Healthcare professionals' views on supporting young mothers with eating and moving during and after pregnancy: An interview study using the COM-B framework.
diet
family nurse partnership
health visiting
midwifery
physical activity
qualitative research
teenage pregnancy
Journal
Health & social care in the community
ISSN: 1365-2524
Titre abrégé: Health Soc Care Community
Pays: England
ID NLM: 9306359
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
12
11
2018
revised:
26
07
2019
accepted:
12
08
2019
pubmed:
6
9
2019
medline:
1
12
2020
entrez:
6
9
2019
Statut:
ppublish
Résumé
Young mothers under the age of 20 often have poor nutrition and low levels of physical activity, adversely affecting outcomes for themselves and their babies. The aim of this qualitative study was to explore the experiences of healthcare professionals in supporting young women around eating and moving during and after pregnancy. Seventeen semi-structured interviews were conducted with midwives, family nurse practitioners and health visitors involved in the care of pregnant and post-natal mothers under the age of 20 in England and Wales. Data were analysed using thematic analysis and coded within the theoretical framework of the COM-B model to three areas of capability, motivation and opportunity. For capability, participants were broadly divided between those who had specialist knowledge and training in communication skills to support health behaviours in this population and professionals reliant on tacit knowledge. For opportunity, having enough time was seen as critical because young women's difficult social contexts meant supporting improved health behaviours required relationships of trust to be built. For motivation, participants reported that supporting young women with eating and moving was part of their role. However, the decision to prioritise this support sometimes related to perceived need based on BMI and this was complicated as young women were still growing. Motivation was additionally connected to professionals' own body experiences and health behaviours. Moving habits were less frequently discussed than eating as professionals described how young women tended to walk a lot in their daily lives or found that young women were not interested. Results suggest that to support eating and moving behaviours with young women, professionals need to be trained in communication techniques, enabled with the time to hold space for young women and be able to reflect on their own attitudes and beliefs to support a rounded model of health and wellbeing.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
69-80Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Alexander, K. E., Brijnath, B., & Mazza, D. (2014). Barriers and enablers to delivery of the Healthy Kids Check: An analysis informed by the Theoretical Domains Framework and COM-B model. Implementation Science, 9, 60. https://doi.org/10.1186/1748-5908-9-60
Atkinson, L., French, D. P., Ménage, D., & Olander, E. K. (2017). Midwives' experiences of referring obese women to either a community or home-based antenatal weight management service: Implications for service providers and midwifery practice. Midwifery, 49, 102-109. https://doi.org/10.1016/j.midw.2016.10.006
Ayers, S., & Olander, E. (2013). What are we measuring and why? Using theory to guide perinatal research and measurement. Journal of Reproductive and Infant Psychology, 31, 439-448. https://doi.org/10.1080/02646838.2013.834041
Baker, P. N., Wheeler, S. J., Sanders, T. A., Thomas, J. E., Hutchinson, C. J., Clarke, K., … Poston, L. (2009). A prospective study of micronutrient status in adolescent pregnancy. American Journal of Clinical Nutrition, 89, 1114-1124. https://doi.org/10.3945/ajcn.2008.27097
Barker, F., Atkins, L., & de Lusignan, S. (2016). Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult auditory rehabilitation. International Journal of Audiology, 55, S90-S98. https://doi.org/10.3109/14992027.2015.1120894
Barker, M. (2015). Developmental origins, behaviour change and the new public health. Journal of Developmental Origins of Health and Disease, 6, 428-433. https://doi.org/10.1017/S2040174415001312
Behrens, T. K., Bradley, J. E., Kirby, J. B., & Nanney, M. S. (2012). Physical activity among postpartum adolescents: A preliminary report. Perceptual and Motor Skills, 114, 310-318. https://doi.org/10.2466/06.10.13.PMS.114.1.310-318
Birkeland, R., Thompson, J. K., & Phares, V. (2005). Adolescent motherhood and postpartum depression. Journal of Clinical Child and Adolescent Psychology, 34, 292-300. https://doi.org/10.1207/s15374424jccp3402_8
Bostock, L. (2001). Pathways of disadvantage? Walking as a mode of transport among low-income mothers. Health & Social Care in the Community, 9, 11-18. https://doi.org/10.1046/j.1365-2524.2001.00275.x
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. https://doi.org/10.1191/1478088706qp063oa
British Medical Association. (2018). Feeling the squeeze: The local impact of cuts to public health budgets in England met the inclusion criteria. London, UK: BMA.
