.2021.04.010.
- Escañuela Sánchez T, Byrne M, Meaney S, O'Donoghue K, Matvienko-Sikar K. A protocol for a systematic review of behaviour change techniques used in the context of stillbirth prevention [version 2; peer review: 2 approved, 1 approved with reservations]. HRB Open Research. 2022;4:92. https://doi.org/10.12688/hrbopenres.13375.2.
- Escañuela Sánchez T, Meaney S, O’Connor C, Linehan L, O'Donoghue K, Byrne M, Matvienko-Sikar K. Facilitators and barriers influencing weight management behaviours during pregnancy: a meta-synthesis of qualitative research. BMC Pregnancy Childbirth. 2022;22:682. https://doi.org/10.1186/s12884-022-04929-z.
- Escañuela Sánchez T, O´Donoghue K, Byrne M, Meaney S, Matvienko-Sikar K. A systematic review of behaviour change techniques used in the context of stillbirth prevention. Women and Birth. 2023. https://doi.org/10.1016/j.wombi.2023.05.002.
- Escañuela Sánchez T, Meaney S, O’Donoghue K, Byrne M, Matvienko-Sikar K. Reply to: “The partner-an underutilized facilitator to support healthy gestational weight gain”. BMC Pregnancy and Childbirth. 2023;23:445. https://doi.org/10.1186/s12884-023-05713-3.
- Escañuela Sánchez T, Matvienko-Sikar K, Greene R, Byrne M, O'Donoghue K. Designing a behaviour change intervention to address the behavioural risk factors for stillbirth: A study protocol [version 1; peer review: awaiting peer review]. HRB Open Research. 2023;6:35. https://doi.org/10.12688/hrbopenres.13751.1.
Invited commentary
- Escañuela Sánchez T. Invited commentary: Exploring the complexity of stillbirth prevention: Insights from the RELEVANT Study on risk factors and implications for policy and practice. In San Lazaro Campillo I, Manning E, Corcoran P, Keane J, McKernan J, Escanuela Sanchez T, Greene RA, on behalf of the Perinatal Mortality National Clinical Audit Governance Committee. Perinatal Mortality National Clinical Audit in Ireland Annual Report 2021. National Perinatal Epidemiology Centre; 2023:58-68. https://www.ucc.ie/en/media/research/nationalperinatalepidemiologycentre/NPECPMreport2021_digital.pdf.
Policy brief
- Pregnancy Loss Research Group. The RELEVANT study: Rethinking stillbirth through behaviour change. PLRG Policy Brief 9. October 2022.
Project status
Ongoing: October 2018 to Present (Phase 1 completed in March 2023; Phase 2 commenced in March 2023)
Further information
Please email Dr Tamara Escañuela Sánchez: tamara.escanuelasanchez@ucc.ie
Funders
Phase 1 of the RELEVANT Project was funded by Science Foundation Ireland. Phase 2 is supported by the National Perinatal Epidemiology Centre.