Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Warwick Business School, University of Warwick, Coventry, UK.
Obes Rev. 2021 Jul;22(7):e13235. doi: 10.1111/obr.13235. Epub 2021 Mar 22.
Healthy lifestyle behaviors during the preconception period are important to optimize maternal and child outcomes, including weight. However, the majority of women do not have optimal preconception lifestyle behaviors. This systematic review explored enablers and barriers to women's preconception lifestyle behaviors using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Preconception was defined as the time before conception, capturing planned and unplanned pregnancies. Medline Complete, EMBASE, PsycINFO, and CINAHL were searched for peer-reviewed, quantitative and qualitative primary studies (English, 2006-2020) that explored enablers and barriers to lifestyle behaviors (diet, physical activity, smoking, alcohol use, supplement intake). Forty-two studies (of 3406) were included, assessing supplement use (n = 37), diet (n = 10), smoking (n = 10), alcohol use (n = 8), and physical activity (n = 5). All three COM-B components were identified only for diet and supplement use. Of the 14 TDF domains, 7 were identified: knowledge, beliefs about capabilities, beliefs about consequences, goals, intentions, social support, and environmental context and resources. The presence/absence of knowledge on healthy behaviors was the most commonly assessed enabler/barrier. Future studies should explore a wider range of factors influencing preconception women's capability, opportunity, and motivation to modify their lifestyle behaviors.
健康的生活方式行为在备孕期间对于优化母婴结局非常重要，包括体重。然而，大多数女性没有最佳的备孕生活方式行为。本系统综述使用能力、机会、动机、行为（COM-B）模型和理论领域框架（TDF）探讨了女性备孕生活方式行为的促进因素和障碍。备孕被定义为受孕前的时间，包括计划内和计划外怀孕。检索了 Medline Complete、EMBASE、PsycINFO 和 CINAHL 中的同行评议、定量和定性的初级研究（英文，2006-2020 年），以探讨生活方式行为（饮食、身体活动、吸烟、饮酒、补充剂摄入）的促进因素和障碍。纳入了 42 项研究（3406 项中的），评估了补充剂使用（n=37）、饮食（n=10）、吸烟（n=10）、饮酒（n=8）和身体活动（n=5）。仅确定了饮食和补充剂使用的三个 COM-B 组成部分。在 14 个 TDF 领域中，有 7 个被确定：知识、对能力的信念、对后果的信念、目标、意图、社会支持以及环境背景和资源。对健康行为的了解的存在/缺失是评估最常见的促进因素/障碍。未来的研究应探索更广泛的因素，以影响备孕女性改变生活方式行为的能力、机会和动机。
