Aiming to improve nutritional status in pregnant teenagers through development of a complex intervention to support change in diet and lifestyle.

Teenage pregnancy has a high risk of poor outcomes for mother and baby. Teenage girls have the poorest diets of any population group in the UK, a recognised determinant of poor pregnancy outcome. Pregnant teenagers trust advice from their midwives, but midwives struggle to find opportunities to discuss diet with them, and other pregnancy concerns often take priority. The aim of this study is to develop an intervention that uses the relationship between pregnant teenagers and their midwives to deliver support to improve quality of diet and hence pregnancy outcomes for pregnant teenagers.

We are using an innovative Person-Based Approach to intervention development, in conjunction with Social Cognitive Theory, to develop training in midwives’ skills to support behaviour change, and to produce format and content of a digital support tool that is relevant to improving dietary quality and appropriate for the needs of the pregnant teenagers. We have been conducting interviews with pregnant teenagers and health care practitioners who work with them. The findings suggest that teenage girls have low awareness of the importance of a healthy diet for their health and that of their baby; they often feel socially isolated, judged and not in control of their own lives. They face many serious challenges to eating well during pregnancy.

Pregnant teenagers and their midwives do not have a reliable resource for immediate support with eating healthily during their pregnancy. An effective intervention to improve pregnant teenagers’ quality of diet must empower and motivate teen mothers and their midwives, provide an engaging and easy to use 24-hour online source of information and support, and enable connections with other young mothers.  The first phase of intervention development has been funded by the Medical Research Council’s Public Health Intervention Development scheme and will be complete by the end of March 2017.