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Zinga J, McKay FH, Lindberg R, van der Pligt P. Experiences of Food-Insecure Pregnant Women and Factors Influencing Their Food Choices. Matern Child Health J 2022; 26:1434-1441. [PMID: 35460501 PMCID: PMC9034444 DOI: 10.1007/s10995-022-03440-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/22/2022]
Abstract
Introduction
Food insecurity (FI), an inadequate access to healthy, affordable food, is a public health concern primarily driven by material hardship. Optimal antenatal nutrition promotes best health outcomes for the mother and baby. Pregnant women experiencing FI are less able to access healthy foods, increasing the risk of complications such as gestational diabetes and preterm labour. Little is known about the experiences of food-insecure pregnant women in obtaining sufficient, nutritious food, their perceptions regarding antenatal nutrition and how this contributes to their food choices. Methods This qualitative study conducted from August to November 2020, during the COVID-19 pandemic, examined the experiences and coping strategies of food-insecure pregnant women, and the factors influencing their food choices. Seven English-speaking food-insecure pregnant women participated in semi-structured interviews. Interview transcripts were thematically analysed, informed by grounded theory methodology. Results Three themes were identified through analysis of the interviews related to strategies that managed household food supply, factors that influenced food choices, and experiences of pregnancy during the COVID-19 pandemic. As a result of a limited food budget, pregnancy symptoms, the cognitive overload that attends the FI experience, and the acute yet significant impact of the pandemic, food-insecure pregnant women in this study defaulted to cheap and convenient food choices despite acknowledging the importance of eating well for pregnancy. Conclusion FI during pregnancy is burdensome, relentless and undermines women’s wellbeing. Supportive strategies within antenatal healthcare settings are urgently required to deliver an equitable health response for vulnerable women. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03440-3.
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Affiliation(s)
- Julia Zinga
- Royal Women's Hospital, Parkville, VIC, Australia.
| | - Fiona H McKay
- School of Health and Social Development, Deakin University, Burwood, VIC, Australia
| | - Rebecca Lindberg
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Paige van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
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Rockliffe L, Peters S, Smith DM, Heal C, Heazell AEP. Investigating the utility of the COM-B and TM model to explain changes in eating behaviour during pregnancy: A longitudinal cohort study. Br J Health Psychol 2022; 27:1077-1099. [PMID: 35297131 PMCID: PMC9541598 DOI: 10.1111/bjhp.12590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/25/2022] [Indexed: 12/04/2022]
Abstract
Objectives Pregnancy has been described as a ‘teachable moment’ for behaviour change, which presents an important opportunity for health promotion within antenatal care settings. However, no pregnancy‐specific model has been developed or tested in the context of health behaviour change during pregnancy. This study aimed to investigate and compare the utility of the Capability‐Opportunity‐Motivation Behaviour (COM‐B) and Teachable Moments (TM) models, to explain health behaviour change during pregnancy, within the context of eating behaviour. Design Longitudinal cohort study. Methods Five hundred and sixteen women completed a survey at between 12–16 weeks gestation (T1). Follow‐up data were collected at 20–24 weeks (T2), 36–40 weeks (T3), and 6–12 weeks postnatally (T4). The primary outcome was eating behaviour. To assess the utility of the COM‐B model, perceived capability, opportunity, and motivation to eat healthily were measured. To assess the utility of the TM model, risk perceptions, self‐image, and affective response were measured. Results Overall, the COM‐B model explained 18.4% of the variance in eating behaviour, whilst the TM model explained 9%. Both models explained the most variance in eating behaviour at T1 and T3, compared with T2 and T4. Small changes were observed in eating behaviour and the model constructs over the time period studied, although these were not clinically meaningful. Conclusions Neither the COM‐B nor TM model provide a satisfactory explanation of eating behaviour during pregnancy, however the findings suggest that certain stages of pregnancy may create more salient opportunities for behaviour change. The findings also support claims that motivation may not play a key role in directing eating behaviour during pregnancy. Further research is needed to explore the role of timing in antenatal behaviour change. The development of a pregnancy‐specific model is necessary to optimise understanding of pregnancy as a teachable moment for behaviour change.
