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Witte Castro A, Zozaya C, Ruvira S, Arribas SM, López-Giménez MR, Ramiro-Cortijo D. Online pilot intervention to improve nutritional and lifestyle in Spanish breast-feeding women. NUTR HOSP 2024; 41:619-627. [PMID: 38047426 DOI: 10.20960/nh.04846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Introduction Introduction: breastfeeding women often cannot adequately follow dietary and healthy habits recommendations. In addition, after delivery, their care is usually focused on the newborn and the mother´s health may be neglected. The Mediterranean Diet is the standard of healthy eating, with the Healthy Food Pyramid (HFP) being its graphic representation. Objective: the aim of this study was to determine whether a nutritional and lifestyle online intervention may improve HFP adherence in breastfeeding women. Methods: a total of 181 breastfeeding women in the first sixth months postpartum were enrolled in a non-randomized interventional pilot study. These women answered three questionnaires: sociodemographic and for adherence to Healthy Food Pyramid (APQ), before and after an online intervention for 13 weeks, providing information about nutrition and healthy habits. The APQ ranges from 0 to 10, with higher scores corresponding to greater adherence to HFP. The intervention consisted of lifestyle and nutritional information, which was provided through e-mail. Results: a low adherence to HFP was found, which was improved after 13 weeks of intervention. The online intervention significantly increased the scores for physical activity, grain, seeds and legumes consumption, olive oil use, dairy products, and ani-mal proteins, as well as the HFP adherence global score. The adjusted models showed that the online intervention was associated with adherence to the HFP and physical activity. Conclusion: we conclude that an online intervention for breastfeeding women had an impact on their lifestyle, improving nutritional and healthy habits, and can be a useful tool to monitor their health status. Given the importance of this stage for women and their newborns, this is an aspect postnatal healthcare professionals should consider.
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Affiliation(s)
- Ariadna Witte Castro
- Department of Preventive Medicine, Public Health and Microbiology. Facultad de Me-dicina. Universidad Autónoma de Madrid
| | - Carlos Zozaya
- Department of Neonatology. Hospital Universitario La Paz
| | - Santiago Ruvira
- Department of Physiology. Facultad de Medicina. Universidad Autónoma de Madrid
| | - Silvia M Arribas
- Department of Physiology. Facultad de Medicina. Universidad Autónoma de Madrid
| | - María Rosario López-Giménez
- Department of Preventive Medicine, Public Health and Microbiology. Facultad de Me-dicina. Universidad Autónoma de Madrid
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Benson J, DeVries M, McLaurin-Jiang S, Garner CD. Experiences accessing nutritious foods and perceptions of nutritional support needs among pregnant and post-partum mothers with low income in the United States. MATERNAL & CHILD NUTRITION 2024:e13660. [PMID: 38812121 DOI: 10.1111/mcn.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 04/05/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
Access to nutritious foods, a social determinant of health, contributes to disparities in maternal and infant health outcomes such as mental health, breastfeeding intensity and cardiometabolic risk. This study explored perceived nutrition access and intake among pregnant or post-partum women eligible for Medicaid. Qualitative, semistructured interviews were conducted with 18 women who were either currently pregnant (n = 4) or up to 12 months post-partum (n = 14) in 2021-2022. Mothers spoke English (n = 11) or Spanish (n = 7) and lived in the Texas Panhandle. Interviews were audio-recorded, transcribed, translated (Spanish to English) and verified. Two or more researchers coded each interview until consensus was reached using thematic analysis with ATLAS.ti software. The study revealed five drivers for nutrition access. (1) Social factors influenced nutrition; those with less support expressed limited ability to eat healthfully. (2) The Women, Infants and Children program was perceived as a helpful resource for some, while others faced challenges obtaining it. (3) Stress was bidirectionally related to unhealthy food choices, with food sometimes used as a coping mechanism. (4) Mothers prioritized their babies and others and had limited ability and time to prepare healthy meals. (5) Most participants felt they received inadequate nutrition guidance from their healthcare providers. Participants provided positive responses to a proposed nutritious home-delivered meal intervention. Low-income women may experience nutritional challenges specific to this life stage. Interventions that reduce stress and burden of household tasks (e.g. cooking) and improve education and access to nutritious foods may improve mothers' ability to consume nutritious foods.
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Affiliation(s)
- Jessie Benson
- School of Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
| | - Matthew DeVries
- School of Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
- Phoenix Children's Pediatric Residency Program Alliance, Phoenix, Arizona, USA
| | - Skye McLaurin-Jiang
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
| | - Christine D Garner
- InfantRisk Center, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Amarillo, Texas, United States
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Horn CE, Seely EW, Levkoff SE, Isley BC, Nicklas JM. Postpartum women's experiences in a randomized controlled trial of a web-based lifestyle intervention following Gestational Diabetes: a qualitative study. J Matern Fetal Neonatal Med 2023; 36:2194012. [PMID: 36977603 DOI: 10.1080/14767058.2023.2194012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is associated with an increased maternal risk for the development of type 2 diabetes (T2DM). We previously demonstrated in a randomized trial that a web-based postpartum lifestyle intervention program, Balance After Baby, increased weight loss among postpartum women with recent pregnancies complicated by GDM. The aim of this analysis is to identify the impact of the intervention on study participants as assessed by exit interviews after completion of the 12 month study. METHODS We conducted structured exit interviews created with a concurrent-contextual design with subjects randomized to the intervention group at the conclusion of their participation (∼12 months) in the Balance After Baby study, with the objectives of 1) understanding the impact of the intervention on participants and their family members, 2) identifying which program components were most and least helpful, and 3) identifying the perceived best timing for diabetes prevention interventions in postpartum women with recent GDM. RESULTS Seventy-nine percent (26/33) of eligible intervention participants participated in interviews. Participants noted changes in diet and physical activity as a result of the intervention. Several components of the intervention, particularly the online modules and support from the lifestyle coach, were perceived by intervention participants to have had a positive effect on personal and familial lifestyle change, while other components were less utilized, including the community forum, YMCA memberships, and pedometers. Nearly all participants felt that the timing in the intervention study, beginning about 6 weeks postpartum, was ideal. DISCUSSION Results of this study identify the importance of individualized coaching, impact on family members, and demonstrate that postpartum women feel ready to make changes by 6 weeks postpartum. Findings from this study will help inform the development of future technologically-based lifestyle interventions for postpartum women with recent GDM.
