This is the accepted version of the paper.This version of the publication may differ from the final published version. This study was supported by the University of Gothenburg Centre for PersonCentred Care (GPCC). Permanent repository link Conflict of Interest StatementNo conflict of interest is declared. AbstractMaternal obesity is linked with adverse outcomes for mothers and babies. To get an overview of risk related to obesity in pregnant women, a systematic review of reviews was conducted. For inclusion, reviews had to compare pregnant women of healthy weight with women with obesity, and measure a health outcome for mother and/or baby. Authors conducted full-text screening, quality assurance using the AMSTAR tool, and data extraction steps in pairs. Narrative analysis of the 22 reviews included showed gestational diabetes, pre-eclampsia, gestational hypertension, depression, instrumental and caesarean birth, and surgical site infection to be more likely to occur in pregnant women with obesity compared to women with a healthy weight. Maternal obesity is also linked to greater risk of preterm birth, large-for-gestational-age babies, fetal defects, congenital anomalies, and perinatal death. Furthermore breastfeeding initiation rates are lower and there is greater risk of early breastfeeding cessation in women with obesity compared with healthy weight women. These adverse outcomes may result in longer duration of hospital stay, with concomitant resource implications. It is crucial to reduce the burden of adverse maternal and fetal/child outcomes caused by maternal obesity.Women with obesity need support to lose weight before they conceive, and to minimise their weight gain in pregnancy.4

Increasing self-efficacy is generally considered to be an important mediator of the effects of physical activity interventions. A previous review identified which behaviour change techniques (BCTs) were associated with increases in self-efficacy and physical activity for healthy non-obese adults. The aim of the current review was to identify which BCTs increase the self-efficacy and physical activity behaviour of obese adults. A systematic search identified 61 comparisons with obese adults reporting changes in self-efficacy towards engaging in physical activity following interventions. Of those comparisons, 42 also reported changes in physical activity behaviour. All intervention descriptions were coded using Michie et al’s (2011) 40 item CALO-RE taxonomy of BCTs. Meta-analysis was conducted with moderator analyses to examine the association between whether or not each BCT was included in interventions, and size of changes in both self-efficacy and physical activity behaviour. Overall, a small effect of the interventions was found on self-efficacy (d = 0.23, 95% confidence interval (CI): 0.16-0.29, p < 0.001) and a medium sized effect on physical activity behaviour (d = 0.50, 95% CI 0.38-0.63, p < 0.001). Four BCTs were significantly associated with positive changes in self-efficacy; ‘action planning’, ‘time management’, ‘prompt self-monitoring of behavioural outcome’ and ‘plan social support/social change’. These latter two BCTs were also associated with positive changes in physical activity. An additional 19 BCTs were associated with positive changes in physical activity. The largest effects for physical activity were found where interventions contained ‘teach to use prompts/cues’, ‘prompt practice’ or ‘prompt rewards contingent on effort or progress towards behaviour’. Overall, a non-significant relationship was found between change in self-efficacy and change in physical activity (Spearman’s Rho = −0.18 p = 0.72). In summary, the majority of techniques increased physical activity behaviour, without having discernible effects on self-efficacy. Only two BCTs were associated with positive changes in both physical activity self-efficacy and behaviour. This is in contrast to the earlier review which found a strong relationship between changes in physical activity self-efficacy and behaviour. Mechanisms other than self-efficacy may be more important for increasing the physical activity of obese individuals compared with non-obese individuals.

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractBackground. Increasing self-efficacy is an effective mechanism for increasing physical

. (2011). The views of pre-and post-natal women and health professionals regarding gestational weight gain: an exploratory study. Sexual & Reproductive Healthcare, 2(1), pp. 43-48. doi: 10.1016/j.srhc.2010.10.004 This is the unspecified version of the paper.This version of the publication may differ from the final published version. Permanent Study DesignIn total, five focus groups were conducted with pregnant women (n=9), post-natal women (n=14) and health professionals (including midwives, n=7). The focus groups were transcribed verbatim and analysed thematically. Main Outcome MeasuresThe women's views regarding weight gain in pregnancy and what the health professionals' thoughts were concerning the current provision of care they provide to their patients regarding gestational weight gain. ResultsThe women expressed a lack of concern regarding their weight in pregnancy, and reported not receiving any information regarding what constitutes healthy gestational weight gain. The pregnant women reported not monitoring their weight and assumed they would lose weight post-natally through breastfeeding. The health professionals reported being aware of the women's beliefs, however lacked information to give to the women relating to healthy weight gain. ConclusionsIt is likely that the women lacked concern and knowledge regarding gestational weight gain due to not receiving information from their midwives and other health professionals regarding this issue. The health professionals were in turn unsure of what to advise women regarding appropriate gestational weight gain. By ensuring midwives and other health professionals have the knowledge and skills to discuss weight with pregnant women, the women in turn may be more motivated and confident in maintaining a healthy weight at this time.3

This systematic review constitutes the first synthesis of research on computer- or web-based interventions for perinatal mental health issues and provides preliminary support that this could be a promising form of treatment during this period. However, there are significant gaps in the current evidence-base so further research is needed.