Postpartum Women’s Preferences for Lifestyle Intervention after Childbirth: A Multi-Methods Study Using the TIDieR Checklist
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Participants
2.3. Data Collection
2.4. Data Analysis
3. Results
3.1. Semi-Structured Interviews
3.1.1. Theme 1: Practical Strategies Involving Social Support
3.1.2. Theme 2: Flexible and Embedded Routine Care Delivered by Health Professional
3.1.3. Theme 3: Early and Regular Postpartum Support
3.1.4. Theme 4: Manageable Duration Tailored to Individual Needs
3.2. Survey
4. Discussion
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
- Endres, L.K.; Straub, H.; McKinney, C.; Plunkett, B.; Minkovitz, C.S.; Schetter, C.D.; Ramey, S.; Wang, C.; Hobel, C.; Raju, T.; et al. Postpartum weight retention risk factors and relationship to obesity at one year. Obstet. Gynecol. 2015, 125, 144. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- McKinley, M.C.; Allen-Walker, V.; McGirr, C.; Rooney, C.; Woodside, J.V. Weight loss after pregnancy: Challenges and opportunities. Nutr. Res. Rev. 2018, 31, 225–238. [Google Scholar] [CrossRef] [Green Version]
- Abebe, D.S.; Von Soest, T.; Von Holle, A.; Zerwas, S.C.; Torgersen, L.; Bulik, C.M. Developmental trajectories of postpartum weight 3 years after birth: Norwegian Mother And Child Cohort study. Matern. Child Health J. 2015, 19, 917–925. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mannan, M.; Doi, S.A.; Mamun, A.A. Association between weight gain during pregnancy and postpartum weight retention and obesity: A bias-adjusted meta-analysis. Nutr. Rev. 2013, 71, 343–352. [Google Scholar] [CrossRef]
- Nehring, I.; Schmoll, S.; Beyerlein, A.; Hauner, H.; von Kries, R. Gestational weight gain and long-term postpartum weight retention: A meta-analysis. Am. J. Clin. Nutr. 2011, 94, 1225–1231. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Makama, M.; Skouteris, H.; Moran, L.J.; Lim, S. Reducing Postpartum Weight Retention: A Review of the Implementation Challenges of Postpartum Lifestyle Interventions. J. Clin. Med. 2021, 10, 1891. [Google Scholar] [CrossRef]
- Gore, S.A.; Brown, D.M.; West, D.S. The role of postpartum weight retention in obesity among women: A review of the evidence. Ann. Behav. Med. 2003, 26, 149–159. [Google Scholar] [CrossRef] [PubMed]
- Kew, S.; Ye, C.; Hanley, A.J.; Connelly, P.W.; Sermer, M.; Zinman, B.; Retnakaran, R. Cardiometabolic implications of postpartum weight changes in the first year after delivery. Diabetes Care 2014, 37, 1998–2006. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Farpour-Lambert, N.J.; Ells, L.J.; Martinez de Tejada, B.; Scott, C. Obesity and weight gain in pregnancy and postpartum: An evidence review of lifestyle interventions to inform maternal and child health policies. Front. Endocrinol. 2018, 9, 546. [Google Scholar] [CrossRef] [Green Version]
- Lim, S.; Hill, B.; Teede, H.J.; Moran, L.J.; O’Reilly, S. An evaluation of the impact of lifestyle interventions on body weight in postpartum women: A systematic review and meta-analysis. Obes. Rev. 2020, 21, e12990. [Google Scholar] [CrossRef]
- Lim, S.; O’Reilly, S.; Behrens, H.; Skinner, T.; Ellis, I.; Dunbar, J. Effective strategies for weight loss in post-partum women: A systematic review and meta-analysis. Obes. Rev. 2015, 16, 972–987. [Google Scholar] [CrossRef] [PubMed]
- Jones, E.J.; Fraley, H.E.; Mazzawi, J. Appreciating recent motherhood and culture: A systematic review of multimodal postpartum lifestyle interventions to reduce diabetes risk in women with prior gestational diabetes. Matern. Child Health J. 2017, 21, 45–57. [Google Scholar] [CrossRef] [PubMed]
- Makama, M.; Awoke, M.A.; Skouteris, H.; Moran, L.J.; Lim, S. Barriers and facilitators to a healthy lifestyle in postpartum women: A systematic review of qualitative and quantitative studies in postpartum women and healthcare providers. Obes Rev. 2021, 22, e13167. [Google Scholar] [CrossRef] [PubMed]
