Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Overweight | Research article

Factors influencing the adoption of health promoting behaviors in overweight pregnant women: a qualitative study

Authors: Azita Fathnezhad-Kazemi, Sepideh Hajian

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

Login to get access

Abstract

Background

The ability to adopt and implement health promotion behaviors is one of the most important determinants of health status. Various factors affect the successful changing of behaviors and choosing a healthy lifestyle. The present study aims at exploring the experiences of overweight pregnant women in terms of the factors influencing selection and adoption of health promoting behaviors during pregnancy.

Methods

This qualitative study reports the findings of individual and group in-depth interviews with 32 overweight pregnant women using semi-structured questions which was conducted in Tabriz-Iran in 2017 and lasted for 6 months. The data collection continued until the saturation of the data. Participants were selected using purposive sampling and study inclusion criteria. Interviews were recorded and transcribed. Thereafter, content analysis was made using MAXQDA v. 10. Strength of data was verified by both participants and external control.

Results

The reported effective factors led to identification of the two themes of two contextual perceived barriers and facilitators, which were classified into four main categories and nine subcategories: 1. Individual barriers (disabilities-additional needs in pregnancy and mental barriers) 2. Socio- environmental barriers (adverse effects of the environment, adverse effects of the relatives and financial pressures) 3. Individual facilitators (intrinsic incentives, abundance and individual skills) 4. Socio- environmental (social and family support, incentive environments, and raising awareness).

