Enablers and barriers to physical activity in pregnancy: drawing on the TDF and COM-B model

Abstract

Background: Obesity during pregnancy is associated with increased risk of gestational diabetes and other complications. Although physical activity (PA) is a modifiable lifestyle factor that may help prevent these complications, many women become less active in pregnancy. Antenatal interventions are on-going but few identify the behaviour change mechanisms by which the intervention is expected to work. To enhance the effectiveness of interventions tools in behavioural science; the Theoretical Domains Framework (TDF) and COM-B model have been employed to help understand behaviours. Using these methods, this study aimed to identify the enablers and barriers to PA in overweight and obese pregnant women. Methods: Semi-structured interviews were conducted with a purposive sample of overweight and obese pregnant women attending a public antenatal clinic in a maternity hospital in Cork, Ireland. Interviews were recorded and transcribed. The framework approach was employed, drawing on the TDF and COM-B model. Results: Social opportunity to engage in PA was identified as an enabler; pregnant women suggested being active was easier when supported by their partners. Knowledge was a commonly reported barrier with women lacking information on safe activities and describing the information received as ‘limited’. Physical capability and physical opportunity to carry out PA were also identified as barriers; experiencing pain, lack of time, other children, and working prevented women from being active. Conclusion: This study is a theoretical starting point in making a ‘behavioural diagnoses’ and the results will be used to inform the development of a PA intervention for overweight and obese pregnant women.