- Hoffmann, T.C.; Glasziou, P.P.; Boutron, I.; Milne, R.; Perera, R.; Moher, D.; Altman, D.G.; Barbour, V.; Macdonald, H.; Johnston, M.; et al. Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. Bmj 2014, 348, g1687. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cotterill, S.; Knowles, S.; Martindale, A.-M.; Elvey, R.; Howard, S.; Coupe, N.; Wilson, P.; Spence, M. Getting messier with TIDieR: Embracing context and complexity in intervention reporting. BMC Med. Res. Methodol. 2018, 18, 12. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Anguera, M.T.; Blanco-Villaseñor, A.; Losada, J.L.; Sánchez-Algarra, P.; Onwuegbuzie, A.J. Revisiting the difference between mixed methods and multimethods: Is it all in the name? Qual. Quant. 2018, 52, 2757–2770. [Google Scholar] [CrossRef]
- Tong, A.; Sainsbury, P.; Craig, J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care 2007, 19, 349–357. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Australian Bureau of Statistics. National, State and Territory Population. 2021. Available Online: https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/latest-release# (accessed on 8 August 2022).
- Guest, G.; Bunce, A.; Johnson, L. How many interviews are enough? An experiment with data saturation and variability. Field Methods 2006, 18, 59–82. [Google Scholar] [CrossRef]
- Michie, S.; Van Stralen, M.M.; West, R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement. Sci. 2011, 6, 42. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kessler, R.C.; Andrews, G.; Colpe, L.J.; Hiripi, E.; Mroczek, D.K.; Normand, S.-L.; Walters, E.E.; Zaslavsky, A.M. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002, 32, 959–976. [Google Scholar] [CrossRef] [PubMed]
- Feinberg, M.E.; Brown, L.D.; Kan, M.L. A Multi-Domain Self-Report Measure of Coparenting. Parent Sci. Pract. 2012, 12, 1–21. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Brown, W.J.; Burton, N.W.; Marshall, A.L.; Miller, Y.D. Reliability and validity of a modified self-administered version of the Active Australia physical activity survey in a sample of mid-age women. Aust. N. Z. J. Public Health 2008, 32, 535–541. [Google Scholar] [CrossRef] [PubMed]
- Malek, L.; Umberger, W.; Makrides, M.; Zhou, S.J. Adherence to the Australian dietary guidelines during pregnancy: Evidence from a national study. Public Health Nutr. 2016, 19, 1155–1163. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Buysse, D.J.; Yu, L.; Moul, D.E.; Germain, A.; Stover, A.; Dodds, N.E.; Johnston, K.L.; Shablesky-Cade, M.A.; Pilkonis, P.A. Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments. Sleep 2010, 33, 781–792. [Google Scholar] [CrossRef] [Green Version]
- Traylor, J.; Chandrasekaran, S.; Limaye, M.; Srinivas, S.; Durnwald, C.P. Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy. J. Matern. Fetal Neonatal Med. 2016, 29, 2067–2072. [Google Scholar] [CrossRef]
- Walker, E.A.; Mertz, C.K.; Kalten, M.R.; Flynn, J. Risk perception for developing diabetes: Comparative risk judgments of physicians. Diabetes Care 2003, 26, 2543–2548. [Google Scholar] [CrossRef] [Green Version]
- Kim, C.; McEwen, L.N.; Piette, J.D.; Goewey, J.; Ferrara, A.; Walker, E.A. Risk perception for diabetes among women with histories of gestational diabetes mellitus. Diabetes Care 2007, 30, 2281–2286. [Google Scholar] [CrossRef] [Green Version]
- Rossiter, C.; Fowler, C.; Hesson, A.; Kruske, S.; Homer, C.S.; Schmied, V. Australian parents’ use of universal child and family health services: A consumer survey. Health Soc. Care Community 2019, 27, 472–482. [Google Scholar] [CrossRef]
- Australian Institute of Health and Welfare. Diabetes: Australian facts; AIHW, Australian Government, 2022. Available Online: https://www.aihw.gov.au/reports/diabetes/diabetes/contents/about (accessed on 1 October 2022).