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Affiliation(s)
- Christine E Horn
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ellen W Seely
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sue E Levkoff
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Breanna C Isley
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Jacinda M Nicklas
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Dempsey K, Mottola MF, Atkinson SA. Comparative Assessment of Diet Quality and Adherence to a Structured Nutrition and Exercise Intervention Compared with Usual Care in Pregnancy in a Randomized Trial. Curr Dev Nutr 2023; 7:100097. [PMID: 37441683 PMCID: PMC10334218 DOI: 10.1016/j.cdnut.2023.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 07/15/2023] Open
Abstract
Background In trials testing the efficacy of diet and exercise modifications during pregnancy on health outcomes, assessment of participant adherence to interventions of diet and exercise is rarely reported, with few standard methods existing to measure adherence. Objective We aimed to assess the maternal diet quality and create an algorithm to evaluate adherence to an intervention of high protein/dairy nutrition and walking exercise from early pregnancy to birth. Methods In Be Healthy in Pregnancy randomized trial (NCT01693510), diet quality was measured using scores from an adapted PrimeScreen food frequency questionnaire, nutrient intake assessed by 3-day diet records, and physical activity using accelerometry at 14-17 (early), 26-28 (middle), and 36-38 (late) weeks' gestation. A novel adherence score was derived by combining data for compliance with prescribed protein and energy intakes and daily step counts in the intervention group. Between-group diet quality scores and changes in adherence scores in the intervention group across pregnancy were analyzed using generalized estimating equations adjusted for prepregnancy body mass index and study site. Results Diet scores were similar for intervention (n = 55) and control (n = 56) groups at baseline but only the intervention group significantly improved and maintained their scores from early to middle (18.7 ± 7.6 vs. 22.9 ± 6.1; P < 0.001) and late (22.5 ± 6.9; P < 0.008) pregnancy. Protein intake was significantly (P < 0.001) higher but energy intakes were similar in the intervention group compared with those in the control group. Adherence scores for the intervention increased significantly (P < 0.01) from early (1.52 ± 0.70) to midpregnancy (1.89 ± 0.82) but declined from midpregnancy to late (1.55 ± 0.78; P < 0.0005) pregnancy primarily owing to lower step counts. Conclusions Adherence to an intervention may decline toward the end of pregnancy, particularly in maintaining physical activity. Creation of adherence scores is a feasible approach to measure combined intervention compliance for diet and physical activity and may increase transparency in interpreting results of randomized trials in pregnancy.This trial was registered at clinicaltrials.gov as NCT01689961 (https://clinicaltrials.gov/ct2/show/NCT01689961?cond=NCT01689961&rank=1; registered on 21 September 2012).
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Affiliation(s)
- Kendra Dempsey
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Michelle F. Mottola
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
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Kumari A, Ranjan P, Vikram NK, Kaur D, Balsarkar G, Malhotra A, Puri M, Batra A, Madan J, Tyagi S, Guleria K, Dabral A, Sarkar S, Nigam A, Anwar W, Kamath S, Bhatla N, Kumari SS, Kumar R, Choranur A, Venkataraman S, Kaur T, Rathore AM, Kaloiya GS, Prakash A, Tiwaskar M, Verma A, Singh R, Sharma KA, Baitha U, Tewary K, Misra A, Guleria R. Evidence and consensus-based clinical practice guideline for the management of obesity and overweight in postpartum women: An AIIMS-DST initiative. J Family Med Prim Care 2023; 12:812-855. [PMID: 37448937 PMCID: PMC10336934 DOI: 10.4103/jfmpc.jfmpc_45_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 07/18/2023] Open
Affiliation(s)
- Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K. Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Divjyot Kaur
- Department of Home Science, University of Delhi, Delhi, India
| | - Geetha Balsarkar
- Department of Obstetrics and Gynaecology, Seth G. S. Medical College, Mumbai, Maharashtra, India
| | - Anita Malhotra
- Department of Home Science, University of Delhi, Delhi, India
| | - Manju Puri
- Director Professor and Head, Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India
| | - Achla Batra
- President, Association of Obstetricians and Gynaecologists of Delhi (AOGD), New Delhi, India
- Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Jagmeet Madan
- National President, Indian Dietetic Association, New Delhi, India
| | - Shakun Tyagi
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
| | - Anjali Dabral
- Professor and Head, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Aruna Nigam
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences & Research, New Delhi, India
| | - Wareesha Anwar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sandhya Kamath
- Former Dean, LT Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
- Former Dean, Seth G. S. Medical College, and KEM Hospital, Mumbai, Maharashtra, India
| | - Neerja Bhatla
- Professor and Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S. Shantha Kumari
- President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Raman Kumar
- President, Academy of Family Physicians of India, India
- President, World Organization of Family Doctors (WONCA), New Delhi, India
| | | | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Tanveer Kaur
- Department of Psychology, University of Delhi, Delhi, India
| | - Asmita Muthal Rathore
- Director Professor and Head, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Gauri Shankar Kaloiya
- Department of Clinical Psychology and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Prakash
- Department of Medicine, LHMC and SSK Hospital, New Delhi, India
| | | | - Archana Verma
- Vice President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Rakhi Singh
- The Federation of Obstetric and Gynaecological Societies of India, India
| | - K Aparna Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamlesh Tewary
- President, Association of the Physicians of India, India
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India
- Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India
- President, Diabetes Foundation (India) (DFI), New Delhi, India
| | - Randeep Guleria
- Director, All India Institute of Medical Sciences, New Delhi, India
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6
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Ruby E, McDonald SD, Berger H, Melamed N, Li J, Darling EK, Barrett J, G Ray J, Geary M, Murray-Davis B. Exploring patients' perspectives of gestational diabetes mellitus screening and counselling in Ontario: A grounded theory study. Health Expect 2023; 26:827-835. [PMID: 36651675 PMCID: PMC10010101 DOI: 10.1111/hex.13708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/29/2022] [Accepted: 01/07/2023] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. Approaches to screening for GDM continue to evolve, introducing potential variability of care. This study explored the impact of these variations on GDM counselling and screening from the perspectives of pregnant individuals. METHODS Following a Corbin and Strauss approach to qualitative, grounded theory we recruited 28 individuals from three cities in Ontario, Canada who had a singleton pregnancy under the care of either a midwife, family physician or obstetrician. Convenience and purposive sampling techniques were used. Semi-structured telephone interviews were conducted and transcribed verbatim between March and December 2020. Transcripts were analysed inductively resulting in codes, categories and themes. RESULTS Three themes were derived from the data about GDM screening and counselling: 'informing oneself', 'deciding' and 'screening'. All participants, regardless of geographical region, or antenatal care provider, moved through these three steps during the GDM counselling and screening process. Differences in counselling approaches between pregnancy care providers were noted throughout the 'informing' and 'deciding' stages of care. Factors influencing these differences included communication, healthcare autonomy and patient motivation to engage with health services. No differences were noted within care provider groups across the three geographic regions. Participant experiences of GDM screening were influenced by logistical challenges and personal preferences towards testing. CONCLUSION Informing oneself about GDM may be a crucial step for facilitating decision-making and screening uptake, with an emphasis on information provision to facilitate patient autonomy and motivation. PATIENT OR PUBLIC CONTRIBUTION Participants of our study included patients and service users. Participants were actively involved in the study design due to the qualitative, patient-centred nature of the research methods employed. Analysis of results was structured according to the emergent themes of the data which were grounded in patient perspectives and experiences.
