Identifying target behaviors for weight management interventions for women who are overweight during pregnancy and the postpartum period: a qualitative study informed by the Behaviour Change Wheel

Abstract

Background Maternal overweight is increasing, and it is associated with several risk factors for both the mother and child. Healthy lifestyle behaviors adopted during pregnancy are likely to impact women’s health positively after pregnancy. The study’s aim was to identify and describe weight management behaviors in terms of the Capability, Opportunity and Motivation Behaviour (COM-B) -model to target weight management interventions from both the perspectives of women who are overweight and maternity care professionals. Methods This qualitative, descriptive study was conducted between 2019 and 2020. Individual interviews with pregnant and postpartum women who were overweight (n = 11) and focus group interviews with public health nurses (n = 5) were undertaken in two public maternity clinics in Southwest Finland. The data were analyzed using deductive content analysis consistent with the COM-B model. Results In the capability category, the women and the public health nurses thought that there was a need to find consistent ways to approach overweight, as it had often become a feature of the women’s identities. The use of health technology was considered to be an element of antenatal care that could be used to approach the subject of weight and weight management. Smart wearables could also support an evaluation of the women’s lifestyles. The opportunity category highlighted the lack of resources for support during perinatal care, especially after birth. Both groups felt that support from the family was the most important facilitating factor besides motivation. The women also expressed a conflict between pregnancy as an excuse to engage in unhealthy habits and pregnancy as a motivational period for a change of lifestyle. Furthermore, the women wanted to be offered a more robust stance on weight management and discreet counseling. Conclusions Our findings offer a theoretical basis on which future research can define intervention and implementation strategies. Such interventions may offer clear advice and non-judgmental support during pregnancy and after delivery by targeting women’s capabilities, opportunities, and motivation. Health technology could be a valuable component of intervention, as well as an implementation strategy, as they provide ways during maternity care to approach this topic and support women.

Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention

“…Besides personal motivation, social motivation also had an influence on GWM behaviors. A study reported that maternity health professionals’ encouragement for pregnant women increased their GWM enthusiasm, and family support was very crucial [ 43 ]. Several studies highlighted the importance of motivational interventions for pregnant women.…”

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

“…It is a matter of serious concern as it can impact various aspects of maternity care [ 16 ].The management of obesity is highly dependent on an individual’s willingness to bring about a behaviour change. This behaviour change depends on the knowledge, attitude and practices which is further guided by the source of information and socio-cultural myths and practices [ 17 ]. While exploring the knowledge, attitude, beliefs and perspectives of mothers regarding their weight status in the postpartum period, this study revealed certain noteworthy facts.…”

Supporting lifestyle change in obese pregnant mothers through the wearable internet-of-things (SLIM) -intervention for overweight pregnant women: Study protocol for a quasi-experimental trial

“…Step 2 : The analysis of performance, the target group and settings were examined through individual interviews with overweight women (n = 11) and focus group interviews with PHNs (n = 5) [ 28 ]. Weight management behaviors were identified from the perspective of the maternity care professionals and the overweight and obese women with the help of the Behaviour Change Wheel (BCW) [ 29 ].…”

“…Step 3 : Development and selection of strategies and measures for practicing change were conducted by linking identified target behaviors and determinants of the national guidelines to the intervention components. Previously identified weight management target behaviors [ 28 ] were mapped to the matrix of BCW ( S1 Table ). These results were presented to the PHNs and based on their discussions and consensus the most helpful elements for their clinical work in maternity clinics were chosen.…”