- Ingstrup, M.S.; Wozniak, L.A.; Mathe, N.; Butalia, S.; Davenport, M.H.; Johnson, J.A.; Johnson, S.T. Women’s experience with peer counselling and social support during a lifestyle intervention among women with a previous gestational diabetes pregnancy. Health Psychol. Behav. Med. 2019, 7, 147–159. [Google Scholar] [CrossRef] [Green Version]
- MacKenzie-Shalders, K.; Matthews, C.; Dulla, J.; Orr, R. Law enforcement personnel are willing to change, but report influencing beliefs and barriers to optimised dietary intake. BMC Public Health 2020, 20, 1638. [Google Scholar] [CrossRef]
- Lim, S.; Hill, B.; Pirotta, S.; O’Reilly, S.; Moran, L. What Are the Most Effective Behavioural Strategies in Changing Postpartum Women’s Physical Activity and Healthy Eating Behaviours? A Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 237. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Contento, I.R. Nutrition education: Linking research, theory, and practice. Asia Pac. J. Clin. Nutr. 2008, 17 (Suppl S1), 176–179. [Google Scholar] [PubMed]
- Carter-Edwards, L.; Østbye, T.; Bastian, L.A.; Yarnall, K.S.; Krause, K.M. Barriers to adopting a healthy lifestyle: Insight from postpartum women. BMC Res. Notes 2009, 2, 161. [Google Scholar] [CrossRef] [Green Version]
- Nicklas, J.M.; Zera, C.A.; Seely, E.W.; Abdul-Rahim, Z.S.; Rudloff, N.D.; Levkoff, S.E. Identifying postpartum intervention approaches to prevent type 2 diabetes in women with a history of gestational diabetes. BMC Pregnancy Childbirth 2011, 11, 23. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kruske, S.; Schmied, V.; Sutton, I.; O’Hare, J. Mothers’ experiences of facilitated peer support groups and individual child health nursing support: A comparative evaluation. J. Perinat Educ. 2004, 13, 31–38. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Scott, D.; Brady, S.; Glynn, P. New mother groups as a social network intervention: Consumer and maternal and child health nurse perspectives. Aust. J. Adv. Nurs. 2001, 18, 23–29. [Google Scholar]
- Herring, S.J.; Bersani, V.M.; Santoro, C.; McNeil, S.J.; Kilby, L.M.; Bailer, B. Feasibility of using a peer coach to deliver a behavioral intervention for promoting postpartum weight loss in Black and Latina mothers. Transl. Behav. Med. 2021, 11, 1226–1234. [Google Scholar] [CrossRef]
- Lim, S.; Liang, X.; Hill, B.; Teede, H.; Moran, L.J.; O’Reilly, S. A systematic review and meta-analysis of intervention characteristics in postpartum weight management using the TIDieR framework: A summary of evidence to inform implementation. Obes. Rev. 2019, 20, 1045–1056. [Google Scholar] [CrossRef]
- Harrison, C.L.; Lombard, C.B.; Teede, H.J. Limiting postpartum weight retention through early antenatal intervention: The HeLP-her randomised controlled trial. Int. J. Behav. Nutr. Phys. Act. 2014, 11, 134. [Google Scholar] [CrossRef]
- Huseinovic, E.; Bertz, F.; Leu Agelii, M.; Hellebö Johansson, E.; Winkvist, A.; Brekke, H.K. Effectiveness of a weight loss intervention in postpartum women: Results from a randomized controlled trial in primary health care. Am. J. Clin. Nutr. 2016, 104, 362–370. [Google Scholar] [CrossRef] [Green Version]
- Dasgupta, K.; Maindal, H.T.; Nielsen, K.K.; O’Reilly, S. Achieving penetration and participation in diabetes after pregnancy prevention interventions following gestational diabetes: A health promotion challenge. Diabetes Res. Clin. Pract. 2018, 145, 200–213. [Google Scholar] [CrossRef]
- Colleran, H.L.; Lovelady, C.A. Use of MyPyramid Menu Planner for Moms in a weight-loss intervention during lactation. J. Acad. Nutr. Diet. 2012, 112, 553–558. [Google Scholar] [CrossRef] [PubMed]