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Affiliation(s)
- Lauren Rockliffe
- Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, UK
| | - Sarah Peters
- Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, UK
| | - Debbie M Smith
- Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, UK
| | - Calvin Heal
- Faculty of Biology, Medicine and Health, Centre for Biostatistics, University of Manchester, UK
| | - Alexander E P Heazell
- Faculty of Biology, Medicine and Health, Maternal and Fetal Health Research Centre, School of Medical Sciences, University of Manchester, UK.,St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, UK
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Taking a Health Perspective on Roller Derby: A Qualitative Exploration of Women’s Experiences. WOMEN 2022. [DOI: 10.3390/women2010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although far fewer women exercise regularly than men, one women-dominated sport growing in popularity internationally is roller derby. A limited number of predominantly US-based and qualitative studies have explored roller derby. This Scotland-based qualitative study explored reasons for women starting, continuing, and stopping participation in roller derby in order to inform people involved in promoting physical activity for health benefits. Semi-structured interviews with six participants from a Scottish women’s roller derby league were recorded and transcribed verbatim. Data analysis using Interpretative Phenomenological Analysis generated five super-ordinate themes. Most participants learned about roller derby from watching the sport on film, attending a bout (game), or word of mouth. The main motivators and benefits of participating in this sport were found to be challenge, enjoyment, increased confidence, health benefits, and motivation to exercise. Participants were empowered by involvement and motivated by community, team spirit, and support to develop. Despite high commitment, some women could not sustain team involvement due to barriers such as injury, changing life roles, and conflicting commitments—a lack of support was described when this happened. Greater inclusivity is needed to enable changing levels of participation as women’s commitments change, to facilitate ongoing health benefits and inspire others.
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Simmons K, Meloncelli N, Kearney L, Maher J. Low vegetable intake in pregnancy and associated maternal factors: A scoping review. Nutr Res 2022; 99:78-97. [DOI: 10.1016/j.nutres.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 12/16/2022]
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Sato PDM, Couto MT, Wells J, Cardoso MA, Devakumar D, Scagliusi FB. Mothers' food choices and consumption of ultra-processed foods in the Brazilian Amazon: A grounded theory study. Appetite 2020; 148:104602. [PMID: 31953143 DOI: 10.1016/j.appet.2020.104602] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
In recent decades, an increase in consumption of ultra-processed foods (UPF), a type of product frequently associated with diet-related obesity, chronic diseases, decrease of eating traditions and loss of culinary diversity, has been observed in middle-income countries. However, there is lack of information on factors related to choosing UPF. In this study, we aimed to understand the factors promoting UPF choices and consumption among mothers living in an urban context in the Brazilian Amazon, and to present a conceptual model grounded on their experiences that illustrates the dynamics between the observed factors. For this qualitative study, we used a constructive grounded theory approach, with a theoretical sampling of 40 women, to choose mothers with high and low consumption of ultra-processed foods. Data production and the first steps of analysis were performed concomitantly, followed by four steps of coding focused on creating conceptual categories and explaining the interactions between them. Our findings highlighted the importance of context in promoting UPF choice and consumption, particularly the "food environment", physical and virtual, and the "sociocultural environment". These contextual aspects interacted with the two main personal aspects influencing participants' UPF consumption, one concerning practices, "cooking behaviors", and the other concerning preferences, "food tastes". Factors such as economic and time constraints were also important and competed to shape eating practices through interactions with participants' health valorization. Findings are discussed in relation to food choice theories, social roles and the food environment. Implications for public health initiatives include the importance of considering environmental changes, sociocultural and economic influences, the reliance on UPF, and the role of women in the home, when promoting healthy diets.
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Affiliation(s)
- Priscila de Morais Sato
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
| | - Marcia Thereza Couto
- Department of Preventive Medicine, Medical School, University of São Paulo, Avenida Doutor Arnaldo 455, 01246-903, São Paulo, Brazil.
| | - Jonathan Wells
- Pop, Policy & Practice Program, UCL Great Ormond Street Institute of Child Health, London, WC1N1EH, United Kingdom.
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
| | - Delanjathan Devakumar
- Institute for Global Health, University College of London, London, WC1N1EH, United Kingdom.