Cane, J., O’Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science, 7, 37. https://doi.org/10.1186/1748-5908-7-37
Christenson, A., Johansson, E., Reynisdottir, S., Torgerson, J., & Hemmingsson, E. (2018). Shame and avoidance as barriers in midwives' communication about body weight with pregnant women: A qualitative interview study. Midwifery, 63, 1-7. https://doi.org/10.1016/j.midw.2018.04.020
Ewers, H. (2014). Body image in pregnancy. London, UK: The Royal College of Midwives. Retrieved from https://www.rcm.org.uk/news-views-and-analysis/news/body-image-in-pregnancy
Family Nurse Partnership. (2019). Retrieved from https://fnp.nhs.uk/
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough?: An experiment with data saturation and variability. Field Methods, 18, 59-82. https://doi.org/10.1177/1525822X05279903
Hackshaw-McGeagh, L., Jamie, K., Beynon, R., & O’Neill, R. (2018). Health behaviours of young mothers: Implications for health promotion and cancer prevention. Health Education Journal, 77(3), 277-292. https://doi.org/10.1177/0017896917745106
Hall Moran, V. (2007). Nutritional status in pregnant adolescents: A systematic review of biochemical markers. Maternal and Child Nutrition, 3, 74-93. https://doi.org/10.1111/j.1740-8709.2007.00081.x
Harden, A., Brunton, G., Fletcher, A., & Oakley, A. (2009). Teenage pregnancy and social disadvantage: Systematic review integrating controlled trials and qualitative studies. BMJ, 339, b4254. https://doi.org/10.1136/bmj.b4254
Harrison, M. E., Balasubramanaiam, B., Robinson, A., & Norris, M. L. (2018). Adolescent pregnancy and eating disorders: A minireview and case report. Eating & Weight Disorders, 23, 389-393. https://doi.org/10.1007/s40519-017-0380-2
Heslehurst, N., Russell, S., McCormack, S., Sedgewick, G., Bell, R., & Rankin, J. (2013). Midwives perspectives of their training and education requirements in maternal obesity: A qualitative study. Midwifery, 29, 736-744. https://doi.org/10.1016/j.midw.2012.07.007
Hoare, E., Fuller-Tyszkiewicz, M., Skouteris, H., Millar, L., Nichols, M., & Allender, S. (2015). Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents. British Medical Journal Open, 5, e006586. https://doi.org/10.1136/bmjopen-2014-006586
Hodgkinson, E. L., Smith, D. M., & Wittkowski, A. (2014). Women’s experiences of their pregnancy and postpartum body image: A systematic review and meta-synthesis. BMC Pregnancy and Childbirth, 14, 330. https://doi.org/10.1186/1471-2393-14-330
Hoffmann, D. A., Marx, J. M., Kiefner-Burmeister, A., & Musher-Eizenman, D. R. (2016). Influence of maternal feeding goals and practices on children's eating behaviors. Appetite, 107, 21-27. https://doi.org/10.1016/j.appet.2016.07.014
Institute of Health Visiting. (n.d.). What is a health visitor? Retrieved from https://ihv.org.uk/families/what-is-a-hv/
Kansu-Celik, H., Kisa Karakaya, B., Guzel, A. I., Tasci, Y., & Erkaya, S. (2017). To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women. The Journal of Maternal-Fetal & Neonatal Medicine, 30, 1574-1578. https://doi.org/10.1080/14767058.2016.1214122
Kelly, M., Wills, J., & Sykes, S. (2017). Do nurses’ personal health behaviours impact on their health promotion practice? A systematic review. International Journal of Nursing Studies, 76, 62-77. https://doi.org/10.1016/j.ijnurstu.2017.08.008
Local Government Association. (2018). Good progress but more to do. Teenage pregnancy and young parents. London, UK: Local Government Association and Public Health England.
McParlin, C., Bell, R., Robson, S. C., Muirhead, C. R., & Araujo-Soares, V. (2017). What helps or hinders midwives to implement physical activity guidelines for obese pregnant women? A questionnaire survey using the Theoretical Domains Framework. Midwifery, 49, 110-116. https://doi.org/10.1016/j.midw.2016.09.015.
Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6, 42. https://doi.org/10.1186/1748-5908-6-42
National Institute for Health and Care Excellence (NICE). (2010a). Weight management before, during and after pregnancy. Public health Guideline, 27. Retrieved from https://www.nice.org.uk/guidance/ph27
National Institute for Health and Care Excellence (NICE). (2011). Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. Clinical Guideline 110. Retrieved from https://www.nice.org.uk/guidance/cg110
Office for National Statistics. (2014). Teenage conception rates highest in the most deprived areas. Retrieved from www.ons.gov.uk/ons/rel/regional-trends/area-based-analysis/conceptions-deprivation-analysis-toolkit/conceptions-deprivation-measures-2009-11.html
Office for National Statistics. (2017). Births by Parents' Characteristics, England and Wales, 2016. Retrieved from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsbyparentscharacteristicsinenglandandwales/2016
Office for National Statistics. (2019). Conceptions in England and Wales: 2017. Retrieved from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/conceptionandfertilityrates/bulletins/conceptionstatistics/2017
Olander, E. K., Darwin, Z. J., Atkinson, L., Smith, D. M., & Gardner, B. (2016). Beyond the 'teachable moment' - A conceptual analysis of women's perinatal behaviour change. Women and Birth, 29, e67-71. https://doi.org/10.1016/j.wombi.2015.11.005
Patton, M. Q. (1990). Qualitative evaluation and research methods, 2nd ed.. Newbury Park, CA: Sage.
