Coaching for Childbearing Health

The current ANS featured article is titled “Coaching for Childbearing Health: A Theory Synthesis” authored by Jennifer M. Ohlendorf, PhD, RN and Lisa Anders, PhD, RN, IBCLC. This article is available at no cost from the ANS website while it is featured! Here is a message from Dr. Ohlendorf about the importance of this work:

One of the highest priorities of nursing and advanced nursing practice is health promotion, specifically health behavior change.  Over the past 20 years, the science of health behavior change has developed into the science of self-management—because most of the actual “doing” of health promotion is comprised of daily choices made by people in the midst of their complicated lives.   What this means is that providers must find effective ways to use the limited time they have with patients to influence health behaviors people may engage in in their daily lives.

In my work, I am interested in patient-centric approaches to making physical activity and nourishing eating behaviors part of the perinatal transition.   Transitions are periods of disorganization, followed by a process of engagement in the life change, and then a period of reorganization.  The way the transition unfolds results in a person having achieved a new identity.  Nursing interventions aimed at key timepoints–taking into account the context of the person’s life–to promote positive self-management can result in the person having incorporated health behaviors as part of this new identity. 

This article presents a model that can be used during perinatal care visits to engage in goal setting and planning with pregnant people to promote physical activity and nourishing eating behaviors.   The Coaching for Childbearing Health (CoaCH) Model incorporates salient concepts from Ryan and Sawin’s Individual and Family Self Management Theory (2009) and from Meleis’s Transitions Theory (2000), along with qualitative data women shared as part of a goal-setting intervention during pregnancy.  The qualitative data was keyThe resulting model can be used to design context-appropriate interventions nurses could use in prenatal practice to promote healthy behaviors across the perinatal transition.

This model has already been used to design a coaching intervention and feasibility testing is complete for the intervention. Next steps are to work with our clinical partners to begin a full-scale trial so that, in the future, this coaching can be implemented by nurses in perinatal practice to partner with people who are pregnant or postpartum to develop sustainable, healthy behaviors.