Conclusion

The adoption of health behaviors and healthy lifestyle is under the mutual influence of individual characteristics and socio-environmental factors. What should be considered in planning and designing interventions is focused on removing barriers and strengthening facilitators, in particular by moderating social factors and taking into account individual needs and personal expectations.
Literature
1.
go back to reference Geense WW, van de Glind IM, Visscher TL, van Achterberg T. Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study. BMC Fam Pract. 2013;14(1):20.CrossRef Geense WW, van de Glind IM, Visscher TL, van Achterberg T. Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study. BMC Fam Pract. 2013;14(1):20.CrossRef
2.
go back to reference Kazemi AF, Hajian S, Ebrahimi-Mameghani M, Khob MK. The perspectives of pregnant women on health-promoting behaviors: an integrative systematic review. Int J Womens Health Reprod. Sci. 2018;6(2):97–105.CrossRef Kazemi AF, Hajian S, Ebrahimi-Mameghani M, Khob MK. The perspectives of pregnant women on health-promoting behaviors: an integrative systematic review. Int J Womens Health Reprod. Sci. 2018;6(2):97–105.CrossRef
3.
go back to reference Dodd JM, Turnbull D, McPhee AJ, Deussen AR, Grivell RM, Yelland LN, Crowther CA, Wittert G, Owens JA, Robinson JS. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ. 2014;348:g1285.CrossRef Dodd JM, Turnbull D, McPhee AJ, Deussen AR, Grivell RM, Yelland LN, Crowther CA, Wittert G, Owens JA, Robinson JS. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ. 2014;348:g1285.CrossRef
4.
go back to reference Dodd JM, Turnbull DA, McPhee AJ, Wittert G, Crowther CA, Robinson JS: Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: the LIMIT randomised controlled trial. BMC pregnancy and Childbirth 2011, 11(1):1. Dodd JM, Turnbull DA, McPhee AJ, Wittert G, Crowther CA, Robinson JS: Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: the LIMIT randomised controlled trial. BMC pregnancy and Childbirth 2011, 11(1):1.
5.
go back to reference Giuli C, Papa R, Bevilacqua R, Felici E, Gagliardi C, Marcellini F, Boscaro M, De Robertis M, Mocchegiani E, Faloia E. Correlates of perceived health related quality of life in obese, overweight and normal weight older adults: an observational study. BMC Public Health. 2014;14(1):35.CrossRef Giuli C, Papa R, Bevilacqua R, Felici E, Gagliardi C, Marcellini F, Boscaro M, De Robertis M, Mocchegiani E, Faloia E. Correlates of perceived health related quality of life in obese, overweight and normal weight older adults: an observational study. BMC Public Health. 2014;14(1):35.CrossRef
6.
go back to reference Cho JH, Jae SY, Choo IH, Choo J. Health-promoting behaviour among women with abdominal obesity: a conceptual link to social support and perceived stress. J Adv Nurs. 2014;70(6):1381–90.CrossRef Cho JH, Jae SY, Choo IH, Choo J. Health-promoting behaviour among women with abdominal obesity: a conceptual link to social support and perceived stress. J Adv Nurs. 2014;70(6):1381–90.CrossRef
7.
go back to reference Hui A, Back L, Ludwig S, Gardiner P, Sevenhuysen G, Dean H, Sellers E, McGavock J, Morris M, Bruce S. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG Int J Obstet Gynaecol. 2012;119(1):70–7.CrossRef Hui A, Back L, Ludwig S, Gardiner P, Sevenhuysen G, Dean H, Sellers E, McGavock J, Morris M, Bruce S. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG Int J Obstet Gynaecol. 2012;119(1):70–7.CrossRef
8.
go back to reference Mourtakos SP, Tambalis KD, Panagiotakos DB, Antonogeorgos G, Arnaoutis G, Karteroliotis K, Sidossis LS. Maternal lifestyle characteristics during pregnancy, and the risk of obesity in the offspring: a study of 5,125 children. BMC pregnancy and childbirth. 2015;15(1):1.CrossRef Mourtakos SP, Tambalis KD, Panagiotakos DB, Antonogeorgos G, Arnaoutis G, Karteroliotis K, Sidossis LS. Maternal lifestyle characteristics during pregnancy, and the risk of obesity in the offspring: a study of 5,125 children. BMC pregnancy and childbirth. 2015;15(1):1.CrossRef
9.
go back to reference Tovar A, Chasan-Taber L, Bermudez OI, Hyatt RR, Must A. Knowledge, attitudes, and beliefs regarding weight gain during pregnancy among Hispanic women. Matern Child Health J. 2010;14(6):938–49.CrossRef Tovar A, Chasan-Taber L, Bermudez OI, Hyatt RR, Must A. Knowledge, attitudes, and beliefs regarding weight gain during pregnancy among Hispanic women. Matern Child Health J. 2010;14(6):938–49.CrossRef
