OBJECTIVE: to use realist evaluation to describe and explain how and in what circumstances screening and @entity285 brief interventions work in routine antenatal care. DESIGN: a realist evaluation incorporating systematic reviews and qualitative data. SETTING: NHS Lothian, which is one of the 14 Scottish health boards. @entity1 : @entity1 were recruited from two maternity units. In phase one, interviews were conducted with four @entity1 responsible for policy implementation. These data were supported by two systematic reviews. In phase two, 17 pregnant @entity1 and 15 midwives participated in interviews, with a further six midwifery team leaders involved in a focus group. FINDINGS: training and resources provided to midwives as part of the programme acted as facilitating mechanisms that improved their skills and confidence to screen and deliver @entity285 brief interventions. The programme elicited positive change in attitudes to drinking in pregnancy and possibly stimulated drinking behaviour change amongst pregnant @entity1 . However, the small numbers of pregnant @entity1 being identified for @entity285 brief interventions meant delivery was infrequent and resulted in the programme not working as anticipated. The findings also revealed contextual issues around midwife-pregnant @entity1 relationship and the challenges of negotiating the timing of screening and @entity285 brief interventions delivery. CONCLUSIONS: Drinking in pregnancy is an emotive issue, therefore delivering @entity285 brief interventions at the first antenatal appointment when they are more likely to achieve the most benefits poses challenges. When training midwives to screen and deliver @entity285 brief interventions, special attention is needed to improve @entity1 -centred communication skills to overcome barriers associated with discussing sensitive prenatal @entity285 use and enhance early identification and delivery of @entity285 brief interventions at the first antenatal appointment.

A realist evaluation of an antenatal programme to change drinking behaviour of pregnant XXXX .

@entity1 :: ('9606', 'Species') :: ['participants', 'women', 'woman', 'person', 'PARTICIPANTS'] @entity285 :: ('D000431', 'Chemical') :: ['alcohol']
@entity1 :: (9606,Species) :: ['women']