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Affiliation(s)
- Emma Ruby
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Sarah D McDonald
- Departments of Obstetrics and Gynecology Radiology and Clinical Epidemiology and Biostatistics, Division of Maternal-Fetal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Howard Berger
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nir Melamed
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jenifer Li
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth K Darling
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Jon Barrett
- Departments of Obstetrics and Gynecology Radiology and Clinical Epidemiology and Biostatistics, Division of Maternal-Fetal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Joel G Ray
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Michael Geary
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - Beth Murray-Davis
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
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Ozcan S. Does the postpartum body image of primiparous women giving vaginal delivery affect their sexual functions and depression and fatigue levels? Health Care Women Int 2023; 45:495-511. [PMID: 36943288 DOI: 10.1080/07399332.2023.2190980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Abstract
The body image-related problems can negatively affect women's lives in many ways. The study was aimed at investigating the effects of postpartum body image on sexual functions, and fatigue and depression levels of primiparous women who gave birth vaginally. This cross-sectional study was conducted with 133 women who presented to the obstetrics and gynecology clinics of a state hospital in Turkey between June 2021 and December 2021. At the end of the study, a moderate relationship was determined between the women's body image and their depression (r = 0.500; p < 0.001) and fatigue (r = 0.666; p < 0.001) levels, and a weak relationship between their body image and sexual functions (r = -0.372; p < 0.001). According to the backward regression model used in the study, the women's fatigue and education levels accounted for their body image by 45.7%.
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Affiliation(s)
- Sadiye Ozcan
- Faculty of Health Sciences, Department of Obstetrics & Gynecological Nursing, Yalova University, Yalova, Turkey
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8
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Matsuda K, Shiraishi M, Hori N, Horiguchi H, Matsuzaki M. Psychosocial Experiences Related to Dietary Behavior of Japanese Lactating Women: A Qualitative Study. Nutrients 2023; 15:nu15030789. [PMID: 36771501 PMCID: PMC9920491 DOI: 10.3390/nu15030789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/19/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Adequate dietary intake during the lactation period is important for breast milk components, postpartum recovery, and physical and mental health. This study aimed to clarify the psychosocial experiences related to dietary behavior around one month postpartum among Japanese lactating women. Semi-structured interviews were conducted with 18 women between February and June 2022 in Osaka, Japan. The data were analyzed using qualitative descriptive approaches. Four core categories were identified. All participants had a [desire to have healthy meals for themselves or their families] to improve their postpartum health, regain their pre-pregnancy body shape, produce sufficient and good-quality breast milk, and keep their families healthy. Some participants, who had [subjective difficulties in getting information on diet and preparing meals] due to insufficient or complicated information and viewing meal preparation as a burden, used [services and support regarding their postpartum diet] to alleviate these difficulties. They had [postpartum-specific appetite and dietary views], including an increased appetite triggered by breastfeeding and postpartum stress and the effects of the dietary changes during pregnancy. Some of these psychosocial experiences were influenced by Japanese traditional customs in the postpartum period and familiar food preferences in the Japanese. Healthcare professionals should consider these experiences when providing tailored dietary guidance.
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Killeen SL, Byrne DF, Geraghty AA, Yelverton CA, van Sinderen D, Cotter PD, Murphy EF, O’Reilly SL, McAuliffe FM. Recruiting and Engaging Women of Reproductive Age with Obesity: Insights from A Mixed-Methods Study within A Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13832. [PMID: 36360712 PMCID: PMC9658053 DOI: 10.3390/ijerph192113832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Engaging women with obesity in health-related studies during preconception is challenging. Limited data exists relating to their participation. The aim of this study is to explore the experiences and opinions of women participating in a weight-related, preconception trial. This is an explanatory sequential (quan-QUAL) mixed-methods Study Within A Trial, embedded in the GetGutsy randomized controlled trial (ISRCTN11295995). Screened participants completed an online survey of eight questions (single or multiple choice and Likert scale) on recruitment, motivations and opinions on study activities. Participants with abdominal obesity (waist circumference ≥ 80 cm) were invited to a subsequent semi-structured, online focus group (n = 2, 9 participants) that was transcribed and analyzed using inductive thematic analysis, with a pragmatic epistemological approach. The survey (n = 102) showed the main research participation motivations were supporting health research (n = 38, 37.3%) and wanting health screening (n = 30, 29.4%). Most participants were recruited via email (n = 35, 34.7%) or social media (n = 15, 14.7%). In the FGs, participants valued flexibility, convenience and. research methods that aligned with their lifestyles. Participants had an expanded view of health that considered emotional well-being and balance alongside more traditional medical assessments. Clinical trialists should consider well-being, addressing the interconnectedness of health and incorporate a variety of research activities to engage women of reproductive age with obesity.
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Affiliation(s)
- Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - David F. Byrne
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Aisling A. Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Cara A. Yelverton
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Douwe van Sinderen
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
- School of Microbiology, National University of Ireland, T12 K8AF Cork, Ireland
| | - Paul D. Cotter
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland
| | - Eileen F. Murphy
- Precision Biotics Ltd. (Novozymes Cork), Cork Airport Business Park, Kinsale Road, T12 D292 Cork, Ireland
| | - Sharleen L. O’Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
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Arranz-Martín B, Navarro-Brazález B, Sánchez-Sánchez B, McLean L, Carazo-Díaz C, Torres-Lacomba M. The Impact of Hypopressive Abdominal Exercise on Linea Alba Morphology in Women Who Are Postpartum: A Short-Term Cross-Sectional Study. Phys Ther 2022; 102:6652576. [PMID: 35908286 DOI: 10.1093/ptj/pzac086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/13/2022] [Accepted: 05/06/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the acute effect of an abdominal hypopressive exercise (AHE) on linea alba morphology among women who are primiparous and to compare this effect with that of other common abdominal exercise modalities. METHODS A cross-sectional study of 46 women 3 months after first delivery was conducted. B-mode ultrasound imaging of the interrectus distance (IRD) and linea alba distortion was performed 2 cm below (I-point) and above (S-point) the umbilicus and at the mid-point between the umbilicus and xiphoid process (X-point). Images were recorded at rest and during an AHE performed in a supine position, a semi curl-up (SCU), an abdominal drawing-in maneuver (ADIM), and a SCU performed after an initial ADIM (ADIM+SCU). RESULTS The SCU exercise narrowed the IRD at the X- and S-points. Compared with SCU, AHE and ADIM widened the IRD at the S- and X-points. No significant differences were found when comparing the IRD at rest, during AHE and during ADIM, but AHE tended to narrow I-point IRD more than ADIM but to widen S-point IRD more than ADIM+SCU. No participant showed linea alba distortion during the AHE or ADIM. When compared, SCU increased the occurrence of distortion with respect to AHE and ADIM. The isolated hypopressive posture did not change the IRD or linea alba distortion. CONCLUSION Among women who were postpartum, AHE seemed to narrow IRD below the umbilicus compared with ADIM without either of these 2 modalities generating linea alba distortion, as SCU or ADIM+SCU does. Thus, although no significant differences were found when comparing the IRD at rest and during AHE, the AHE could improve the tensile response of the linea alba without increasing the IRD. IMPACT This is believed to be the first study to describe linea alba changes during AHE in women who are postpartum. AHE and ADIM seem to show different effects on infraumbilical IRD. The lack of distortion suggests that linea alba may undergo tensile loading at all levels.