Public Health England (PHE). (2016). Teenage mothers and young fathers: Support framework. Retrieved from https://www.gov.uk/government/publications/teenage-mothers-and-young-fathers-support-framework
Reid, A. E., Rosenthal, L., Earnshaw, V. A., Lewis, T. T., Lewis, J. B., Stasko, E. C., … Ickovics, J. R. (2016). Discrimination and excessive weight gain during pregnancy among Black and Latina young women. Social Science & Medicine, 156, 134-141. https://doi.org/10.1016/j.socscimed.2016.03.012
Royal College of Midwives. (n.d.). How to become a midwife. Retrieved from https://www.rcm.org.uk/learning-and-career/becoming-a-midwife
Russell, C. G., Taki, S., Azadi, L., Campbell, K. J., Laws, R., Elliott, R., & Denney-Wilson, E. (2016). A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment. BMC Pediatrics, 16, 69. https://doi.org/10.1186/s12887-016-0601-2
Sanders, J., Hunter, B., & Warren, L. (2016). A wall of information? Exploring the public health component of maternity care in England. Midwifery, 34, 253-260. https://doi.org/10.1016/j.midw.2015.10.013
SmithBattle, L., Loman, D. G., Chantamit-o-pas, C., & Schneider, J. K. (2017). An umbrella review of meta-analyses of interventions to improve maternal outcomes for teen mothers. Journal of Adolescence, 59, 97-111. https://doi.org/10.1016/j.adolescence.2017.05.022
Soltani, H., Duxbury, A., Rundle, R., & Marvin-Dowle, K. (2017). Dietary habits and supplementation practices of young women during pregnancy: An online cross-sectional survey of young mothers and health care professionals. BMC Nutrition, 3, 19. https://doi.org/10.1186/s40795-017-0137-3
Spicer, J., Werner, E., Zhao, Y., Choi, C. W., Lopez-Pintado, S., Feng, T., … Monk, C. (2013). Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy. Journal of Psychosomatic Research, 75, 305-313. https://doi.org/10.1016/j.jpsychores.2013.07.001
Steinl, G. K., Whisner, C. M., Pressman, E. K., Cooper, E. M., Groth, S. W., & O’Brien, K. O. (2018). Patterns and correlates of self-reported physical activity in a cohort of racially diverse pregnant adolescents. Journal of Pediatric and Adolescent Gynecology, 32(1), 51-56. https://doi.org/10.1016/j.jpag.2018.09.003
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349-357. https://doi.org/10.1093/intqhc/mzm042
Viner, R. M., Ozer, E. M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., & Currie, C. (2012). Adolescence and the social determinants of health. Lancet. 379(9826), 1641-1652. https://doi.org/10.1016/S0140-6736(12)60149-4
While, A. E. (2015). Promoting healthy behaviours - Do we need to practice what we preach? London Journal of Primary Care, 7, 112-114. https://doi.org/10.1080/17571472.2015.1113716
Whisner, C. M., Bruening, M., & O'Brien, K. O. (2016). A brief survey of dietary beliefs and behaviors of pregnant adolescents. Journal of Pediatric and Adolescent Gynecology, 29, 476-481. https://doi.org/10.1016/j.jpag.2016.03.002
Whitworth, M., Cockerill, R., & Lamb, H. (2017). Antenatal management of teenage pregnancy. Obstetrics, Gynaecology & Reproductive Medicine, 27, 50-56. https://doi.org/10.1016/j.ogrm.2016.11.005
Women In Sport. (2016). Girls Strategy 2016-9. Retrieved from http://www.womeninsport.org/wp-content/uploads/2017/03/Ambitions-for-Girls-2016-Strategy.pdf?x99836
World Health Organisation. (2018). Social determinants of health. Retrieved from http://www.who.int/social_determinants/sdh_definition/en/
Zaltzman, A., Falcon, B., & Harrison, M. E. (2015). Body image in adolescent pregnancy. Journal of Pediatric and Adolescent Gynecology, 28, 102-108. https://doi.org/10.1016/j.jpag.2014.06.003