- Branquinho, M.; Canavarro, M.C.; Fonseca, A. A blended psychological intervention for postpartum depression: Acceptability and preferences in women presenting depressive symptoms. J. Reprod. Infant Psychol. 2021, 1–15. [Google Scholar] [CrossRef] [PubMed]
- Lim, S.; Dunbar, A.J.; Versace, V.; Janus, E.; Wildey, C.; Skinner, T.; O’Reilly, S. Comparing a telephone-and a group-delivered diabetes prevention program: Characteristics of engaged and non-engaged postpartum mothers with a history of gestational diabetes. Diabetes Res. Clin. Pract. 2017, 126, 254–262. [Google Scholar] [CrossRef] [PubMed]
- Frambach, J.M.; van der Vleuten, C.P.; Durning, S.J. AM last page. Quality criteria in qualitative and quantitative research. Acad. Med. 2013, 88, 552. [Google Scholar] [CrossRef]
Characteristics | Interviews n (%) 1 |
---|---|
Age (mean ± SD) | 36.5 ± 4.3 |
BMI (median ± IQR) | 23.1 ± 3.2 |
Age of youngest child | |
Less than 6 months | 4 (19.0) |
6 months to less than 1 year | 1 (4.8) |
1 year old | 16 (76.2) |
Country of birth | |
Australian born | 13 (61.9) |
Overseas born | 8 (38.1) |
Education | |
High school | 1 (4.8) |
Diploma/Advanced diploma | 0 |
Degree/higher | 20 (95.2) |
Employment | |
Unemployed/homemaker | 2 (9.5) |
Employed/studying | 19 (90.5) |
Complication in pregnancy | |
Gestational diabetes | 4 (19.0) |
Preeclampsia | 1 (4.8) |
TIDieR Element | Subtheme | Theme | Representative Quotes 1 |
---|---|---|---|
What (program content or type) | No need for more information | Theme 1: Practical strategies involving social support | Uh, to be honest, I don’t really feel like I need more information. I feel like (laughs) at the moment it’s information overload (laughs). #3, 43 |
Involve partners, family and mothers groups as the main sources of support | It’s helpful if, um, if we find some mums that really, um, similar- similar- similar background for myself, yeah. #1, 44 | ||
Practical support and activities that can be done with children | So any, any sort of service that can help with allowing you to have more time, um, I think would be great. #7, 34 | ||
Practical strategies and accountability | …whatever the model is, it’s about having, you know, accountability to keep you on that track…. I just think something where you’ve got people who check in on you who make that, who keep you consistent. #19, 42 | ||
Peer coaching | Yeah, I think that is a good source of support because we understand what each other is going through and what some of the barriers may be to looking after our health. Getting out and about with other mothers and exercising is really great. #6, 39 | ||
Who (program provider) | Maternal and child health nurses | Theme 2: Flexible and embedded routine care delivered by health professional | in those early days given the amount of, um, interaction you have with the maternal and child health nurse- that would probably be a really good avenue because certainly they’re already talking to you around, you know, they’re doing the depression screener and things. #12, 37 |
Other health professionals | And for me a GP not so much, because I don’t really have any major health problems. But Allied Health, a personal trainer exercise, you know, a physiologist who could set a program would be good. #13, 33 | ||
How (delivery mode and setting) | Embedded within regular schedules of infant care | if it’s something that fits into your regular routine, so if you’re seeing those mothers on a regular basis and it’s something that you could implement #19, 42 | |
