Beth Murray-Davis1, Lindsay N Grenier2, Stephanie A Atkinson3, Michelle F Mottola4, Olive Wahoush5,6, Lehana Thabane3,7,8, Feng Xie7, Jennifer Vickers-Manzin9, Caroline Moore6, Eileen K Hutton2. 1. McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada. bmurray@mcmaster.ca. 2. McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada. 3. Department of Pediatrics, McMaster University, Hamilton, ON, Canada. 4. R. Samuel McLaughlin Foundation- Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, ON, Canada. 5. Global Health, McMaster University, Hamilton, ON, Canada. 6. School of Nursing, McMaster University, Hamilton, ON, Canada. 7. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. 8. Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada. 9. Public Health Services-Healthy Families, Healthy & Safe Communities, City of Hamilton, Hamilton, ON, Canada.
Abstract
OBJECTIVE: Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women are frequently not engaging in healthy behaviours linked to appropriate weight gain. The purpose of the current study was to explore women's values and beliefs related to weight, nutrition and physical activity during pregnancy and to describe how these beliefs influence their behaviours. METHODS: As part of a larger randomized controlled trial, we conducted 20 focus groups with 66 pregnant women between 16 and 24-weeks gestation using a semi-structured interview guide. Focus groups were recorded and transcribed verbatim and analyzed using a grounded theory approach. RESULTS: Three personal health schemas emerged from the findings which illustrated women's diverging beliefs about their health behaviours in pregnancy. 'Interconnected health' described beliefs regarding the impact their health had on that of their growing baby and awareness of risks associated with inappropriate weight gain. 'Gestational weight gain as an indicator of health' illustrated perceptions regarding how GWG impacted health and the utility of guidelines. Finally, 'Control in pregnancy' described the sense of agency over one's body and health. CONCLUSIONS FOR PRACTICE: Our results showed that health-related behaviours in pregnancy are driven by personal health schemas which are often discordant with clinical evidence. Interventions and health care provider advice aimed at behaviour modification would benefit from first understanding and addressing these schemas. Tackling the conflict between beliefs and behaviour may improve health outcomes associated with appropriate weight gain in pregnancy.
OBJECTIVE: Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women are frequently not engaging in healthy behaviours linked to appropriate weight gain. The purpose of the current study was to explore women's values and beliefs related to weight, nutrition and physical activity during pregnancy and to describe how these beliefs influence their behaviours. METHODS: As part of a larger randomized controlled trial, we conducted 20 focus groups with 66 pregnant women between 16 and 24-weeks gestation using a semi-structured interview guide. Focus groups were recorded and transcribed verbatim and analyzed using a grounded theory approach. RESULTS: Three personal health schemas emerged from the findings which illustrated women's diverging beliefs about their health behaviours in pregnancy. 'Interconnected health' described beliefs regarding the impact their health had on that of their growing baby and awareness of risks associated with inappropriate weight gain. 'Gestational weight gain as an indicator of health' illustrated perceptions regarding how GWG impacted health and the utility of guidelines. Finally, 'Control in pregnancy' described the sense of agency over one's body and health. CONCLUSIONS FOR PRACTICE: Our results showed that health-related behaviours in pregnancy are driven by personal health schemas which are often discordant with clinical evidence. Interventions and health care provider advice aimed at behaviour modification would benefit from first understanding and addressing these schemas. Tackling the conflict between beliefs and behaviour may improve health outcomes associated with appropriate weight gain in pregnancy.
Authors: Sarah D McDonald; Eleanor Pullenayegum; Keyna Bracken; Ann Marie Chen; Helen McDonald; Anne Malott; Robert Hutchison; Susan Haley; Olha Lutsiv; Valerie H Taylor; Catherine Good; Eileen Hutton; Wendy Sword Journal: J Obstet Gynaecol Can Date: 2012-02
Authors: Rebecca L Emery; Maria Tina Benno; Rachel H Salk; Rachel P Kolko; Michele D Levine Journal: J Obstet Gynaecol Date: 2018-03-22 Impact factor: 1.246
Authors: Lotte Broberg; Anne S Ersbøll; Mette G Backhausen; Peter Damm; Ann Tabor; Hanne K Hegaard Journal: BMC Pregnancy Childbirth Date: 2015-11-27 Impact factor: 3.007