| | - Fernanda Baeza Scagliusi
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
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Bryant J, Waller AE, Cameron EC, Sanson-Fisher RW, Hure AJ. Receipt of information about diet by pregnant women: A cross-sectional study. Women Birth 2018; 32:e501-e507. [PMID: 30559008 DOI: 10.1016/j.wombi.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 01/12/2023]
Abstract
PROBLEM Given the influence of diet on infant and maternal health outcomes, adequate knowledge about nutrition during pregnancy is critical. AIMS To examine among women receiving antenatal care the proportion who: (1) believe information about diet should be provided as part of routine antenatal care; (2) recall receiving advice about diet as part of care including: (a) when information was provided, (b) the healthcare provider who gave information, and (c) the format in which it was provided; and (3) attitudes towards information received. METHODS A cross-sectional survey was conducted with women attending a public antenatal clinic in New South Wales, Australia. Women were eligible to participate if they were: pregnant or had given birth in the previous 10 weeks; ≥18 years; and had at least one prior antenatal appointment for their current pregnancy. FINDINGS A total of 223 women (64% consent rate) participated. While the majority (86%) believed healthcare providers should be giving dietary information to pregnant women, only 63% recalled receiving information during their current pregnancy. Most often it was given by a midwife (76%). Information was initially provided in the first (52%) or second (38%) trimester, in both written and verbal form (60%). Approximately one third of participants felt overwhelmed or confused by which foods should be avoided during pregnancy. CONCLUSIONS A third of women did not recall receiving advice about diet as part of routine antenatal care. There is a need to develop a pathway to provide women with reliable, comprehensive advice about diet early in pregnancy.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Amy E Waller
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Emilie C Cameron
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rob W Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alexis J Hure
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Priority Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, New South Wales, Australia
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Nichols SF, Galesloot S, Bondarianzadeh D, Buhler S. Dietary Changes Albertan Women Make During Pregnancy: Thematic Analysis of Self-reported Changes and Reasons. CAN J DIET PRACT RES 2018; 80:39-43. [PMID: 30280925 DOI: 10.3148/cjdpr-2018-031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE To explore dietary changes Albertan women make during pregnancy, reasons they make changes, and alignment with prenatal nutrition recommendations. METHODS Women up to 6 months postpartum were recruited in public health centres and Primary Care Networks. Qualitative data were collected through a self-administered survey including 2 open-ended questions that asked about changes made to food/beverage intake during pregnancy and why these changes were made. RESULTS A majority (n = 577) of the 737 women completing the survey described changes they made to their food/beverage intake during pregnancy and 193 respondents provided reasons for these changes. Increased intake of fruits/vegetables, meat, milk, and their alternatives (n = 600); limiting or avoidance of foods/beverages known to be harmful during pregnancy (n = 445); and increased food/fluid intake or meal/snack frequency (n = 405) were commonly reported dietary changes. Motivations relating to health and to control physiological changes/manage health conditions were the most frequent reasons provided. CONCLUSIONS Women make diverse dietary changes and have various motivations for food choices during pregnancy. A majority make dietary changes to support a healthy pregnancy. However, the motivation to control discomforts and respond to hunger and thirst sensations reflect a stronger influencer on women's choices than is currently addressed in prenatal nutrition messages.
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Affiliation(s)
| | - Suzanne Galesloot
- Alberta Health Services, Calgary, AB.,Alberta Health Services, Calgary, AB
| | | | - Susan Buhler
- Alberta Health Services, Calgary, AB.,Alberta Health Services, Calgary, AB
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Online nutrition information seeking among Australian primigravid women. Midwifery 2018; 58:37-43. [DOI: 10.1016/j.midw.2017.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 11/16/2017] [Accepted: 12/06/2017] [Indexed: 11/18/2022]
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Storr T, Maher J, Swanepoel E. Online nutrition information for pregnant women: a content analysis. MATERNAL & CHILD NUTRITION 2017; 13:e12315. [PMID: 27353248 PMCID: PMC6865949 DOI: 10.1111/mcn.12315] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 11/30/2022]
Abstract
Pregnant women actively seek health information online, including nutrition and food-related topics. However, the accuracy and readability of this information have not been evaluated. The aim of this study was to describe and evaluate pregnancy-related food and nutrition information available online. Four search engines were used to search for pregnancy-related nutrition web pages. Content analysis of web pages was performed. Web pages were assessed against the 2013 Australian Dietary Guidelines to assess accuracy. Flesch-Kincaid (F-K), Simple Measure of Gobbledygook (SMOG), Gunning Fog Index (FOG) and Flesch reading ease (FRE) formulas were used to assess readability. Data was analysed descriptively. Spearman's correlation was used to assess the relationship between web page characteristics. Kruskal-Wallis test was used to check for differences among readability and other web page characteristics. A total of 693 web pages were included. Web page types included commercial (n = 340), not-for-profit (n = 113), blogs (n = 112), government (n = 89), personal (n = 36) and educational (n = 3). The accuracy of online nutrition information varied with 39.7% of web pages containing accurate information, 22.8% containing mixed information and 37.5% containing inaccurate information. The average reading grade of all pages analysed measured by F-K, SMOG and FOG was 11.8. The mean FRE was 51.6, a 'fairly difficult to read' score. Only 0.5% of web pages were written at or below grade 6 according to F-K, SMOG and FOG. The findings suggest that accuracy of pregnancy-related nutrition information is a problem on the internet. Web page readability is generally difficult and means that the information may not be accessible to those who cannot read at a sophisticated level. © 2016 John Wiley & Sons Ltd.
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Affiliation(s)
- Tayla Storr
- School of Health and Sports Science, Faculty of Science, Health, Engineering and EducationUniversity of the Sunshine CoastSippy DownsQueensland Australia
| | - Judith Maher
- School of Health and Sports Science, Faculty of Science, Health, Engineering and EducationUniversity of the Sunshine CoastSippy DownsQueensland Australia
| | - Elizabeth Swanepoel
- School of Health and Sports Science, Faculty of Science, Health, Engineering and EducationUniversity of the Sunshine CoastSippy DownsQueensland Australia
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McNaughton SA. Advancing nutrition promotion research and practice. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah A. McNaughton
- Centre for Physical Activity and Nutrition Research; School of Exercise and Nutrition Sciences; Deakin University
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