Healthcare professionals’ views on supporting young mothers with eating and moving during and after pregnancy: An interview study using the COM‐B framework

Abstract

Young mothers under the age of 20 often have poor nutrition and low levels of physical activity, adversely affecting outcomes for themselves and their babies. The aim of this qualitative study was to explore the experiences of healthcare professionals in supporting young women around eating and moving during and after pregnancy. Seventeen semi‐structured interviews were conducted with midwives, family nurse practitioners and health visitors involved in the care of pregnant and post‐natal mothers under the age of 20 in England and Wales. Data were analysed using thematic analysis and coded within the theoretical framework of the COM‐B model to three areas of capability, motivation and opportunity. For capability, participants were broadly divided between those who had specialist knowledge and training in communication skills to support health behaviours in this population and professionals reliant on tacit knowledge. For opportunity, having enough time was seen as critical because young women's difficult social contexts meant supporting improved health behaviours required relationships of trust to be built. For motivation, participants reported that supporting young women with eating and moving was part of their role. However, the decision to prioritise this support sometimes related to perceived need based on BMI and this was complicated as young women were still growing. Motivation was additionally connected to professionals’ own body experiences and health behaviours. Moving habits were less frequently discussed than eating as professionals described how young women tended to walk a lot in their daily lives or found that young women were not interested. Results suggest that to support eating and moving behaviours with young women, professionals need to be trained in communication techniques, enabled with the time to hold space for young women and be able to reflect on their own attitudes and beliefs to support a rounded model of health and wellbeing.

Determinants of changes in women’s and men’s eating behavior across the transition to parenthood: a focus group study

“…It is moreover clear from our data that pregnant women experience social pressure and support from colleagues, family and friends, but equally from healthcare providers. Their important role in providing nutritional support and education has been extensively described in populations of pregnant women [50,58,[60][61][62]. But, there is a need to educate healthcare providers themselves in order to give adequate, individualized and practical nutritional support and assistance [55,60,61].…”

“…Their important role in providing nutritional support and education has been extensively described in populations of pregnant women [50,58,[60][61][62]. But, there is a need to educate healthcare providers themselves in order to give adequate, individualized and practical nutritional support and assistance [55,60,61]. The importance of the social environment, including the father, has also been highlighted in other studies [35,59].…”

Relative Importance of Determinants of Changes in Eating Behavior during the Transition to Parenthood: Priorities for Future Research and Interventions

“…Although healthcare providers are expected to play an important role during the transition to parenthood, they experience barriers such as time constraints, gaps in their own nutritional knowledge, and a lack of communication skills, preventing them from providing adequate nutritional support and assistance on improving parents’ self-regulation skills [ 36 , 48 ]. Therefore, educating healthcare providers about nutritional knowledge, the needs and barriers that expecting and first-time parents experience, and training their motivational interviewing skills is recommended [ 49 ].…”

“…A particular emphasis on communication techniques may be important. This must enable healthcare providers to reflect on their own values and beliefs around health and well-being, which is needed in order to properly communicate [ 48 ]. Using principles of motivational interviewing may facilitate parents’ behavioral change [ 32 , 49 , 50 ].…”

Healthcare Professional Training Regarding Gestational Weight Gain: Recommendations and Future Directions

“…Whilst it is not always possible to provide healthcare professionals with more time, focus can instead be on how to discuss weight gain concisely and signpost to information and resources. Training also needs to acknowledge the diversity of pregnant women and incorporate resources for specific populations such as teenage women [ 44 , 64 ], different cultures [ 37 ] and women at risk of eating disorders [ 65 , 66 ].…”