Abstract
The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. However, the success of a lifestyle intervention is dependent on uptake and continued compliance. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention. Barrier factors include time constraints, poor baseline knowledge, family culture, food accessibility, and lack of relevant data sources. Enabling factors were motivation to be healthy for themselves and their offspring, family and social support, a holistic delivery platform providing desired information delivered at appropriate times, regular feedback, goal setting, and nudges. From the findings of this study, we propose components of an idealized lifestyle intervention including (i) taking a holistic life-course approach to education, (ii) using mobile health platforms to reduce barriers, provide personalized feedback and promote goal-setting, and (iii) health nudges to cultivate sustained lifestyle habits.
Highlights
The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring
In line with the Developmental Origins of Health and Disease (DOHaD) paradigm, where early-life developmental influences are associated with later-life health and disease, optimizing the health of the mother can achieve the greatest benefit for mother and c hild[10]
As the eventual goal of this study is to create a lifestyle intervention program targeted at women with high body mass index (BMI), utilizing this framework will help to identify both enabler and barrier factors that should be resolved when designing a successful behavioral change intervention
Summary
The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention. As the eventual goal of this study is to create a lifestyle intervention program targeted at women with high body mass index (BMI), utilizing this framework will help to identify both enabler and barrier factors that should be resolved when designing a successful behavioral change intervention. The i-PARIHS framework was applied as a guide to understand how perceived enablers and barriers would influence the adoption of a lifestyle intervention program for the overweight or obese among preconception, pregnant and postnatal women, from which features of an ideal lifestyle intervention program with improved uptake and compliance are suggested
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