Small groups or one-on-one | One-on-one might be… group is always nice, because you hear other people’s experiences, too, and sometimes then you can open up and share, but one-on-one with the mat nurse is, is okay, too. Either, I think either would be okay. #11, 31 | ||
Flexibility | …having sessions …that set up or even the option to drop in and have those discussions as you need. Um, I think that’s really important because I know that with a young child at home, um, having appointments or having set times and days for things isn’t always possible… #9, 30 | ||
Where (delivery platform) | Child-friendly space | I’m kind of imagining like a bit of a creche area or something like that. Where your… Where the babies have like a safe area to be. Maybe someone who can kind of watch them, but you’re still right there, like you can see them and um, yeah. #21, 34 | |
Online accessibility | I would choose online. group environment. #14, 38 | ||
Face-to-face | Um, I think, I think, it’s better to meet personally than online just- just only… I mean, online probably for information but, yeah, we still need that social interaction. #1, 44 | ||
Maternal and child health centre | Yeah, I mean I guess um, the maternal child health nurse would be the obvious thing, because that’s, I was going there anyway you know, fairly regularly. So we could have had that incorporated into something I’m already doing. #3, 43 | ||
Program cost | Free or small cost | …having something provided for you that is free of charge I think is, um, I, yeah. I just think it’s, um, it’s a good way to make you feel supported. #4, 38 | |
When and how much (program commencement) | 3–6 months after birth | Theme 3: Early and regular postpartum support | …after six months probably….Cause the first, the early month is, um, it’s just tiring and busy with, uh, feeding and you know, adjusting. #2, 43 |
When and how much (How often—program frequency) | Weekly | So yeah. Look, when you’re at home and you don’t have much to do or go to, I really liked having something to go to every week. #5, 32 | |
Fortnightly or monthly | But now like with work, I think once, uh, once fortnightly or something like that will be nice to have like a group where you can go on talk or discussions or even to activities or go out for something, whatever. #15, 38 | ||
When and how much (length of session) | Short sessions of about 30 min and not more than 1 h | Theme 4: Manageable duration tailored to individual needs | Yeah, yeah, up to an hour. An hour’s a long time for a baby. #21, 34 |
Depends on the nature of the support | I’m quite happy to receive the information and then do the work on my own but other women may need or want more support. … but I’m sure there’s plenty of mums out there that would actually like more frequent intensive support. It’s a personal choice depending on how well supported you may feel. #6, 39 | ||
When and how much (program duration) | As needed | yeah probably, as regular as you need them there after …I think as long as, if they worked… in tandem with those, um, maternity health care appointments. That could work. #16, 33 | |
Short term | I think long term, people lose interest. But this is me being biased. #13, 33 |
Characteristics | Whole Population (n = 520)n(%) 1 | Women with Children < 2 Years (n = 214) n (%) | Women with Children 2–5 Years (n = 306)n(%) | pValue 2 |
Age (mean ± SD) | 33.6 ± 5.4 | 31.7 ± 5.0 | 35.0 ± 5.3 | <0.001 |
BMI (median ± IQR) | 25.7 ± 9.4 | 25.7 ± 9.4 | 25.6 ± 9.2 | 0.9201 |