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Affiliation(s)
- Beatriz Arranz-Martín
- Physiotherapy in Women's Health Research Group (FPSM), Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Beatriz Navarro-Brazález
- Physiotherapy in Women's Health Research Group (FPSM), Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Beatriz Sánchez-Sánchez
- Physiotherapy in Women's Health Research Group (FPSM), Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Linda McLean
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Carmen Carazo-Díaz
- Applied Statistical Methods in Medical Research Group, Catholic University of Murcia (UCAM), Murcia, Spain
| | - María Torres-Lacomba
- Physiotherapy in Women's Health Research Group (FPSM), Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
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11
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Newson L, Bould K, Aspin‐Wood B, Sinclair L, Ikramullah Z, Abayomi J. The lived experiences of women exploring a healthy lifestyle, gestational weight gain and physical activity throughout pregnancy. Health Expect 2022; 25:1717-1729. [PMID: 35514097 PMCID: PMC9327828 DOI: 10.1111/hex.13514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Weight gain is inevitable during pregnancy. However, high prepregnancy body mass index and excessive gestational weight gain are associated with poor pregnancy outcomes. Understanding the experiences, social influences and decisions women make to maintain a healthy lifestyle during pregnancy are essential to consider how to improve services and interventions to help women engage in a healthy diet and physical activity (PA) behaviours. OBJECTIVE The study investigated women's opinions and lived experiences of engaging in a healthy diet, promoting optimal gestational weight gain and PA during and after pregnancy. DESIGN AND METHODS Twenty-two pregnant women contributed to qualitative data collection for this Grounded Theory (GT) study. Nineteen women completed semi-structured interviews and three patient and public involvement (PPI) representatives sought to validate the analysis and GT framework. RESULTS Two substantive categories were constructed: (1) Evolving from 'I' to 'we', as informed by two subcategories and (2) the power of information and guidance, as informed by three subcategories. These categories informed the core category, 'A navigational journey and evolution of the pregnant self'. The navigational journey involves constantly searching for knowledge and information to support and balance the interests of personal beliefs, the health of their unborn baby, their social circle and the wider world. A woman's psychological capability (e.g., their knowledge of a healthy lifestyle and confidence to implement such knowledge) is continuously tested. CONCLUSIONS Pregnancy may create a 'teachable moment' but there is a need for appropriate guidance from professionals to assist with lifestyle choices during pregnancy. The findings showed a significant influence of online resources, and lack of guidance on behaviour during pregnancy and may highlight areas of focus for future research and intervention. PUBLIC CONTRIBUTION Three pregnant women were recruited to act as PPI representatives to assist with the validation of the analytical findings and aid the final theoretical saturation of the GT framework. Commentary from these PPI representatives was used to validate the analysis and support the interpretation of the data. In addition, these PPI representatives were also invited to provide commentary on the draft manuscript and those involved in this later process have been included as coauthors.
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Affiliation(s)
- Lisa Newson
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Kathryn Bould
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Bronte Aspin‐Wood
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Lauren Sinclair
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Zainab Ikramullah
- Patient and Public Involvement Representative, Member of the PublicServiceuser of Mamafit interventionLiverpoolUK
| | - Julie Abayomi
- School of Applied Health and Social Care, Faculty of Health, Social Care and MedicineEdge Hill UniversityOrmskirkUK
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12
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Peralta LR, Yager Z, Prichard I. Practice-based evidence: Perspectives of effective characteristics of Australian group-based physical activity programs for postpartum women. Health Promot J Austr 2022; 33:891-903. [PMID: 34839546 DOI: 10.1002/hpja.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Many postpartum women often do not achieve recommendations of at least 150 minutes moderate-to-vigorous physical activity (MVPA) each week. Previous qualitative work has focused on postpartum women's barriers and challenges to being active, with recent research starting to explore the characteristics of PA programs and women who are active during the postpartum period. Yet, little research has focused on the characteristics of key stakeholders and community organisations that support women to sustain their PA engagement during the postpartum period. METHODS This research generates practice-based evidence to provide essential insights for effective implementation, strategies and actions of community group-based PA programs that recruit and retain postpartum women to ensure future interventions are scalable and sustainable. Ten participants (90% female), ranging in age from 34 to 40 years, were recruited from nine community organisations/businesses. The ten participants engaged in semi-structured interviews for an average length of 31 minutes. RESULTS Inductive thematic analysis revealed four overarching themes (i) effective practitioners have a history of, and passion for women's health and PA; (ii) low-cost, connected approaches attract postpartum women into community group-based PA programs; (iii) inclusive, flexible, varied, and holistic approaches sustain postpartum women's participation; and (iv) utilise connections to overcome barriers to community group-based PA programs. These four themes were informed by twelve sub-themes relating to the background of stakeholders and practitioners and the approaches that they use to attract and sustain postpartum women in community group-based PA programs. CONCLUSIONS Practice-based findings should inform future practices and the development of future real-world group-based PA interventions for postpartum women. SO WHAT?: Specifically, interventions will need to be designed and implemented by practitioners who have a history of, and passion for women's health and PA, be low-cost, connected approaches, that are inclusive, flexible, varied, and holistic that prioritise physical, emotional, and social wellbeing.
