“It’s not easy” — A qualitative study of lifestyle change during pregnancy

Walker, Ruth; Choi, Tammie; Quong, Sara; Hodges, Ryan; Truby, Helen; Kumar, Arunaz

doi:10.1016/j.wombi.2019.09.003

Cited by 18 publications

(17 citation statements)

References 32 publications

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“…Later in pregnancy, women reported strong satisfaction with the service provided, with 88% reporting satisfaction with information provided about lifestyle and 90% describing a good relationship with their healthcare provider. The reported satisfaction is higher than that reported in Australia in routine antenatal care [17]. This strong satisfaction may have contributed to improved self-management and improvement in diet (making time to prepare healthy meals, having food available for quick healthy meals, more likely to try new foods and recipes, and replacing snack foods with healthier alternatives).…”

Section: Discussionmentioning

confidence: 80%

“…Exploratory studies have indicated that women desire clear, unambiguous and personalised strategies [ 13 , 17 , 18 , 47 , 48 ] for making lifestyle changes in pregnancy. Confidence is considered a key element for behaviour change during pregnancy according to the Theory of Planned behaviour [ 34 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Generally, women are motivated to make positive changes, but want support and direction from qualified health professionals (e.g. midwives, dieticians, allied health professionals) [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

Goldstein

Boyle

et al. 2021

BMC Pregnancy Childbirth

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Background Maternal obesity is associated with health risks for women and their babies and is exacerbated by excess gestational weight gain. The aim of this study was to describe women’s experiences and perspectives in attending a Healthy Pregnancy Service designed to optimise healthy lifestyle and support recommended gestational weight gain for women with obesity. Methods An explanatory sequential mixed methods study design utilised two questionnaires (completed in early and late pregnancy) to quantify feelings, motivation and satisfaction with the service, followed by semi-structured interviews that explored barriers and enablers of behaviour change. Data were analysed separately and then interpreted together. Results Overall, 49 women attending the service completed either questionnaire 1, 2 or both and were included in the analysis. Fourteen women were interviewed. Prior to pregnancy, many women had gained weight and attempted to lose weight independently, and reported they were highly motivated to achieve a healthy lifestyle. During pregnancy, diet changes were reported as easier to make and sustain than exercise changes. Satisfaction with the service was high. Key factors identified in qualitative analysis were: service support enabled change; motivation to change behaviour, social support, barriers to making change (intrinsic, extrinsic and clinic-related), post-partum lifestyle and needs. On integration of data, qualitative and quantitative findings aligned. Conclusions The Healthy Pregnancy service was valued by women. Barriers and enablers to the delivery of an integrated model of maternity care that supported healthy lifestyle and recommended gestational weight gain were identified. These findings have informed and improved implementation and further scale up of this successful service model, integrating healthy lifestyle into routine antenatal care of women with obesity. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (no.12620000985987). Registration date 30/09/2020, retrospectively registered. http://www.anzctr.org.au/

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

Goldstein

Boyle

et al. 2021

BMC Pregnancy Childbirth

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show abstract

“…Our results showed that the women who had the most chance of receiving information were those who felt comfortable asking questions. This indicates that in order to obtain information, women should be able to ask for it; however, they are generally less proactive in seeking advice from health professionals ( Walker et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between Maternal Body Mass and Physical Activity Counseling During Pregnancy

Ruart¹,

Sinnapah²,

Janky

et al. 2021

Front. Psychol.

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Aims: The antenatal period provides an important opportunity for giving advice on healthy lifestyle choices. However, the prevalence of maternal obesity is increasing, and women report that they do not receive counseling. We investigated the information given to pregnant women on gestational weight gain, physical activity, and nutrition during pregnancy in relation with their initial weight status, current gestational weight gain and diagnoses of either pre-pregnancy overweight/obesity or excessive gestational weight gain.Methods: Cross-sectional survey using a questionnaire. Pregnant participants (n = 141) were recruited from a midwife center. They completed a structured questionnaire on the information they received during their pregnancy and we assessed its relationship with their weight.Results: We found that many pregnant women did not receive advice about physical activity, gestational weight gain and nutrition (37.5, 53.2, and 66.2%, respectively). Women with weight problems (pre-pregnancy overweight/obesity and excessive gestational weight gain) were less targeted for counseling, although more than 80% of the women viewed receiving information on these topics as positive. Also, being informed of a weight problem was associated with a greater chance of receiving information about physical activity, gestational weight gain and nutrition (all p < 0.05). However, verbalization of the weight problems was low (14.0% of women with pre-pregnancy overweight were informed of their status).Conclusion: Health professionals should dispense more information, especially on PA and particularly for women with weight problems. Verbalization of the weight problem seems associated with more frequent transmission of information.

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“…Diet quality, including low consumption of nutrient dense foods (e.g., vegetables, fruits, dairy) and high consumption of foods with added sugar and fast foods, has been associated with preterm birth and low birthweight [22,23]. Poor diet quality can also lead to micronutrient deficiencies, including iron, folate, and iodine deficiencies, which have been linked to adverse pregnancy outcomes, such as miscarriage and preterm birth [11,[24][25][26].…”

Section: Pregnancy Health Outcomes and Food Environmentmentioning

confidence: 99%

A Mixed Methods Case Study of Food Shopping in a Community with High Infant Mortality

2021

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In the U.S., preterm birth disproportionately impacts certain racial/ethnic groups, with Black women experiencing preterm birth at a rate 50% higher than other groups. Among the numerous factors that likely contribute to these increased rates are neighborhood characteristics, such as food environment. In this mixed-methods case study, we evaluated how pregnant women living in a predominately minority, lower income community with high preterm birth rates navigate and perceive their food environment. Qualitative interviews were performed to assess perceptions of food environment (n = 7) along with geographic and observational assessments of their food environment. Participants traveled an average of 2.10 miles (SD = 1.16) and shopped at an average of 3 stores. They emphasized the importance of pricing and convenience when considering where to shop and asserted that they sought out healthier foods they thought would enhance their pregnancy health. Observational assessments of stores’ nutrition environment showed that stores with lower nutritional scores were in neighborhoods with greater poverty and a higher percent Black population. Future policies and programmatic efforts should focus on improving nutrition during pregnancy for women living in communities with high rates of poor birth outcomes. Availability, affordability, and accessibility are key aspects of the food environment to consider when attempting to achieve birth equity.

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“It’s not easy” — A qualitative study of lifestyle change during pregnancy

Cited by 18 publications

References 32 publications

Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

Association Between Maternal Body Mass and Physical Activity Counseling During Pregnancy

A Mixed Methods Case Study of Food Shopping in a Community with High Infant Mortality

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