ABSTRACT
OBJECTIVE: To assess barriers and facilitators to implementation of an occupational health guideline aimed at preventing weight gain. METHODS: Barriers and facilitators to implementation were assessed among 14 occupational physicians (OPs) and employers and analyzed following a systematic approach using Atlas.ti. RESULTS: Barriers and facilitators mentioned by OPs and employers were related to the sociopolitical context, organization, OP, and guideline. Recommendations include the formation of a linkage group, collaboration with other experts, formation of peer support groups, and communicating benefits of investments, expectations, and ethical considerations. Results of this study recommend incorporating these barriers and facilitators in the guideline, including strategies about how to overcome barriers and stimulate facilitators. CONCLUSIONS: The identified barriers and facilitators can be used to increase the chance of successful implementation of the final guideline into occupational health practices throughout the Netherlands.
Subject(s)
Occupational Health Services/standards , Overweight/prevention & control , Practice Guidelines as Topic , Weight Gain/physiology , Adult , Female , Focus Groups/methods , Guideline Adherence/ethics , Guideline Adherence/organization & administration , Humans , Male , Middle Aged , Netherlands , Workplace/organization & administration , Workplace/psychologyABSTRACT
Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and postnatal growth (weight and length), as well as the potential role of vitamin D status in explaining ethnic disparities in these outcomes. Data were derived from a large multi-ethnic cohort in The Netherlands (Amsterdam Born Children and their Development (ABCD) cohort), and included 3730 women with live-born singleton term deliveries. Maternal serum vitamin D was measured during early pregnancy (median 13 weeks, interquartile range: 12-14), and was labelled 'deficient' (