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Affiliation(s)
- Louisa R Peralta
- School of Education and Social Work, Faculty of Education and Social Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Ivanka Prichard
- Health & Exercise Sciences, College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Kaur D, Ranjan P, Kumari A, Malhotra A, Kaloiya GS, Meena VP, Sethi P, Vikram NK. Awareness, Beliefs and Perspectives Regarding Weight Retention and Weight Gain among Postpartum Women in India: A Thematic Analysis of Focus Group Discussions and In-Depth Interviews. J Obstet Gynaecol India 2022; 72:168-174. [PMID: 35313546 PMCID: PMC8927526 DOI: 10.1007/s13224-022-01644-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background and Aims The pregnancy weight is usually retained in the form of abdominal fat during the postpartum period. The willingness to lose weight is influenced by knowledge, attitude, beliefs and practices. This study aims to comprehend the awareness, beliefs and perspectives of postpartum women regarding their perceived factors, barriers and facilitators associated with post-pregnancy weight status. Methods Overweight and obese postpartum women aged between 20 and 40 years and had delivered an infant in the last 2 years were recruited via convenience and purposive sampling techniques. The final sample comprised 27 participants with a mean age of 29.96 ± 4.50 years. Four focus group discussions and eight in-depth interviews carried out were audio-recorded and transcribed verbatim. Codes, sub-themes and themes were generated using Atlas.ti 9 software. Results Major themes identified were perceived factors causing postpartum weight retention/weight gain including social and cultural beliefs related to diet and exercise specifically associated with this period, perceived motivators and deterrents of weight loss including eagerness to lose weight and perceived facilitators and barriers to weight loss including intrinsic and extrinsic factors such as time, energy, evidence-based knowledge about diet and physical activity, family support and obligation to family’s advice. Conclusion The unique challenges and barriers associated with postpartum weight loss efforts should be taken into consideration by healthcare professionals and public health policy-makers to design strategies specific to postpartum women. Supplementary Information The online version contains supplementary material available at 10.1007/s13224-022-01644-9.
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Affiliation(s)
- Divjyot Kaur
- Department of Home Science, University of Delhi, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, New Delhi, India
| | - Gauri Shankar Kaloiya
- Department of Psychiatry & National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Ved Prakash Meena
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Prayas Sethi
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Naval K. Vikram
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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14
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Kumari A, Ranjan P, Vikram NK, Kaur D, Balsalkar G, Malhotra A, Puri M, Batra A, Madan J, Tyagi S, Guleria K, Dabral A, Sarkar S, Nigam A, Anwar W, Kamath S, Bhatla N, Kumari SS, Kumar R, Choranur A, Venkataraman S, Kaur T, Rathore AM, Kaloiya G, Prakash A, Tiwaskar M, Verma A, Singh R, Sharma KA, Baitha U, Tewary K, Misra A, Guleria R. Executive summary of evidence and consensus-based clinical practice guideline for management of obesity and overweight in postpartum women: An AIIMS-DST initiative. Diabetes Metab Syndr 2022; 16:102425. [PMID: 35248972 DOI: 10.1016/j.dsx.2022.102425] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Postpartum obesity is a public health concern. There is a need to counsel women about their postpartum weight management, accounting for various barriers they face. Limited literature in the Indian context underscored the need to develop the clinical practice guideline to be used by healthcare providers in Indian healthcare settings. METHODS The guideline was formulated by following the standardised methodology proposed by the National Health and Medical Research Council. Various steps such as identification of the patient population, assembly of the guideline development groups, identification of the key clinical questions, guideline development methods, grading the quality of evidence and recommendations and guideline translation were carried out to develop and validate the clinical practice recommendations. RESULTS The evidence and consensus-based clinical practice guideline has been developed, providing recommendations for key topics of interest for first-line treatment of obesity (lifestyle-related management). Recommendations focus on screening and initiating discussion with overweight and obese postpartum women as well as those who had normal pre-pregnancy body mass index but have retained excessive weight in the postpartum period. Recommendations highlight the evaluation and management of dietary, physical activity and breastfeeding behaviour. Recommendations also account for behavioural modification techniques to improve adherence to the prescribed weight management advice. Duration and frequency of follow-ups as well as the advice to be disseminated have also been discussed in the recommendations. CONCLUSION The guideline provides clinical practice points that can be used by healthcare providers, postpartum women and policymakers for opportunistic screening and management of postpartum obesity.
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Affiliation(s)
- Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Divjyot Kaur
- Department of Home Science, University of Delhi, New Delhi, India
| | - Geetha Balsalkar
- Department of Obstetrics and Gynaecology, Seth G. S. Medical College, Mumbai, India
| | - Anita Malhotra
- Food and Nutrition, Department of Home Science, Vice-principal, Lakshmibai College, University of Delhi, New Delhi, India
| | - Manju Puri
- Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India
| | - Achla Batra
- President, Association of Obstetricians and Gynaecologists of Delhi (AOGD), Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | | | - Shakun Tyagi
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
| | - Anjali Dabral
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Aruna Nigam
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences & Research, New Delhi, India
| | - Wareesha Anwar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sandhya Kamath
- Seth G S Medical College and KEM Hospital, Mumbai, LT Municipal Medical College and General Hospital, Mumbai, India
| | - Neerja Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S Shantha Kumari
- The Federation of Obstetric and Gynaecological Societies of India, India
| | - Raman Kumar
- Academy of Family Physicians of India, India
| | - Ambuja Choranur
- President, Indian Menopause Society, Former Professor and Head, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, India
| | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Tanveer Kaur
- Department of Psychology, University of Delhi, New Delhi, India
| | - Asmita Muthal Rathore
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Gaurishankar Kaloiya
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Prakash
- Department of Medicine, LHMC and SSK Hospital, New Delhi, India
| | | | - Archana Verma
- The Federation of Obstetric and Gynaecological Societies of India, India
| | - Rakhi Singh
- Endocrinology Committee, The Federation of Obstetric and Gynaecological Societies of India, India
| | - K Aparna Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamlesh Tewary
- All India Institute of Medical Sciences, New Delhi, India
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and President, Diabetes Foundation (India), New Delhi, India
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15
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How Do Health Schemas Inform Healthy Behaviours During Pregnancy? Qualitative Findings from the Be Healthy in Pregnancy (BHIP) Study. Matern Child Health J 2022; 26:1861-1870. [PMID: 35217935 DOI: 10.1007/s10995-022-03385-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
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.
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16
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Versele V, Stok FM, Dieberger A, Deliens T, Aerenhouts D, Deforche B, Bogaerts A, Devlieger R, Clarys P. Determinants of Changes in Women's and Men's Physical Activity and Sedentary Behavior across the Transition to Parenthood: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042421. [PMID: 35206608 PMCID: PMC8878758 DOI: 10.3390/ijerph19042421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Becoming a parent may cohere with drastic changes in physical activity (PA) and sedentary behavior (SB). A clear understanding of determinants of changes in PA and SB during pregnancy and postpartum is needed to facilitate the development of tailored family-based interventions. METHODS Thirteen focus group discussions targeting determinants of changes in PA and SB behavior were conducted, involving a total of 74 expecting and first-time parents. A semi-structured question guide was used to facilitate the discussions. RESULTS Four main levels of determinants were identified: the individual (including psychological, situational and biological determinants), interpersonal, environmental and policy level. Some determinants were mentioned to be a barrier (e.g., "barriers to self-care") while others were a facilitator (e.g., "weight control"). Determinants were related to both PA and SB and applicable during pregnancy as well as postpartum (e.g., "self-regulation"), or only related to one behavior and/or one period (e.g., "feeding baby"). Some were described by both parents (e.g., "parenthood perceptions"), whereas others were mentioned by women (e.g., "PA knowledge") or men (e.g., "time opportunities") only. CONCLUSIONS Focus should be given to interventions aimed at improving parents' self-regulation skills and support on how to cope with interpersonal and situational constraints as well as parenthood perceptions.