10.
go back to reference Auerbach MV, Lobel M, Cannella DT. Psychosocial correlates of health-promoting and health-impairing behaviors in pregnancy. J Psychosom Obstet Gynecol. 2014;35(3):76–83.CrossRef Auerbach MV, Lobel M, Cannella DT. Psychosocial correlates of health-promoting and health-impairing behaviors in pregnancy. J Psychosom Obstet Gynecol. 2014;35(3):76–83.CrossRef
11.
go back to reference Cyphers NA, Clements AD, Lindseth G. The relationship between religiosity and health-promoting behaviors in pregnant women. West J Nurs Res. 2017;39(11):1429–46.CrossRef Cyphers NA, Clements AD, Lindseth G. The relationship between religiosity and health-promoting behaviors in pregnant women. West J Nurs Res. 2017;39(11):1429–46.CrossRef
12.
go back to reference Gokyildiz S, Alan S, Elmas E, Bostanci A, Kucuk E. Health-promoting lifestyle behaviours in pregnant women in Turkey. Int J Nurs Pract. 2014;20(4):390–7.CrossRef Gokyildiz S, Alan S, Elmas E, Bostanci A, Kucuk E. Health-promoting lifestyle behaviours in pregnant women in Turkey. Int J Nurs Pract. 2014;20(4):390–7.CrossRef
13.
go back to reference Orr ST. Social support and pregnancy outcome: a review of the literature. Clin Obstet Gynecol. 2004;47(4):842–55.CrossRef Orr ST. Social support and pregnancy outcome: a review of the literature. Clin Obstet Gynecol. 2004;47(4):842–55.CrossRef
14.
go back to reference Abdolkarimy M, Zareipour M, Mahmoodi H, Dashti S, Faryabi R, Movahed E. Health promoting behaviors and their relationship with self-efficacy of health workers. Iran J Nurs. 2017;30(105):68–79.CrossRef Abdolkarimy M, Zareipour M, Mahmoodi H, Dashti S, Faryabi R, Movahed E. Health promoting behaviors and their relationship with self-efficacy of health workers. Iran J Nurs. 2017;30(105):68–79.CrossRef
15.
go back to reference Khodaveisi M, Omidi A, Farokhi S, Soltanian AR. The effect of Pender’s health promotion model in improving the nutritional behavior of overweight and obese women. Int J Community Based Nurs Midwifery. 2017;5(2):165. Khodaveisi M, Omidi A, Farokhi S, Soltanian AR. The effect of Pender’s health promotion model in improving the nutritional behavior of overweight and obese women. Int J Community Based Nurs Midwifery. 2017;5(2):165.
16.
go back to reference Baker D. Health promotion in nursing practice. Family & Community Health. 2007;30(1):85–6.CrossRef Baker D. Health promotion in nursing practice. Family & Community Health. 2007;30(1):85–6.CrossRef
17.
go back to reference Kazemi AF, Hajian S. Experiences related to health promotion behaviors in overweight pregnant women: a qualitative study. Reprod Health. 2018;15(1):219.CrossRef Kazemi AF, Hajian S. Experiences related to health promotion behaviors in overweight pregnant women: a qualitative study. Reprod Health. 2018;15(1):219.CrossRef
18.
go back to reference Ghahremani L, Alipoor M, Amoee S, Keshavarzi S. Health promoting behaviors and self-efficacy of physical activity during pregnancy: an interventional study. Int J Women’s Health Reprod Sci. 2017;5(3):181–6.CrossRef Ghahremani L, Alipoor M, Amoee S, Keshavarzi S. Health promoting behaviors and self-efficacy of physical activity during pregnancy: an interventional study. Int J Women’s Health Reprod Sci. 2017;5(3):181–6.CrossRef
19.
go back to reference Edvardsson K, Ivarsson A, Eurenius E, Garvare R, Nyström ME, Small R, Mogren I. Giving offspring a healthy start: parents' experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Public Health. 2011;11(1):1.CrossRef Edvardsson K, Ivarsson A, Eurenius E, Garvare R, Nyström ME, Small R, Mogren I. Giving offspring a healthy start: parents' experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Public Health. 2011;11(1):1.CrossRef
20.
go back to reference Edwards N, Sims-Jones N. Smoking and smoking relapse during pregnancy and postpartum: results of a qualitative study. Birth. 1998;25(2):94–100.CrossRef Edwards N, Sims-Jones N. Smoking and smoking relapse during pregnancy and postpartum: results of a qualitative study. Birth. 1998;25(2):94–100.CrossRef
21.
go back to reference Sui Z, Dodd JM. Exercise in obese pregnant women: positive impacts and current perceptions. Int J Women's Health. 2013;5(1):389–98.CrossRef Sui Z, Dodd JM. Exercise in obese pregnant women: positive impacts and current perceptions. Int J Women's Health. 2013;5(1):389–98.CrossRef
22.
