Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond
Abstract
:1. Introduction
2. Materials and Methods
2.1. Phase I
2.1.1. Phase Ia: PPI Workshop 1
2.1.2. Phase Ib: Online Survey
2.1.3. Phase Ic: Development of Pilot Resources 1
2.2. Phase II
2.2.1. Phase IIa: Stakeholder Event
2.2.2. Phase IIb: PPI Workshops 2
2.2.3. Phase IIc: Development of Pilot Resources 2
3. Results
3.1. Phase I
3.1.1. PPI Workshop 1
3.1.2. Quantitative Survey Findings
3.1.3. Qualitative Survey Themes
3.1.4. Phase I Pilot Resource Development
3.2. Phase II
3.2.1. Summary of Phase II Stakeholder and PPI Workshops
3.2.2. Feedback on Phase I Pilot Resources and Recommendations for Future Development
3.2.3. Phase II Pilot Resource Development
4. Discussion
4.1. The Importance of Collaboration, and Recognition of Intrapersonal Differences in Experience and Context
4.2. Importance of Clear Relatable and Practical Advice
4.3. Importance of the Credibility
4.4. Strengths and limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Dipietro, L.; Evenson, K.R.; Bloodgood, B.; Sprow, K.; Troiano, R.P.; Piercy, K.L.; Vaux-Bjerke, A.; Powell, K.E.; 2018 Physical Activity Guidelines Advisory Committee. Benefits of Physical Activity during Pregnancy and Postpartum: An Umbrella Review. Med. Sci. Sports Exerc. 2019, 51, 1292–1302. [Google Scholar] [CrossRef]
- American College of Obstetrics and Gynecology. Physical Activity and Exercise during Pregnancy and the Postpartum Period: ACOG Committee Opinion Summary, Number 804. Obstet. Gynecol. 2020, 135, 991–993. [Google Scholar] [CrossRef] [PubMed]
- Mottola, M.F.; Davenport, M.H.; Ruchat, S.M.; Davies, G.A.; Poitras, V.J.; Gray, C.E.; Jaramillo Garcia, A.; Barrowman, N.; Adamo, K.B.; Duggan, M.; et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br. J. Sports Med. 2018, 52, 1339–1346. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Davenport, M.H.; Ruchat, S.M.; Poitras, V.J.; Jaramillo Garcia, A.; Gray, C.E.; Barrowman, N.; Skow, R.J.; Meah, V.L.; Riske, L.; Sobierajski, F.; et al. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: A systematic review and meta-analysis. Br. J. Sports Med. 2018, 52, 1367–1375. [Google Scholar] [CrossRef]
- Davenport, M.H.; Mccurdy, A.P.; Mottola, M.F.; Skow, R.J.; Meah, V.L.; Poitras, V.J.; Garcia, A.J.; Gray, C.E.; Barrowman, N.; Riske, L.; et al. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: A systematic review and meta-analysis. Br. J. Sports Med. 2018, 52, 1376–1385. [Google Scholar] [CrossRef] [PubMed]
- Ruchat, S.M.; Mottola, M.F.; Skow, R.J.; Nagpal, T.S.; Meah, V.L.; James, M.; Riske, L.; Sobierajski, F.; Kathol, A.J.; Marchand, A.A.; et al. Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: A systematic review and meta-analysis. Br. J. Sports Med. 2018, 52, 1347–1356. [Google Scholar] [CrossRef]
- Ruifrok, A.E.; Althuizen, E.; Oostdam, N.; Van Mechelen, W.; Mol, B.W.; De Groot, C.J.M.; Van Poppel, M.N.M. The relationship of objectively measured physical activity and sedentary behaviour with gestational weight gain and birth weight. J. Pregnancy 2014, 2014, 1–6. [Google Scholar] [CrossRef]
- Phelan, S. Pregnancy: A “teachable moment” for weight control and obesity prevention. Am. J. Obs. Gynecol. 2010, 202, 135.e1–135.e8. [Google Scholar] [CrossRef] [Green Version]
- Reid, H.; Smith, R.; Calderwood, C.; Foster, C. Physical activity and pregnancy: Time for guidance in the UK. Br. J. Sports Med. 2017, 51, 1511–1512. [Google Scholar] [CrossRef] [Green Version]
- Lindqvist, M.; Persson, M.; Mogren, I. “Longing for individual recognition”—Pregnant women’s experiences of midwives’ counselling on physical activity during pregnancy. Sex. Reprod. Healthc. 2018, 15, 46–53. [Google Scholar] [CrossRef]