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Affiliation(s)
- Vickà Versele
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (T.D.); (D.A.); (B.D.); (P.C.)
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (A.B.); (R.D.)
- Correspondence:
| | - Femke Marijn Stok
- Department of Interdisciplinary Social Science, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands;
| | - Anna Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria;
| | - Tom Deliens
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (T.D.); (D.A.); (B.D.); (P.C.)
| | - Dirk Aerenhouts
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (T.D.); (D.A.); (B.D.); (P.C.)
| | - Benedicte Deforche
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (T.D.); (D.A.); (B.D.); (P.C.)
- Department of Public Health and Primary Care, Faculty of Medicine and Health Science, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Annick Bogaerts
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (A.B.); (R.D.)
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Roland Devlieger
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (A.B.); (R.D.)
- Obstetrics and Gynaecology, University Hospitals, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Obstetrics, Gynaecology and Fertility, GZA Campus Wilrijk, Oosterveldlaan 24, 2610 Wilrijk, Belgium
| | - Peter Clarys
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (T.D.); (D.A.); (B.D.); (P.C.)
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17
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'There's Just Something Really Peaceful About It': a Qualitative Exploration of Mothers with Young Children and Engagement in Group-Based Physical Activity Programs. Int J Behav Med 2022; 29:807-819. [PMID: 35175540 PMCID: PMC8853414 DOI: 10.1007/s12529-022-10062-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 11/15/2022]
Abstract
Background Many mothers with young children often do not achieve recommendations of at least 150-min moderate-to-vigorous physical activity (MVPA) each week. Previous qualitative work has generally focused on getting inactive mothers with young children to be active, so the characteristics of women who are active during early postpartum period are not well understood. This research set out to capture the characteristics of mothers with young children who engage in MVPA and how these women manage barriers and harness enablers to sustain in engagement in physical activity (PA) over an extended period. Method Thirty-two participants ranging in age from 27 to 42 years (35.2 ± 4.8), with age of their youngest child ranging from 6 weeks old to 5 years, participated in semi-structured interviews. Results Inductive thematic analysis revealed three overarching themes and fourteen sub-themes relating to the characteristics of active mothers with young children and the engagement and maintenance factors that recruit and sustain these women in group-based physical activity programs. Specifically, mothers with young children relish a welcoming and supportive environment that accommodates babies and young children, is affordable and convenient, focuses on building strength and functionality, and is non-judgmental. Conclusion These findings advance knowledge by providing considerations and recommendations that support intervention and program designers to be able to develop group-based physical activity programs for mothers with young children.
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Atkinson SA, Maran A, Dempsey K, Perreault M, Vanniyasingam T, Phillips SM, Hutton EK, Mottola MF, Wahoush O, Xie F, Thabane L. Be Healthy in Pregnancy (BHIP): A Randomized Controlled Trial of Nutrition and Exercise Intervention from Early Pregnancy to Achieve Recommended Gestational Weight Gain. Nutrients 2022; 14:nu14040810. [PMID: 35215461 PMCID: PMC8879855 DOI: 10.3390/nu14040810] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12–17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. Although the intervention compared to control group was more likely to achieve GWG within recommendations (OR = 1.51; 95% CI (0.81, 2.80)) and total GWG was lower by 1.45 kg (95% CI: (−11.9, 8.88)) neither reached statistical significance. The intervention group achieved significantly higher protein intake at 26–28 week (mean difference (MD); 15.0 g/day; 95% CI (8.1, 21.9)) and 36–38 week gestation (MD = 15.2 g/day; 95% CI (9.4, 21.1)) and higher healthy diet scores (22.5 ± 6.9 vs. 18.7 ± 8.5, p < 0.005) but step counts were similar averaging 6335 steps/day. Pregnancy and infant birth outcomes were similar between groups. While the structured and monitored nutrition with counselling improved diet quality and protein intake and may have benefited GWG, the exercise goal of 10,000 steps/day was unachievable. The results can inform future recommendations for diet and physical activity in pregnancy.
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Affiliation(s)
- Stephanie A. Atkinson
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada; (A.M.); (K.D.); (M.P.)
- Correspondence: ; Tel.: +1-905-521-2100 (ext. 75644)
| | - Atherai Maran
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada; (A.M.); (K.D.); (M.P.)
| | - Kendra Dempsey
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada; (A.M.); (K.D.); (M.P.)
| | - Maude Perreault
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada; (A.M.); (K.D.); (M.P.)
| | - Thuva Vanniyasingam
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada; (T.V.); (L.T.)
| | - Stuart M. Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Eileen K. Hutton
- Midwifery Research Centre, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Michelle F. Mottola
- Department of Anatomy & Cell Biology, School of Kinesiology, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Olive Wahoush
- School of Nursing, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Feng Xie
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada; (T.V.); (L.T.)
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Kochan M, Kabukcuoglu K. 'I wish I had my pre-pregnancy body after birth… but I have to be supported': a theoretical study based on body image perception in working mothers during the postpartum period. J OBSTET GYNAECOL 2022; 42:1103-1111. [PMID: 34989293 DOI: 10.1080/01443615.2021.2006160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The body image of women in the postpartum period can be far from society's idealised body, and this can cause body dissatisfaction. This qualitative study aimed to evaluate the body image perception of women who had started working in the postpartum period, based on the grounded theory research method. A total of 22 face-to-face interviews were conducted with participants who were actively involved in working life and between 3 months and 1 year postpartum. The data were collected through in-depth interviews with a personal information form and semi-structured interview form. Coding created four main categories ('weight fluctuations and body shape', 'body-related perception', 'body-related responses from the environment' and 'body perception improvement process') and eight sub-categories. The results found that the postpartum period is a sensitive one for working women, where they have both positive and negative experiences. Their responsibilities increase, they have little time for themselves and their bodies, they experience body image dissatisfaction, and they expect support from their spouses, families, social circles and health professionals.Impact StatementWhat is already known on this subject? Postpartum body image is an important research subject because it expands the scope of body image literature and has significant effects on gender problems. Not being able to lose the weight gained in postpartum period or the weight gained during pregnancy is an important problem for women. With women starting working life, this period seems to be a more sensitive and anxious one for some women.What do the results of this study add? Most of the women in this study experience body dissatisfaction in the postpartum period. Some women do not want to leave the house because of their negative body image perceptions. It is an important finding that women want their spouse to gain weight during this period.What are the implications of these findings for clinical practice and/or further research? The findings of our study revealed that working mothers in the postpartum period have difficulty in sparing time for themselves and their bodies due to increased responsibilities. Working women are in particular need for more support due to their increased workloads, roles and responsibilities in childcare. Our study may guide future studies focussing on women's body image perceptions and influencing factors.
