Clinician self-efficacy in initiating discussions about gestational weight gain.

OBJECTIVE: To compare prenatal care providers' perceived self-efficacy in starting discussions about gestational weight gain with pregnant women under a variety of conditions of gradated difficulty, when weight gain has been in excess of current guidelines.

DESIGN: A 42-item online questionnaire related to the known barriers to and facilitators of having discussions about gestational weight gain.

SETTING: Canada.

PARTICIPANTS: Prenatal care providers were contacted through the Family Medicine Maternity Care list server of the College of Family Physicians of Canada.

MAIN OUTCOME MEASURES: The 42 items were clustered into categories representing patient factors, interpersonal factors, and system factors. Participants scored their self-efficacy on a scale from 0 ("cannot do at all") to 5 ("moderately certain can do") to 10 ("highly certain can do"). The significance level was set at α = .05.

RESULTS: Overall, clinicians rated their self-efficacy to be high, ranging from a low mean (SD) score of 5.14 (3.24) if the clinic was running late, to a high mean score of 8.97 (1.34) if the clinician could externalize the reason for undertaking the discussion. There were significant differences in self-efficacy scores within categories depending on the degree of difficulty proposed by the items in those categories.

CONCLUSION: The results were inconsistent with previous studies that have demonstrated that prenatal care providers do not frequently raise the subject of excess gestational weight gain. On the one hand providers rate their self-efficacy in having these discussions to be high, but on the other hand they do not undertake the behaviour, at least according to their patients. Future research should explore this discrepancy with a view to informing interventions to help providers and patients in their efforts to address excess gestational weight gain, which is increasingly an important contributor to the obesity epidemic.