- Hayman, M.; Reaburn, P.; Alley, S.; Cannon, S.; Short, C. What exercise advice are women receiving from their healthcare practitioners during pregnancy? Women Birth 2020, 33, e357–e362. [Google Scholar] [CrossRef]
- Smith, R.; Shakespeare, J.; Williams, Z.; Knight, M.; Foster, C. Physical activity for pregnant women: An infographic for healthcare professionals. Br. J. Gen. Pract. 2017, 67, 460. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Smith, R.; Reid, H.; Matthews, A.; Calderwood, C.; Knight, M.; Foster, C.; CMO Physical Activity Expert Committee for Physical Activity and Pregnancy. Infographic: Physical activity for pregnant women. Br. J. Sports Med. 2018, 52, 532–533. [Google Scholar] [CrossRef]
- UK Chief Medical Officers’ Physical Activity Guidelines. Physical Activity for Women after Childbirth: Birth to 12 Months. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/841936/Postpartum_infographic.pdf (accessed on 23 September 2020).
- Mills, H.; Atkinson, L.; Olander, E.; Smith, D.; Hayes, L.; Currie, S.; Newham, J.; Foster, C.; De Vivo, M. Bump start needed: Linking guidelines, policy and practice in promoting physical activity during and beyond pregnancy. Br. J. Sports Med. 2020, 54, 764–765. [Google Scholar] [CrossRef]
- Wagnild, J.M.; Pollard, T.M. “Sit Yourself Down”: Women’s Experiences of Negotiating Physical Activity during Pregnancy. Qual. Health Res. 2020, 30, 1072–1082. [Google Scholar] [CrossRef]
- Olander, E.K.; Atkinson, L.; Edmunds, J.K.; French, D.P. The views of pre- and post-natal women and health professionals regarding gestational weight gain: An exploratory study. Sex. Reprod. Healthc. 2011, 2, 43–48. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- van Mulken, M.R.H.; McAllister, M.; Lowe, J.B. The stigmatisation of pregnancy: Societal influences on pregnant women’s physical activity behaviour. Cult. Health Sex. 2016, 18, 921–935. [Google Scholar] [CrossRef] [PubMed]
- Faircloth, C.; Gürtin, Z.B. Fertile Connections: Thinking across Assisted Reproductive Technologies and Parenting Culture Studies. Sociology 2017. [Google Scholar] [CrossRef] [Green Version]
- Martin, G.P.; Carter, P. Patient and public involvement in the new NHS: Choice, voice, and the pursuit of legitimacy. In Decentring Health Policy; Bevir, M., Waring, J., Eds.; Routledge: London, UK, 2017; pp. 121–139. [Google Scholar]
- Robert, G.; Donetto, S.; Williams, O. Co-designing Healthcare Services with Patients. In The Palgrave Handbook of Co-Production of Public Services and Outcomes; Loeffler, E., Bovaird, T., Eds.; Palgrave Macmillan: Cham, Switzerland, 2021; pp. 313–333. [Google Scholar]
- Bergeron, C.D.; Tanner, A.H.; Friedman, D.B.; Zheng, Y.; Schrock, C.S.; Bornstein, D.B.; Segar, M.; Swift, N. Physical Activity Communication: A Scoping Review of the Literature. Health Promot. Pract. 2019, 20, 344–353. [Google Scholar] [CrossRef]
- Nobles, J.; Thomas, C.; Banks Gross, Z.; Hamilton, M.; Trinder-Widdess, Z.; Speed, C.; Gibson, A.; Davies, R.; Farr, M.; Jago, R.; et al. “Let’s Talk about Physical Activity”: Understanding the Preferences of Under-Served Communities when Messaging Physical Activity Guidelines to the Public. Int. J. Environ. Res. Public Health 2020, 17, 2782. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Martin, G.P. “Ordinary people only”: Knowledge, representativeness, and the publics of public participation in healthcare. Sociol. Health Illn. 2008, 30, 35–54. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef] [Green Version]