go back to reference Sui Z, Turnbull D, Dodd J. Overweight and obese women’s perceptions about making healthy change during pregnancy: a mixed method study. Matern Child Health J. 2013;17(10):1879–87.CrossRef Sui Z, Turnbull D, Dodd J. Overweight and obese women’s perceptions about making healthy change during pregnancy: a mixed method study. Matern Child Health J. 2013;17(10):1879–87.CrossRef
23.
go back to reference Gregory S, Bostock Y, Backett-Milburn K. Recovering from a heart attack: a qualitative study into lay experiences and the struggle to make lifestyle changes. Fam Pract. 2005;23(2):220–5.CrossRef Gregory S, Bostock Y, Backett-Milburn K. Recovering from a heart attack: a qualitative study into lay experiences and the struggle to make lifestyle changes. Fam Pract. 2005;23(2):220–5.CrossRef
24.
go back to reference Hesketh K, Waters E, Green J, Salmon L, Williams J. Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health Promot Int. 2005;20(1):19–26.CrossRef Hesketh K, Waters E, Green J, Salmon L, Williams J. Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health Promot Int. 2005;20(1):19–26.CrossRef
25.
go back to reference Timmerman GM. Addressing barriers to health promotion in underserved women. Family & Community Health. 2007;30:S34–42.CrossRef Timmerman GM. Addressing barriers to health promotion in underserved women. Family & Community Health. 2007;30:S34–42.CrossRef
26.
go back to reference Jelsma JG, van Leeuwen KM, Oostdam N, Bunn C, Simmons D, Desoye G, Corcoy R, Adelantado JM, Kautzky-Willer A, Harreiter J. Beliefs, barriers, and preferences of European overweight women to adopt a healthier lifestyle in pregnancy to minimize risk of developing gestational diabetes mellitus: an explorative study. J Pregnancy. 2016;2016:3435791.CrossRef Jelsma JG, van Leeuwen KM, Oostdam N, Bunn C, Simmons D, Desoye G, Corcoy R, Adelantado JM, Kautzky-Willer A, Harreiter J. Beliefs, barriers, and preferences of European overweight women to adopt a healthier lifestyle in pregnancy to minimize risk of developing gestational diabetes mellitus: an explorative study. J Pregnancy. 2016;2016:3435791.CrossRef
27.
go back to reference Beck CT, Polit D. Essentials of nursing research. Appraising evidence for nursing practice. Wolters Kluwer/Lippincott, Wil-liams & Wilkins, Philadelphia. 2010;7:121–5. Beck CT, Polit D. Essentials of nursing research. Appraising evidence for nursing practice. Wolters Kluwer/Lippincott, Wil-liams & Wilkins, Philadelphia. 2010;7:121–5.
28.
go back to reference Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRef Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRef
29.
go back to reference Amiri P, Ghofranipour F, Ahmadi F, Hosseinpanah F, Montazeri A, Jalali-Farahani S, Rastegarpour A. Barriers to a healthy lifestyle among obese adolescents: a qualitative study from Iran. Int. J. Public Health. 2011;56(2):181–9.CrossRef Amiri P, Ghofranipour F, Ahmadi F, Hosseinpanah F, Montazeri A, Jalali-Farahani S, Rastegarpour A. Barriers to a healthy lifestyle among obese adolescents: a qualitative study from Iran. Int. J. Public Health. 2011;56(2):181–9.CrossRef
30.
go back to reference Befort CA, Thomas JL, Daley CM, Rhode PC, Ahluwalia JS. Perceptions and beliefs about body size, weight, and weight loss among obese African American women: a qualitative inquiry. Health Educ Behav. 2008;35(3):410–26.CrossRef Befort CA, Thomas JL, Daley CM, Rhode PC, Ahluwalia JS. Perceptions and beliefs about body size, weight, and weight loss among obese African American women: a qualitative inquiry. Health Educ Behav. 2008;35(3):410–26.CrossRef
31.
go back to reference Smedley J, Jancey JM, Dhaliwal S, Zhao Y, Monteiro SM, Howat P. Women’s reported health behaviours before and during pregnancy: a retrospective study. Health Educ J. 2014;73(1):28–40.CrossRef Smedley J, Jancey JM, Dhaliwal S, Zhao Y, Monteiro SM, Howat P. Women’s reported health behaviours before and during pregnancy: a retrospective study. Health Educ J. 2014;73(1):28–40.CrossRef
32.
go back to reference Smith DM, Cooke A, Lavender T. Maternal obesity is the new challenge; a qualitative study of health professionals’ views towards suitable care for pregnant women with a body mass index (BMI)≥ 30 kg/m 2. BMC pregnancy and childbirth. 2012;12(1):157.CrossRef Smith DM, Cooke A, Lavender T. Maternal obesity is the new challenge; a qualitative study of health professionals’ views towards suitable care for pregnant women with a body mass index (BMI)≥ 30 kg/m 2. BMC pregnancy and childbirth. 2012;12(1):157.CrossRef
