Beyond the ‘teachable moment’ – A conceptual analysis of women's perinatal behaviour change

Olander, Ellinor K.; Darwin, Zoë; Atkinson, Lou; Smith, Debbie; Gardner, Benjamin

doi:10.1016/j.wombi.2015.11.005

Cited by 93 publications

(85 citation statements)

References 24 publications

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“…Health behaviour change is affected by a complex combination of ability, motivation and opportunity [34, 35] and therefore risk information alone is unlikely to induce behaviour change. The Health belief model, Social cognitive theory as well as the Capability-opportunity-motivation-behaviour framework all have in common that they describe that lifestyle change is influenced by perceived self-efficacy [36].…”

Section: Discussionmentioning

confidence: 99%

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

et al. 2016

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IntroductionObesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions.MethodsQualitative interview study (semi-structured) using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories.ResultsParticipants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss.ConclusionThere is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.

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Section: Discussionmentioning

confidence: 99%

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

et al. 2016

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“…Pregnancy may provide a stimulus for women to improve their diets and increase their physical activity. Pregnancy is also an opportunity for midwives and other healthcare professionals to provide support for women to adopt healthier behaviour (Olander, Darwin, Atkinson, Smith, & Gardner, ; Phelan, ). Opportunistic brief interventions delivered as part of routine primary care appointments have been shown to achieve significant improvements in health behaviours, including weight loss and smoking reduction, particularly if delivered by respected and trusted authorities (Aveyard et al, ; Aveyard, Begh, Parsons, & West, ).…”

Section: Introductionmentioning

confidence: 99%

How can we best use opportunities provided by routine maternity care to engage women in improving their diets and health?

Lawrence

Vogel

Strömmer

et al. 2019

Maternal & Child Nutrition

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Pregnancy provides motivation for women to improve their diets and increase their physical activity. Opportunistic brief interventions delivered as part of routine primary care have produced improvements in patients' health behaviour. Consequently, there have been calls for midwives to use contacts during pregnancy in this way. This study explored the experiences of pregnant women and research midwives/nurses of a brief intervention called Healthy Conversation Skills (HCS) being delivered as part of a randomised control trial, assessing the acceptability and feasibility of including this intervention in routine maternity care. Three research questions were addressed using mixed methods to produce four datasets: face-to-face interviews with participants, a focus group with the HCS-trained midwives/nurses, case reports of participants receiving HCS and audio-recordings of mid-pregnancy telephone calls to the women which produced midwife/nurse HCS competency scores. Midwives/nurses used their HCS to support women to make plans for change and set goals. Women welcomed the opportunity to address their own health and well-being as distinct from that of their baby. Midwives/nurses were competent in using the skills and saw healthy conversations as an effective means of raising issues of diet and physical activity. Recent extension of maternity appointment times provides ideal opportunities to incorporate a brief intervention to support behaviour change. Incorporating HCS training into midwifery education and continuing professional development would facilitate this. HCS is a scalable, brief intervention with the potential to improve the diets and physical activity levels of women during pregnancy, and hence the health of themselves and their babies.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…7 A richer analysis of perinatal behaviour change encompasses and expands on the teachable moment by applying the Capability, Opportunity, and Motivation Behaviour (COM-B) framework. 8 The COM-B framework goes beyond solely motivational aspects of behaviour change; it identifies capability and opportunity as fundamental determinants of behaviour change. 8 Multiple events during pregnancy and the postnatal period not only bring changes to women's motivations, but also to their capabilities and opportunities for change.…”

Section: Introductionmentioning

confidence: 99%

Behaviour change opportunities at mother and baby checks in primary care: a qualitative investigation of the experiences of GPs

et al. 2018

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Although GPs recognise the postnatal check as a potential opportunity for health-related behaviour change, it is underutilised as they do not perceive this to be the purpose of the check and are uncertain as to their role in facilitating lifestyle changes. To enable this long-term lifestyle behaviour change opportunity to be utilised more fully, further research is needed to understand women's expectations of the postnatal checks and the scope for further recommendations, guidance, and communication training around behaviour change.

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Beyond the ‘teachable moment’ – A conceptual analysis of women's perinatal behaviour change

Cited by 93 publications

References 24 publications

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

How can we best use opportunities provided by routine maternity care to engage women in improving their diets and health?

Behaviour change opportunities at mother and baby checks in primary care: a qualitative investigation of the experiences of GPs

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