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Affiliation(s)
- Merve Kochan
- Department of Obstetrics & Gynaecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Kamile Kabukcuoglu
- Department of Obstetrics & Gynaecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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The effect of pregnancy and the duration of postpartum convalescence on the physical fitness of healthy women: A cohort study of active duty servicewomen receiving 6 weeks versus 12 weeks convalescence. PLoS One 2021; 16:e0255248. [PMID: 34320030 PMCID: PMC8318247 DOI: 10.1371/journal.pone.0255248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/03/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Pregnancy profoundly affects cardiovascular and musculoskeletal performance requiring up to 12 months for recovery in healthy individuals. Objective To assess the effects of extending postpartum convalescence from 6 to 12 weeks on the physical fitness of Active Duty (AD) soldiers as measured by the Army Physical Fitness Test (APFT) and Body Mass Index (BMI). Methods We conducted a retrospective study of AD soldiers who delivered their singleton pregnancy of ≥ 32weeks gestation at a tertiary medical center. Pre- and post-pregnancy APFT results as well as demographic, pregnancy, and postpartum data were collected. Changes in APFT raw scores, body composition measures, and failure rates across the 6-week and 12-week convalescent cohorts were assessed. Multivariable regressions were utilized to associate risk factors with failure. Results Four hundred sixty women met inclusion criteria; N = 358 in the 6 week cohort and N = 102 in the 12 week cohort. Demographic variables were similar between the cohorts. APFT failure rates across pregnancy increased more than 3-fold in both groups, but no significant differences were found between groups in the decrement of performance or weight gain. With the combined cohort, multivariable regression analysis showed failure on the postpartum APFT to be independently associated with failure on the pre-pregnancy APFT (OR = 16.92, 95% CI 4.96–57.77), failure on pre-pregnancy BMI (OR = 8.44, 95% CI 2.23–31.92), elevated BMI at 6–8 weeks postpartum (OR = 4.02, 95% CI 1.42–11.35) and not breastfeeding at 2 months (OR = 3.23, 95% CI 1.48–7.02). Within 36 months of delivery date, 75% of women had achieved pre-pregnancy levels of fitness. Conclusion An additional 6 weeks of convalescence did not adversely affect physical performance or BMI measures in AD Army women following pregnancy. Modifiable factors such as pre- and post-pregnancy conditioning and weight, weight gain in pregnancy and always breastfeeding were found to be significant in recovery of physical fitness postpartum.
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21
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Perceived Barriers and Motivators for Physical Activity in Women With Perinatal Depression. J Phys Act Health 2021; 18:801-810. [PMID: 33984835 PMCID: PMC9851467 DOI: 10.1123/jpah.2020-0743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Physical activity (PA) can help reduce depression symptom severity in women with perinatal depression. However, PA is low, and barriers and motivators for PA among women with perinatal depression are not well understood. METHODS An ethnically diverse sample of women with perinatal depression was identified using a universal perinatal depression screening program. The authors conducted 8 focus groups (4 in pregnant women [n = 15] and 4 in postpartum women [n = 20]). Depression symptoms were measured using the Patient Health Questionnaire-8 at recruitment. Focus groups were analyzed using an inductive approach. RESULTS Pregnant participants were 27 weeks gestation, and postpartum participants were 11.5 months postpartum, on average. Depression symptoms were moderately severe (mean Patient Health Questionnaire-8 score: 16). Women identified practical barriers and motivators for PA common to perinatal women (physical health, parental responsibilities, PA tracking tools, and environmental factors) and described emotional and social factors influencing PA. Motivators included using PA to improve mood, relieve stress, boost self-image, and spend time with others. Bad mood, fear of social judgment, and feeling discouraged made it difficult to be active. CONCLUSION PA interventions in women with perinatal depression should include components addressing emotional and social barriers to PA in addition to addressing additional common practical barriers to PA.
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Yu Y, Ma Q, Fernandez ID, Groth SW. Mental Health, Behavior Change Skills, and Eating Behaviors in Postpartum Women. West J Nurs Res 2021; 44:932-945. [PMID: 34088249 DOI: 10.1177/01939459211021625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Excessive postpartum weight retention conveys risks for future metabolic diseases. Eating behaviors influence postpartum weight retention; however, the modifiable predictors of eating behaviors remain unclear. Using data from a three-arm, randomized controlled trial, the purpose of this study was to examine the longitudinal associations of mental health (e.g., depressive symptoms) and behavior change skills (e.g., self-efficacy) with eating behaviors (i.e., compensatory restraint, routine restraint, emotional eating, and external eating) among women (N = 424) over 18-months postpartum. Results revealed that depressive symptoms, perceived stress, healthy eating self-efficacy, overeating self-efficacy, self-weighing, and problem-solving confidence were associated with one or more of the examined eating behaviors. Furthermore, depressive symptoms moderated the association between healthy eating self-efficacy and routine restraint. Perceived stress moderated the associations between healthy eating/overeating self-efficacy and emotional eating. The findings suggest that mental health and behavior change skills may serve as targets for interventions designed to improve postpartum women's eating behaviors.Clinical trials registry:ClinicalTrials.gov #NCT01331564.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - Qianheng Ma
- School of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | | | - Susan W Groth
- School of Nursing, University of Rochester, Rochester, NY, USA
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Geyer K, Spies M, Günther J, Hoffmann J, Raab R, Meyer D, Rauh K, Hauner H. Effects of a Prenatal Lifestyle Intervention in Routine Care on Maternal Health Behaviour in the First Year Postpartum-Secondary Findings of the Cluster-Randomised GeliS Trial. Nutrients 2021; 13:1310. [PMID: 33921063 PMCID: PMC8071441 DOI: 10.3390/nu13041310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022] Open
Abstract
Lifestyle interventions during pregnancy were shown to beneficially influence maternal dietary behaviour and physical activity, but their effect on health behaviour after delivery is unclear. The objective of this secondary analysis was to investigate the sustained effect of a lifestyle intervention in routine care on maternal health behaviour during the first year postpartum. The cluster-randomised controlled "Healthy living in pregnancy" (GeliS) study included 2286 pregnant women. Data on maternal health behaviour were collected at 6-8 weeks (T1pp) and one year postpartum (T2pp) using validated questionnaires. The intervention group showed a lower mean intake of fast food (T1pp: p = 0.016; T2pp: p < 0.001) and soft drinks (T1pp: p < 0.001), a higher mean intake of vegetables (T2pp: p = 0.015) and was more likely to use healthy oils for meal preparation than the control group. Dietary quality rated by a healthy eating index was higher in the intervention group (T1pp: p = 0.093; T2pp: p = 0.043). There were minor trends towards an intervention effect on physical activity behaviour. The proportion of smokers was lower in the intervention group (p < 0.001, both time points). The lifestyle intervention within routine care modestly improved maternal postpartum dietary and smoking behaviours.