33.
go back to reference Weir Z, Bush J, Robson SC, McParlin C, Rankin J, Bell R. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women. BMC Pregnancy and Childbirth. 2010;10(1):18.CrossRef Weir Z, Bush J, Robson SC, McParlin C, Rankin J, Bell R. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women. BMC Pregnancy and Childbirth. 2010;10(1):18.CrossRef
34.
go back to reference Warren L: Keeping the balance: promoting physical activity and healthy dietary behaviour in pregnancy. Doctoral dissertation. Swansea University (College of Human and Health Sciences); 2013. 1–378. Warren L: Keeping the balance: promoting physical activity and healthy dietary behaviour in pregnancy. Doctoral dissertation. Swansea University (College of Human and Health Sciences); 2013. 1–378.
35.
go back to reference Connelly M, Brown H, van der Pligt P, Teychenne M. Modifiable barriers to leisure-time physical activity during pregnancy: a qualitative study investigating first time mother’s views and experiences. BMC pregnancy and childbirth. 2015;15(1):100.CrossRef Connelly M, Brown H, van der Pligt P, Teychenne M. Modifiable barriers to leisure-time physical activity during pregnancy: a qualitative study investigating first time mother’s views and experiences. BMC pregnancy and childbirth. 2015;15(1):100.CrossRef
36.
go back to reference Nikolopoulos H, Mayan M, MacIsaac J, Miller T, Bell RC. Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study. BMC pregnancy and childbirth. 2017;17(1):97.CrossRef Nikolopoulos H, Mayan M, MacIsaac J, Miller T, Bell RC. Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study. BMC pregnancy and childbirth. 2017;17(1):97.CrossRef
37.
go back to reference Strecher VJ, McEvoy DeVellis B, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986;13(1):73–92.CrossRef Strecher VJ, McEvoy DeVellis B, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986;13(1):73–92.CrossRef
38.
go back to reference Kavlak O, Atan SU, Sirin A, Sen E, Guneri SE, Dag HY. Pregnant Turkish women with low income: their anxiety, health-promoting lifestyles, and related factors. Int. J. Nurs. Pract. 2013;19(5):507–15.PubMed Kavlak O, Atan SU, Sirin A, Sen E, Guneri SE, Dag HY. Pregnant Turkish women with low income: their anxiety, health-promoting lifestyles, and related factors. Int. J. Nurs. Pract. 2013;19(5):507–15.PubMed
39.
go back to reference Onat G, Aba YA. Health-promoting lifestyles and related factors among pregnant women. Turkish J Public Health. 2014;12(2):69. Onat G, Aba YA. Health-promoting lifestyles and related factors among pregnant women. Turkish J Public Health. 2014;12(2):69.
40.
go back to reference Thaewpia S, Howland LC, Clark MJ, James KS. Relationships among health promoting behaviors and maternal and infant birth outcomes in older pregnant Thais. Pacific Rim Int J Nurs Res. 2013;17(1):28–38. Thaewpia S, Howland LC, Clark MJ, James KS. Relationships among health promoting behaviors and maternal and infant birth outcomes in older pregnant Thais. Pacific Rim Int J Nurs Res. 2013;17(1):28–38.
41.
go back to reference Walker LO, Cooney AT, Riggs MW. Psychosocial and demographic factors related to health behaviors in the 1st trimester. J Obstet Gynecol Neonatal Nurs. 1999;28(6):606–14.CrossRef Walker LO, Cooney AT, Riggs MW. Psychosocial and demographic factors related to health behaviors in the 1st trimester. J Obstet Gynecol Neonatal Nurs. 1999;28(6):606–14.CrossRef
42.
go back to reference Misra R, Patel T, Davies D, Russo T. Health promotion behaviors of Gujurati Asian Indian immigrants in the United States. J Immigr Health. 2000;2(4):223–30.CrossRef Misra R, Patel T, Davies D, Russo T. Health promotion behaviors of Gujurati Asian Indian immigrants in the United States. J Immigr Health. 2000;2(4):223–30.CrossRef
43.
go back to reference Sanchez-Jones TR. A qualitative analysis of health promotion among older African Americans. PhD thesis. University of Miami; 2006. Sanchez-Jones TR. A qualitative analysis of health promotion among older African Americans. PhD thesis. University of Miami; 2006.
Metadata
Title
Factors influencing the adoption of health promoting behaviors in overweight pregnant women: a qualitative study
Authors
Azita Fathnezhad-Kazemi
Sepideh Hajian
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Overweight
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2199-5

Other articles of this Issue 1/2019

BMC Pregnancy and Childbirth 1/2019 Go to the issue