MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
BMC Pregnancy Childbirth. 2020 Apr 25;20(1):244. doi: 10.1186/s12884-020-02913-z.
Women who gain too much weight in pregnancy are at increased risk of disease and of having children with increased risk. Interventions to improve health behaviours are usually designed for a general population of pregnant women, and trial outcomes show an average impact that does not represent the differences between individuals. To inform the development of future interventions, this study explored the factors that influenced women's diet and physical activity during pregnancy and aimed to identify the needs of these women with regards to lifestyle support.
Women who completed a trial of vitamin D supplementation and nurse support in pregnancy were invited to take part in an interview. Seventeen women were interviewed about their lifestyles during pregnancy, the support they had, and the support they wanted. Interview transcripts were coded thematically and analysed to understand the factors that influenced the diets and physical activity levels of these women and their engagement with resources that could provide support.
Women identified barriers to eating well or being physically active, and pregnancy-specific issues like nausea and pain were common. Women's interest in maintaining a healthy lifestyle and their engagement with lifestyle support was related to the extent to which they self-identified as healthy people. Health-disengaged women were disinterested in talking about their lifestyles while health-focused women did not feel that they needed extra support. Women between these ends of the 'health identity' spectrum were interested in improving their health, and were able to identify barriers as well as sources of support.
Lifestyle interventions in pregnancy should be adapted to meet the needs of individuals with different health identities, and encouraging a change in health identity may be one way of supporting sustained change in health behaviours.
孕期体重增加过多的女性罹患疾病和子女患病的风险增加。旨在改善健康行为的干预措施通常针对一般孕妇人群设计，试验结果显示出平均影响，而无法代表个体之间的差异。为了为未来的干预措施提供信息，本研究探讨了影响女性在怀孕期间饮食和体育活动的因素，并旨在确定这些女性在生活方式支持方面的需求。
完成孕期维生素 D 补充和护士支持试验的女性被邀请参加访谈。对 17 名女性进行了有关其怀孕期间生活方式、所获得的支持以及对生活方式支持的需求的访谈。对访谈记录进行了主题编码和分析，以了解影响这些女性饮食和体育活动水平的因素，以及她们对可能提供支持的资源的参与程度。
女性确定了饮食不良或身体活动的障碍，以及像恶心和疼痛这样的妊娠特定问题很常见。女性保持健康生活方式的兴趣及其对生活方式支持的参与度与她们自我认定为健康人的程度有关。不关注健康的女性对谈论自己的生活方式不感兴趣，而关注健康的女性则认为自己不需要额外的支持。处于健康认同光谱两端的女性对改善自己的健康感兴趣，并且能够识别障碍和支持来源。
孕期生活方式干预措施应根据不同健康认同个体的需求进行调整，鼓励健康认同的改变可能是支持健康行为持续改变的一种方式。
