Behaviour change techniques to change the postnatal eating and physical activity behaviours of women who are obese: a qualitative study

Abstract

Objective To explore the experiences of postnatal women who are obese [body mass index (BMI) ≥ 30 kg/m 2 ] in relation to making behaviour changes and use of behaviour change techniques (BCTs).Design Qualitative interview study.Setting Greater Manchester, UK.Population or Sample Women who were 1 year postnatal aged ≥18 years, who had an uncomplicated singleton pregnancy, and an antenatal booking BMI ≥ 30 kg/m 2 .Methods Eighteen semi-structured, audio-recorded interviews were conducted by a research midwife with women who volunteered to be interviewed 1 year after taking part in a pilot randomised controlled trial. The six stages of thematic analysis were followed to understand the qualitative data. The Behavior Change Technique Taxonomy (version 1) was used to label the behaviour change techniques (BCTs) reported by women.Main outcome measures Themes derived from 1-year postnatal interview transcripts.Results Two themes were evident: 1. A focused approach to postnatal weight management: women reported making specific changes to their eating and physical activity behaviours, and 2. Need for support: six BCTs were reported as helping women make changes to their eating and physical activity behaviours; three were reported more frequently than others: Self-monitoring of behaviour (2.3), Prompts/cues (7.1) and Social support (unspecified; 3.1). All of the BCTs required support from others for their delivery; food diaries were the most popular delivery method.Conclusion Behaviour change techniques are useful to postnatal women who are obese, and have the potential to improve their physical and mental wellbeing. Midwives and obstetricians should be aware of such techniques, to encourage positive changes.

What Are the Most Effective Behavioural Strategies in Changing Postpartum Women’s Physical Activity and Healthy Eating Behaviours? A Systematic Review and Meta-Analysis

“…This suggests that the BCTTv1 could be a useful tool in identifying active ingredients in lifestyle interventions to promote a reduction in energy intake. This is further supported by qualitative findings where postpartum women identified several strategies including self-monitoring of behaviour as helpful in changing diet and physical activity behaviours [51]. Future postpartum lifestyle interventions should focus on the delivery of effective behavioural strategies, particularly those identified for this group.…”

Antenatal physical activity: a qualitative study exploring women’s experiences and the acceptability of antenatal walking groups

“…Hence, recruitment to such interventions requires development of a personal connection with researchers or intervention/class leaders. Research indicates that under study conditions, a dedicated midwife who spends time with women explaining a PA intervention enhances understanding and therefore participation however this may need to be adapted for incorporation into routine antenatal care [ 42 ].…”

Eating for 2: A Systematic Review of Dutch App Stores for Apps Promoting a Healthy Diet during Pregnancy

“…These are relatively easy-to-implement behavior change techniques with a one-size-fits-all approach. In contrast, interactive and personalized guidance strategies [e.g., self-monitoring, prompts/cues, social support ( 32 )] were hardly implemented, even though these are considered effective strategies to improve dietary behaviors. To illustrate, Celis-Morales and colleagues ( 33 ) showed that studies using “barrier identification/problem solving,” “plan social support/social change,” “goal setting,” “use of follow-up prompts,” and “provide feedback on performance” were more successful in improving fruit and vegetable consumption compared with studies not using these techniques.…”