Age of youngest child | <0.001 | |||
Less than 6 months | 62 (11.9) | 62 (29.0) | N/A | |
6 months to less than 1 year | 66 (12.7) | 66 (30.8) | N/A | |
1 year old | 86 (16.5) | 86 (40.2) | N/A | |
2 years old | 95 (18.3) | N/A | 95 (31.1) | |
3 years old | 73 (14.0) | N/A | 73 (23.9) | |
4 years old | 70 (13.5) | N/A | 70 (22.9) | |
5 years old | 68 (13.1) | N/A | 68 (22.2) | |
Country of birth | 0.833 | |||
Australian born | 282 (54.2) | 125 (58.4) | 157 (51.3) | |
Overseas born | 238 (45.8) | 89 (41.6) | 149 (48.7) | |
Marital status | 0.005 | |||
Married/de facto | 450 (88.5) | 194 (90.7) | 266 (86.9) | |
Single (never married/divorced/separated) | 57 (11.0) | 18 (8.4) | 39 (12.8) | |
Missing | 3 (0.6) | 2 (0.9) | 1 (0.3) | |
Education | 0.751 | |||
High school | 128 (24.6) | 54 (25.2) | 74 (24.2) | |
Diploma/Advanced diploma | 101 (19.4) | 36 (16.8) | 65 (21.2) | |
Degree/higher | 288 (55.4) | 124 (57.9) | 164 (53.6) | |
Missing | 3 (0.6) | 0 | 3 (1.0) | |
Employment | 0.535 | |||
Unemployed/homemaker | 147 (28.3) | 65 (30.4) | 82 (26.8) | |
Employed/studying | 365 (70.2) | 145 (67.8) | 220 (71.9) | |
Missing | 8 (1.5) | 4 (1.9) | 4 (1.3) | |
Annual Household Income | 0.192 | |||
Low (<50,000 AUD) | 80 (15.4) | 24 (11.2) | 56 (18.3) | |
Medium (50,000–124,999 AUD) | 247 (47.5) | 107 (50.0) | 140 (45.8) | |
High (≥125,000) | 161 (31.0) | 72 (33.6) | 89 (29.1) | |
Missing | 32 (6.2) | 11 (5.1) | 21 (6.9) | |
Pregnancy complications | ||||
Gestational diabetes | 105 (20.2) | 50 (23.4) | 55 (18.0) | 0.149 |
Preeclampsia | 35 (6.7) | 15 (7.0) | 20 (6.5) | 0.860 |
Gestational hypertension | 38 (7.3) | 20 (9.4) | 18 (5.9) | 0.170 |
Small for gestational age | 23 (4.4) | 13 (6.1) | 10 (3.3) | 0.135 |
Pre-term birth | 64 (12.3) | 29 (13.6) | 35 (11.4) | 0.499 |
Medical conditions | ||||
Diabetes | 17 (3.3) | 5 (2.3) | 12 (3.9) | 0.453 |
Polycystic ovary syndrome | 45 (8.7) | 12 (5.6) | 33 (10.8) | 0.040 |
Infertility | 29 (5.6) | 8 (3.7) | 21 (6.9) | 0.173 |
TIDieR Element | Program Characteristics | Responses, n (%) (Whole Population, n = 520) | Responses, n (%) (Women with Children <2 years, n = 214) | Responses, n (%) (Women with Children 2–5 years, n = 306) | p Value 1 |
---|---|---|---|---|---|
Interest in a lifestyle program | Yes | 470 (90.4) | 196 (91.6) | 274 (89.5) | 0.455 |
No | 50 (9.6) | 18 (8.4) | 32 (10.5) | ||
What (program content) (multiple response question) | Women’s health | 433 (83.3) | 175 (81.8) | 258 (84.3) | 0.475 |
Breastfeeding | 351 (67.5) | 152 (71.0) | 199 (65.0) | 0.155 | |
Caring for my baby | 326 (62.7) | 137 (64.0) | 189 (61.8) | 0.645 | |
Children’s health | 343 (66.0) | 141 (65.9) | 202 (66.0) | 1.000 | |
Mother’s diet | 336 (64.6) | 140 (65.4) | 196 (64.1) | 0.780 | |
How to lose weight | 306 (58.8) | 117 (54.7) | 189 (61.8) | 0.124 | |
How to prevent weight gain | 243 (46.7) | 94 (43.9) | 149 (48.7) | 0.286 | |
How to maintain weight | 226 (43.5) | 88 (41.1) | 138 (45.1) | 0.419 | |
Preventing diabetes or heart disease | 169 (32.5) | 69 (32.2) | 100 (32.7) | 0.925 | |
Mental health | 396 (76.2) | 168 (78.5) | 228 (74.5) | 0.298 | |
Exercise after birth | 369 (71.0) | 175 (81.8) | 194 (63.4) | <0.001 | |
How to determine the credibility of health information | 144 (27.2) | 70 (32.7) | 74 (24.2) | 0.037 | |
How to set goals and action plans for health | 236 (45.4) | 98 (45.8) | 138 (45.1) | 0.929 | |
How to set aside time for health | 259 (49.8) | 115 (53.7) | 144 (47.1) | 0.154 | |
Self-recording diet and physical activity | 145 (27.9) | 61 (28.5) | 84 (27.5) | 0.843 | |