- Droomers, M.; Schrijvers, C.T.M.; Mackenbach, J.P. Educational level and decreases in leisure time physical activity: Predictors from the longitudinal globe study. J. Epidemiol. Community Health 2001, 55, 562–568. [Google Scholar] [CrossRef]
- Powell, L.M.; Slater, S.; Chaloupka, F.J.; Centers, P. The relationship between community physical activity settings and race, ethnicity and socioeconomic status. Evid. Based Prev. Med. 2004, 1, 135–144. [Google Scholar]
- Pharr, J.R.; Lough, N.L.; Terencio, A.M. Sociodemographic Determinants of Physical Activity and Sport Participation among Women in the United States. Sports 2020, 8, 96. [Google Scholar] [CrossRef] [PubMed]
- Pulsford, R.; Rouse, P.; Williams, O.; Jarvie, R.; Weis, C.; Rodgers, L.; Salmon, V.E. Moving through Motherhood: A mixed methods investigation into experiences of physical activity, and physical activity advice around pregnancy. J. Phys. Act. Health 2018, 15, S1–S249. [Google Scholar]
- Findley, A.; Smith, D.M.; Hesketh, K.; Keyworth, C. Exploring womens’ experiences and decision making about physical activity during pregnancy and following birth: A qualitative study. BMC Pregnancy Childbirth 2020, 20, 1–10. [Google Scholar] [CrossRef] [Green Version]
- Seneviratne, S.N.; McCowan, L.M.E.; Cutfield, W.S.; Derraik, J.G.B.; Hofman, P.L. Exercise in pregnancies complicated by obesity: Achieving benefits and overcoming barriers. Am. J. Obstet. Gynecol. 2015, 212, 442–449. [Google Scholar] [CrossRef] [PubMed]
- De Vivo, M.; Mills, H. “They turn to you first for everything”: Insights into midwives’ perspectives of providing physical activity advice and guidance to pregnant women. BMC Pregnancy Childbirth 2019, 19, 462. [Google Scholar] [CrossRef]
- Harrison, A.L.; Taylor, N.F.; Shields, N.; Frawley, H.C. Attitudes, barriers and enablers to physical activity in pregnant women: A systematic review. J. Physiother. 2018, 64, 24–32. [Google Scholar] [CrossRef] [PubMed]
- Coll, C.V.N.; Domingues, M.R.; Gonçalves, H.; Bertoldi, A.D. Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence. J. Sci. Med. Sport 2017, 20, 17–25. [Google Scholar] [CrossRef]
- Lloyd, K.; O’Brien, W.; Riot, C. Mothers with young children: Caring for the self through the physical activity space. Leis. Sci. 2016, 38, 85–99. [Google Scholar] [CrossRef] [Green Version]
- Petrov Fieril, K.; Fagevik Olsén, M.; Glantz, A.; Larsson, M. Experiences of Exercise During Pregnancy Among Women Who Perform Regular Resistance Training: A Qualitative Study. Phys. Ther. 2014, 94, 1135–1143. [Google Scholar] [CrossRef] [Green Version]
- Staneva, A.A.; Bogossian, F.; Wittkowski, A. The experience of psychological distress, depression, and anxiety during pregnancy: A meta-synthesis of qualitative research. Midwifery 2015, 31, 563–573. [Google Scholar] [CrossRef]
- Johnson, S.A. ‘Intimate mothering publics’: Comparing face-to-face support groups and Internet use for women seeking information and advice in the transition to first-time motherhood. Cult. Health Sex. 2015, 17, 237–251. [Google Scholar] [CrossRef] [PubMed]
- Harrison, A.L.; Taylor, N.F.; Frawley, H.C.; Shields, N. Women with gestational diabetes mellitus want clear and practical messages from credible sources about physical activity during pregnancy: A qualitative study. J. Physiother. 2019, 65, 37–42. [Google Scholar] [CrossRef]
- Beresford, P. Public Participation in Health and Social Care: Exploring the Co-production of Knowledge. Front. Sociol. 2019, 3, 41. [Google Scholar] [CrossRef] [Green Version]
- Russell, J.; Greenhalgh, T.; Taylor, M. Patient and Public Involvement in NIHR Research 2006–2019: Policy Intentions, Progress and Themes; National Institute for Health Research: Oxford, UK, 2019.
