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根据 COM-B 模型分析英国产后身体活动行为:一项多方法研究。

Behavioural analysis of postnatal physical activity in the UK according to the COM-B model: a multi-methods study.

机构信息

Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

出版信息

BMJ Open. 2019 Aug 2;9(8):e028682. doi: 10.1136/bmjopen-2018-028682.

Abstract

OBJECTIVE

Develop a behavioural analysis of factors influencing postnatal physical activity (PA) according to the 'capability, opportunity, motivation and behaviour' (COM-B) model of behaviour to inform intervention development using the Behaviour Change Wheel (BCW).

DESIGN

Cross-sectional, multi-method study using semi-structured interviews and a quantitative questionnaire.

SETTING

Children's centres and mother and baby groups in Hertfordshire and Cambridgeshire, UK.

PARTICIPANTS

Convenience samples of postnatal women were interviewed (n=16) and completed the questionnaire (n=158).

METHODS

Semi-structured interviews followed a preprepared topic guide exploring the COM-B model components and analysed using framework analysis. The questionnaire, based on the self-evaluation of behaviour questionnaire, was adapted using patient and public involvement and findings from the interviews. Questionnaire participants rated their agreement with 22 predefined statements related to COM-B model components. Mean, SD and 95% CI were calculated and each item categorised according to importance. Demographic data were collected.

RESULTS

The questionnaire identified that new mothers would be more active if they had more time, felt less tired, had accessible childcare, were part of a group, advised by a healthcare professional, able to develop a habit and had more motivation. Additional themes emerging from qualitative data were engaging in PA groups with other new mothers, limited physical stamina following complicated births, social interaction, enjoyment and parental beliefs as motivation, provision of child-friendly PA facilities and environments and babies' unpredictable routines.

CONCLUSION

The behavioural analysis presented in this paper identifies and adds detail on the range of factors influencing the target behaviour. Some are unique to the target population, requiring targeted interventions for postnatal women, whereas some are individualised, suggesting the need for individually tailored interventions. We will use the behavioural analysis presented to design an intervention using the subsequent steps in the BCW.

摘要

目的

根据行为的“能力、机会、动机和行为”(COM-B)模型,对影响产后体力活动(PA)的因素进行行为分析,以便使用行为改变轮(BCW)为干预措施的制定提供信息。

设计

横断面、多方法研究,使用半结构式访谈和定量问卷。

设置

英国赫特福德郡和剑桥郡的儿童中心和母婴小组。

参与者

采用方便抽样方法对产后妇女进行访谈(n=16)并完成问卷(n=158)。

方法

半结构式访谈遵循预先准备好的主题指南,探讨 COM-B 模型组成部分,并使用框架分析进行分析。问卷基于自我评估行为问卷改编,使用患者和公众参与以及访谈结果。问卷参与者对与 COM-B 模型组成部分相关的 22 个预定义陈述的同意程度进行评分。计算平均值、标准差和 95%置信区间,并根据重要性对每个项目进行分类。收集人口统计学数据。

结果

问卷确定,如果新妈妈有更多时间、感到不那么疲倦、可以获得方便的儿童保育、是团体的一部分、得到医疗保健专业人员的建议、能够养成习惯并有更多动力,她们会更活跃。定性数据中出现的其他主题包括与其他新妈妈一起参加 PA 小组、复杂分娩后体力有限、社会互动、享受和父母信念作为动力、提供适合儿童的 PA 设施和环境以及婴儿不可预测的日常生活。

结论

本文提出的行为分析确定并详细说明了影响目标行为的一系列因素。其中一些因素是针对目标人群特有的,需要为产后妇女提供针对性的干预措施,而另一些因素则是个体化的,这表明需要针对个人进行干预。我们将使用呈现的行为分析,根据 BCW 的后续步骤来设计干预措施。

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