Monitoring blood tests and other health outcomes | 130 (25.0) | 55 (25.7) | 75 (24.5) | 0.759 | |
Others—e.g., body dysmorphia after birth, focusing on becoming fitter and stronger rather than losing weight, how to manage postnatal depression, learning about eczema, relationship, and sex after children, pelvic floor rehabilitation | 7 (1.3) | 6 (2.8) | 1 (0.3) | 0.021 | |
What (additional program inclusions) (multiple response question) | Someone to monitor my progress | 326 (62.7) | 137 (64.0) | 189 (61.8) | 0.645 |
Send me reminders and prompts | 299 (57.5) | 127 (59.3) | 172 (56.2) | 0.476 | |
Social support for health | 337 (64.8) | 146 (68.2) | 191 (62.4) | 0.192 | |
Questions to ask my doctor | 216 (41.5) | 98 (45.8) | 118 (38.6) | 0.104 | |
Others, e.g., include something for the child’s father, physio, mental health is vital postpartum, like someone to check in, but respect wishes and not insist | 5 (1.0) | 1 (0.5) | 4 (1.3) | 0.653 | |
Who (program provider) (multiple response question) | Someone with expertise in women’s health, e.g., health professional | 468 (90.0) | 194 (90.7) | 274 (89.5) | 0.678 |
Someone with expertise in children’s health, e.g., health professional | 283 (54.4) | 114 (53.3) | 169 (55.2) | 0.659 | |
Another mum | 135 (26.0) | 66 (30.8) | 69 (22.5) | 0.042 | |
Someone else—Dietitian, GP, psychologist, postpartum midwife, registered nurse, personal trainer, any person other than a health professional, holistic person, young non-menopausal woman, maternal and child health nurse, someone knowledgeable in nutrition and women’s recovery after childbirth | 10 (1.9) | 5 (2.3) | 5 (1.6) | 0.747 | |
How (delivery mode and setting) (multiple response question) | Online information and resource | 385 (74.0) | 165 (77.1) | 220 (71.9) | 0.188 |
Print information and resource | 191 (36.7) | 70 (32.7) | 121 (39.5) | 0.117 | |
One-on-one video or phone consultation | 214 (41.2) | 90 (42.1) | 124 (40.5) | 0.786 | |
One-on-one face-to-face consultation | 287 (55.2) | 120 (56.1) | 167 (54.6) | 0.788 | |
Group video consultation | 119 (22.9) | 44 (20.6) | 75 (24.5) | 0.340 | |
Group face-to-face consultation | 194 (37.3) | 84 (39.3) | 110 (35.9) | 0.462 | |
Others—nurse home visits | 1 (0.2) | 1 (0.5) | 0 | N/A | |
Where (delivery platform) (multiple response question) | Online | 352 (67.7) | 146 (68.2) | 206 (67.3) | 0.849 |
Maternal child health nurse visit | 390 (75.0) | 164 (76.6) | 226 (73.9) | 0.537 | |
Mothers group/playgroup | 279 (53.7) | 116 (54.2) | 163 (53.3) | 0.858 | |
GP clinic | 269 (51.7) | 114 (53.3) | 155 (50.7) | 0.593 | |
Others—at a paediatric appointment, centre, home visit, in-home or at a gym, maternity ward, in own home, women’s health professional | 1 (0.2) | 4 (1.9) | 3 (1.0) | 0.454 | |
Where (avenue for learning about the program) | Social media (Facebook, Twitter, Instagram, WhatsApp, WeChat, LINE) | 402 (77.3) | 163 (76.2) | 239 (78.1) | 0.604 |
Word of mouth | 222 (42.7) | 92 (43.0) | 130 (42.5) | 0.928 | |
Blog or Forum, e.g., Blog, Google, Healthengine, Mum | 21 (4.0) | 9 (4.2) | 12 (3.9) | 1.000 | |
Newspapers, e.g., Herald sun, 7news, 9news, ABC news, online newspapers | 15 (2.9) | 6 (2.8) | 9 (2.9) | 1.000 | |
Playgroup/Mothers group/Parents group | 230 (44.2) | 106 (49.5) | 124 (40.5) | 0.048 | |
School, childcare, or early learning centre | 199 (38.3) | 77 (36.0) | 122 (39.9) | 0.409 | |
Public library | 103 (19.8) | 42 (19.6) | 61 (19.9) | 1.000 | |
Health facility (hospital, GP clinic, MCH nurse or centre) | 442 (85.0) | 193 (90.2) | 249 (81.4) | 0.006 | |
