Background Overweight and obesity during pregnancy is associated with increased risk of gestational diabetes mellitus (GDM) and other complications. Some lifestyle interventions are effective in reducing excessive weight gain and the risk of GDM however; studies often fail to identify the underlying behaviour change mechanisms by which the intervention is expected to work limiting ability to apply findings. The aim of this study is to identify the barriers and enablers to behaviour change in terms of diet and physical activity from the perspective of overweight and obese pregnant women and healthcare professionals (HCPs) with a view to developing a technology supported lifestyle intervention informed by behaviour change theory.
Methods We selected a purposive sample of overweight and obese women at different stages of pregnancy attending a public antenatal clinic in a large academic maternity hospital in Cork, Ireland (CUMH).We selected a purposive sample of HCPs working in CUMH and General Practitioners (GPs) working in primary care in the region. We conducted interviews using a semi-structured topic guide. The interviews were digitally recorded and transcribed into NVivo V.10 software for coding and analysis. Data analysis is on-going using a Framework approach. The Theoretical Domains Framework (TDF) and the COM-B model of behaviour change are being used as analytical tools to identify barriers and enablers to dietary and physical activity behaviours.
Results Overweight and obese pregnant women (n = 30) were interviewed; nationality (Irish, African, Chinese, French, Lithuanian and Hungarian), BMI range (25.6–41.7), age range (22–39 years), week gestation (12–39 weeks). Social influences were identified as an enabler to lifestyle change; pregnant woman suggested behaviour change was easier for them when their partners engaged in a healthy lifestyle. Knowledge was identified as a barrier; pregnant women lacked information particularly around physical activity in pregnancy. HCPs included consultant obstetricians and midwifes (n = 10); preliminary results identified environmental context and resources within the health system as barriers, particularly the lack of dedicated obesity clinics and access to dietetic services. Interviews with GPs (n = 4–6) are ongoing.
Conclusion Behaviour change during pregnancy is difficult for woman as they lack information and knowledge, particularly around appropriate physical activity during pregnancy. HCPs believe pregnancy is a window of opportunity. However, there are limited targeted resources available to support women to make health behaviour changes. Using the COM-B model, results from this study will be used to identify appropriate intervention functions to inform the development of a technology supported lifestyle intervention to improve physical activity levels in pregnancy.
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