- National Institute for Health Research. UK Standards for Public Involvement in Research: Better Public Involvement for Better Health and Social Care Research; National Institute for Health Research: Oxford, UK, 2019.
- Wilson, S. ‘Hard to reach’ parents but not hard to research: A critical reflection of gatekeeper positionality using a community-based methodology. Int. J. Res. Method Educ. 2020, 43, 461–477. [Google Scholar] [CrossRef]
- Boag-Munroe, G.; Evangelou, M. From hard to reach to how to reach: A systematic review of the literature on hard-to-reach families. Res. Pap. Educ. 2012, 27, 209–239. [Google Scholar] [CrossRef]
- Rayment-Jones, H.; Butler, E.; Miller, C.; Nay, C.; O’Dowd, J. A multisite audit to assess how women with complex social factors access and engage with maternity services. Midwifery 2017, 52, 71–77. [Google Scholar] [CrossRef] [Green Version]
- Emmel, N.; Hughes, K.; Greenhalgh, J.; Sales, A. Accessing Socially Excluded People—Trust and the Gatekeeper in the Researcher-Participant Relationship. Sociol. Res. Online 2007, 12, 43–55. [Google Scholar] [CrossRef] [Green Version]
- Sixsmith, J.; Boneham, M.; Goldring, J.E. Accessing the community: Gaining insider perspectives from the outside. Qual. Health Res. 2003, 13, 578–589. [Google Scholar] [CrossRef] [PubMed]
Characteristic | Category | Percentage (n = 553) |
---|---|---|
Age | 18–24 | 1.8% |
25–34 | 44.9% | |
35–44 | 49.9% | |
45–54 | 2.0% | |
55–64 | 1.3% | |
Missing | 0.2% | |
Location | Scotland | 7.4% |
Wales | 4.0% | |
Northern Ireland | 0.4% | |
England | 77.9% | |
Other | 10.3% | |
Education | Secondary | 3.6% |
College/Further Education | 10.9% | |
Trade/technical/vocational | 2.0% | |
Undergraduate degree | 32.0% | |
Postgraduate degree | 51.2% | |
Missing | 0.4% | |
Ethnicity | White | 91.1% |
Mixed/multiple ethnic groups | 3.6% | |
Asian/Asian British | 2.2% | |
Black/African/Caribbean/Black British | 1.5% | |
Prefer not to say | 0.9% | |
Other ethnic group | 0.5% | |
Missing | 0.2% | |
How many children | 0 | 8.7% |
1 | 51.9% | |
2 | 28.9% | |
3 | 6.3% | |
4 | 1.3% | |
5 | 0.2% | |
Missing | 2.7% | |
Currently | Pregnant | 11.8% |
A mother | 79.2% | |
Both | 8.5% | |
Neither | 0.4% | |
Missing | 0.2% | |
Age of youngest child | 0–2 | 70.5% |
3–5 | 11.8% | |
6–10 | 5.2% | |
11–15 | 1.5% | |
16+ | 1.8% | |
Not applicable | 8.5% | |
Missing | 0.7% |
Template Item | Selected Information and/or” Sample Quotation” from Survey Data |
---|---|
Background | Nausea, tiredness |
Concerns | “Having the motivation to move/exercise when feeling sick and constantly drained of energy is hard.” |
Positive experience/helpful advice | “Even though I felt sick I tried to think about what physical activity I already did and tried to keep doing it. I found it lifted my mood and energy levels, and I even noticed that exercise can actually sometimes make as nausea better!” |
Tips for other women | “Accept that you might have to modify what you do to accommodate your changing body but try not to stop altogether. Set yourself small goals.” |
Theme | Stakeholder/PPI Feedback |
---|---|