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Affiliation(s)
- Kristina Geyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Monika Spies
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Julia Günther
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Julia Hoffmann
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Roxana Raab
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Dorothy Meyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Kathrin Rauh
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
- Competence Centre for Nutrition (KErn), Am Gereuth 4, 85354 Freising, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
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Reconciling relationships with physical activity: a qualitative study of women's postnatal physical activity decision-making. BMC Pregnancy Childbirth 2021; 21:81. [PMID: 33494715 PMCID: PMC7831196 DOI: 10.1186/s12884-020-03537-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 12/30/2020] [Indexed: 11/11/2022] Open
Abstract
Background Challenges with engaging in postnatal physical activity can negatively affect the health of women and their families. This study investigated women’s physical activity decision-making processes and strategies to support their physical activity as part of a healthy postpartum transition. Methods Thirty healthy women with infants aged 2.5–12 months completed 3-day activity diaries and an individual interview. Using Glaser and Charmaz’s grounded theory methodology, the core category, reconciling relationships with physical activity, was constructed, which explained women’s processes of postnatal physical activity decision-making. Results Through reconciling relationships with physical activity, women discerned the types of physical activity they were comfortable pursuing at various points in the postpartum transition. Based on the meaning physical activity held for participants and their views about risks, supports, and resources, women gauged their capacity and the workability of their physical activity desires. Most women were uncertain of their capacity (physical, emotional) to return to physical activity and viewed the achievement of several or all of their desired physical activities as unworkable. Only a small group of women fully pursued the desirable physical activities they viewed as important for their well-being. Women adjusted the strategies they used to achieve physical activity when their expectations of capacity and workability did not align with their experiences. Some women lacked access to resources or supportive messaging about postpartum physical activity and downgraded their physical activity pursuit after negative personal physical or childcare experiences. Conclusions Women can benefit from discussions about physiological birth recovery and navigating community and peer resources to support physical activity access and the safe return to physical activity following birth. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03537-z.
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Toro-Ramos T, Heaner M, Yang Q, DeLuca L, Behr H, Reynolds K, Kim Y, Michaelides A. Postpartum Weight Retention: A Retrospective Data Analysis Measuring Weight Loss and Program Engagement with a Mobile Health Program. J Womens Health (Larchmt) 2021; 30:1645-1652. [PMID: 33481655 DOI: 10.1089/jwh.2020.8584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Mobile health (mHealth) technology can circumvent barriers to participation in weight loss programs faced by new mothers. The objective of this study was to assess weight change and program engagement in postpartum women (n = 130) participating in a 24-week behavior change mHealth weight-loss intervention. Materials and Methods: Participants were recruited through a program offered on a commercial mHealth application that provided evidence-based lifestyle interventions. To meet inclusion criteria, women had to be 18-45 years of age, and given birth within 2 years before the start of the study. Participants signed up for the Noom Healthy Weight program between January and March of 2019 and were offered the program free of charge. Linear mixed models were conducted; the primary outcome was weight change from baseline at 16 and 24 weeks. Secondary outcomes were program engagement and their relationship with completion status. Results: Results showed that time was a significant predictor of weight at week 16 [t(-3.94) = -9.40; p < 0.001] and week 24 [t(-4.08) = -9.74; p < 0.001]; users lost 3.94 kgs at week 16 and 4.08 kgs at week 24, compared with baseline. In addition, body mass index significantly decreased at week 24 [t(112) = 7.33, p < 0.0001] with the majority of participants (80%) experiencing reductions by more than 2 units. On average, subjects who completed the program (completers) lost more weight compared with those who did not complete the program [t(-5.09) = -2.94; p = 0.004], losing 5.09 kgs (95% CI -8.48 to -1.69) throughout the 24 weeks. Conclusion: This cohort study shows that a uniquely mobile, behavior change intervention for weight management is effective at producing significant weight loss with potential to address postpartum weight retention.
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Affiliation(s)
- Tatiana Toro-Ramos
- Noom, Inc., New York, New York, USA
- Project Management, Seed Health, Venice, California, USA
| | - Martica Heaner
- Nutrition Department, School of Urban Public Health, Hunter College, New York, New York USA
| | - Qiuchen Yang
- Clinical Research, Noom, Inc., New York, New York, USA
| | - Laura DeLuca
- Clinical Research, Noom, Inc., New York, New York, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Heather Behr
- Clinical Research, Noom, Inc., New York, New York, USA
| | | | - Youngin Kim
- Clinical Research, Noom, Inc., New York, New York, USA
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine Seoul, Seoul, South Korea
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26
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Grenier LN, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK, Murray-Davis B. Be Healthy in Pregnancy: Exploring factors that impact pregnant women's nutrition and exercise behaviours. MATERNAL AND CHILD NUTRITION 2020; 17:e13068. [PMID: 32705811 PMCID: PMC7729656 DOI: 10.1111/mcn.13068] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/23/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
Excess gestational weight gain is associated with short‐ and long‐term pregnancy complications. Although a healthy diet and physical activity during pregnancy are recommended and shown to reduce the risk of complications and improve outcomes, adherence to these recommendations is low. The aims of this study were to explore women's view of nutrition and physical activity during pregnancy and to describe barriers and facilitators experienced in implementing physical activity and nutrition recommendations. In a substudy of the Be Healthy in Pregnancy randomized trial, 20 semistructured focus groups were conducted with 66 women randomized to the control group when they were between 16 and 24 weeks gestation. Focus groups were recorded, transcribed verbatim, coded and thematically analysed. The results indicate that women felt motivated to be healthy for their baby, but competing priorities may take precedence. Participants described limited knowledge and access to information on safe physical activity in pregnancy and lacked the skills needed to operationalize both physical activity and dietary recommendations. Women's behaviours regarding diet and physical activity in pregnancy were highly influenced by their own and their peers' beliefs and values regarding how weight gain impacted their health during pregnancy. Pregnancy symptoms beyond women's control such as fatigue and nausea made physical activity and healthy eating more challenging. Counselling from care providers about nutrition and physical activity was perceived as minimal and ineffective. Future interventions should address improving counselling strategies and address individual's beliefs around nutrition and activity in pregnancy.
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Affiliation(s)
- Lindsay N Grenier
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | | | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Olive Wahoush
- Global Health, McMaster University, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Vickers-Manzin
- Public Health Services-Healthy Families, Healthy & Safe Communities, Hamilton, Ontario, Canada
| | - Caroline Moore
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Eileen K Hutton
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Beth Murray-Davis
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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