Others, e.g., email, Google search, letters sent directly, survey | 5 (1.0) | 1 (0.5) | 4 (1.3) | ||
When and how much (program commencement) | 6 weeks or earlier | 171 (32.9) | 64 (29.9) | 107 (35.0) | 0.306 |
7 weeks to 3 months | 210 (40.4) | 90 (42.1) | 120 (39.2) | ||
4—6 months | 98 (18.9) | 44 (20.6) | 54 (17.6) | ||
7–12 months | 18 (3.5) | 5 (2.3) | 13 (4.2) | ||
After 12 months | 7 (1.4) | 2 (0.9) | 5 (1.6) | ||
Other—preconception, during pregnancy, straight away, between 0 and 8 weeks at earliest but it can be overwhelming, every woman is different, as soon as possible because it feels like the mother’s wellbeing is forgotten about too quickly after it feels right—it can be 1 month or 12 months | 9 (1.7) | 6 (2.8) | 3 (1.0) | ||
Missing | 7 (1.4) | 3 (1.4) | 4 (1.3) | ||
When and how much (how often—program frequency) | Every 6 months | 27 (5.2) | 7 (3.3) | 20 (6.6) | 0.346 |
Every 3 months | 94 (18.1) | 36 (16.8) | 58 (19.2) | ||
Every month | 190 (36.5) | 84 (39.3) | 106 (35.1) | ||
Every fortnight | 121 (23.3) | 49 (22.9) | 72 (23.8) | ||
Every week | 70 (13.5) | 29 (13.6) | 41 (13.6) | ||
Once off | 4 (0.8) | 1 (0.5) | 3 (1.0) | ||
Others—every day, every 3 weeks, valuable in an app—on demand, every month for 4 months and then quarterly thereafter, an individual plan that caters to the mum and her family | 7 (1.4) | 5 (2.3) | 2 (0.7) | ||
Missing | 7 (1.4) | 3 (1.4) | |||
When and how much (length of session) | Less than 15 min | 30 (5.8) | 12 (5.6) | 18 (6.0) | 0.891 |
Between 15 and 30 min | 226 (43.5) | 94 (43.9) | 132 (43.7) | ||
Between 30 and 45 min | 181 (34.8) | 74 (34.6) | 107 (35.4) | ||
Between 45 and 60 min | 71 (13.7) | 28 (13.1) | 43 (14.2) | ||
More than 60 min | 4 (0.8) | 2 (0.9) | 2 (0.7) | ||
Others | 1 (0.2 | 1 (0.5) | 0 | ||
Missing | 7 (1.4) | 3 (1.4) | 4 (1.3) | ||
When and how much (program duration) | <1 month | 19 (3.7) | 6 (2.8) | 13 (4.3) | 0.899 |
1 month | 47 (9.0) | 19 (8.9) | 28 (9.3) | ||
3 months | 73 (14.0) | 30 (14.0) | 43 (14.2) | ||
6 months | 133 (25.6) | 59 (27.6) | 74 (24.5) | ||
1 year | 235 (45.2) | 94 (43.9) | 141 (46.7) | ||
Others—2 years, as long as it takes to lose the weight, as long as needed, however long or short you want, long term | 6 (1.2) | 3 (1.4) | 3 (1.0) | ||
Missing | 7 (1.4) | 3 (1.4) | 4 (1.3) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Makama, M.; Chen, M.; Moran, L.J.; Skouteris, H.; Harrison, C.L.; Choi, T.; Lim, S. Postpartum Women’s Preferences for Lifestyle Intervention after Childbirth: A Multi-Methods Study Using the TIDieR Checklist. Nutrients 2022, 14, 4229. https://doi.org/10.3390/nu14204229
Makama M, Chen M, Moran LJ, Skouteris H, Harrison CL, Choi T, Lim S. Postpartum Women’s Preferences for Lifestyle Intervention after Childbirth: A Multi-Methods Study Using the TIDieR Checklist. Nutrients. 2022; 14(20):4229. https://doi.org/10.3390/nu14204229
Chicago/Turabian StyleMakama, Maureen, Mingling Chen, Lisa J. Moran, Helen Skouteris, Cheryce L. Harrison, Tammie Choi, and Siew Lim. 2022. "Postpartum Women’s Preferences for Lifestyle Intervention after Childbirth: A Multi-Methods Study Using the TIDieR Checklist" Nutrients 14, no. 20: 4229. https://doi.org/10.3390/nu14204229
APA StyleMakama, M., Chen, M., Moran, L. J., Skouteris, H., Harrison, C. L., Choi, T., & Lim, S. (2022). Postpartum Women’s Preferences for Lifestyle Intervention after Childbirth: A Multi-Methods Study Using the TIDieR Checklist. Nutrients, 14(20), 4229. https://doi.org/10.3390/nu14204229