Information delivery | Create a video with real women or animation—use real-world experiences Include healthcare professionals giving simple advice based on physical activity guidelines Write into soap script Include in leaflets Women do not want more leaflets Include “bigger” ladies in a video Use real voices |
Content | Include a variety of ages Increase racial diversity Make sure the information is reputable/trustworthy Use lay language for people with lower education/reading age (not the words moderate, nausea, modify, accommodate) Involve local maternity voices Cover more topics—myth busting Verbalise for different groups (dyslexic, visually impaired) Include stories focusing on mental health, depression, anxiety—the emotional journey Include pelvic health Use plain language Do not like the word “exercise” Highlight difference between physical activity and exercise Translate into different languages Mention cultural barriers and solutions Use dialect At a glance not clearly about pregnancy |
Format | Cartoons are childish, infantile, confusing, risk of patronising patients—use real images instead Cartoons, name and age give stories a personal touch Visually a lot to digest—needs to be easy and simple Abbreviate messages to grab attention Make it less a block of text—paragraphs, different colours, more spacing, bold keywords Make it look like a social media post—more familiar Add a link for further advice |
Uses/dissemination | Disseminate information in early pregnancy, e.g., in first trimester Provide information in clinical settings e.g., Film/animation and posters in waiting rooms, during clinic appointments, postnatal health visits Make resources available in places frequented by pregnant women/new mothers, e.g., children’s centres, toddler groups, breastfeeding groups including their websites Make information available on trustworthy or recognised websites/platforms Have access to all information in one place, e.g., provide a single link to access extended resources Put on Facebook pages, social media On websites—click + hear women talking Can be used to start discussion in group workshops Instagram Live—expert answers questions Trip advisor of pregnancy Disseminate to Best Beginnings, Baby Buddy App |
General comments | Acknowledge that if you do not exercise, you do not fail as a mum Acknowledge that everyone’s ‘normal’ is different |
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Share and Cite
Salmon, V.E.; Rodgers, L.R.; Rouse, P.; Williams, O.; Cockcroft, E.; Boddy, K.; De Giorgio, L.; Thomas, C.; Foster, C.; Davies, R.; et al. Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond. Int. J. Environ. Res. Public Health 2021, 18, 4482. https://doi.org/10.3390/ijerph18094482
Salmon VE, Rodgers LR, Rouse P, Williams O, Cockcroft E, Boddy K, De Giorgio L, Thomas C, Foster C, Davies R, et al. Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond. International Journal of Environmental Research and Public Health. 2021; 18(9):4482. https://doi.org/10.3390/ijerph18094482
Chicago/Turabian StyleSalmon, Victoria E., Lauren R. Rodgers, Peter Rouse, Oli Williams, Emma Cockcroft, Kate Boddy, Luana De Giorgio, Ciara Thomas, Charlie Foster, Rosie Davies, and et al. 2021. "Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond" International Journal of Environmental Research and Public Health 18, no. 9: 4482. https://doi.org/10.3390/ijerph18094482