A will without a way: barriers and facilitators to exercise during pregnancy of low-income, African American women.
ABSTRACT The objective of the authors in this study was to identify pregnant, low-income African American women's barriers and facilitators to exercise during pregnancy. A series of six focus groups with pregnant African American women were audio-recorded and transcribed verbatim. Focus group transcripts were qualitatively analyzed for major themes and independently coded for barriers and facilitators to exercise during pregnancy. A total of 34 pregnant, African American women participated in six focus groups from June through October of 2007. The majority of women were single (94%), had only a high school education (67%), received Medicaid (100%) and had a mean body mass index of 33 kg/m(2). All participants believed that exercise was beneficial during their pregnancy. However, participants faced multiple barriers including: (1) individual, (2) information, (3) resource, and (4) socio-cultural. African American women also described two facilitators to increase exercise during pregnancy: (1) group exercise classes, and (2) increasing the number of safe, low-cost exercise facilities in their communities. African American women living in low socioeconomic communities face several barriers to exercise during pregnancy. Targeted interventions to overcome barriers and facilitate exercise for this patient population should focus on increasing education from providers regarding the type and frequency of exercise recommended during pregnancy, enhancing social support networks with group exercise programs, and providing affordable and convenient locations to exercise.
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ABSTRACT: Background Traditional risk factors for preterm delivery (PTD) do not account for the disparate rates among African-American women. Physical activity during pregnancy may protect women from PTD, but few studies exist in African Americans. Our objective was to examine the relationships between PTD and intensity and duration of leisure time physical activity (LTPA) as well as non-LTPA such as stair climbing and walking for a purpose during pregnancy. Methods Data were from a hybrid retrospective/prospective cohort study of urban low-income African-American women enrolled from 2001 to 2004 in the Baltimore PTD Study (n = 832). PTD was defined as birth before 37 completed weeks of gestation. Study participants reported physical activity during prenatal (n = 456) and post-partum (n = 376) interviews. Findings The rate of PTD was 16.7%. In unadjusted log-binomial regression models, we found no significant associations. However, in models adjusted for illicit drug use, locus of control, and a validated family resources scale, we found a significant decrease in prevalence of PTD for women who walked for a purpose more than 30 min/d (prevalence ratio, 0.64; 95% CI, 0.43–0.94), compared with women who walked less than or equal to 30 min/d. Conclusions These results suggest that walking for a purpose during pregnancy may confer protection against PTD among urban low-income African Americans.Women s Health Issues 07/2014; 24(4):e389–e395. DOI:10.1016/j.whi.2014.04.007 · 1.61 Impact Factor
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ABSTRACT: To describe the knowledge of underserved pregnant women related to diet, physical activity, and cardiovascular disease (CVD). Underserved pregnant women from the University of North Carolina and Pitt County, North Carolina participated in 9 focus group interviews. Focus group questions focused on knowledge of CVD risk factors, lifestyle prevention strategies such as diet and physical activity, and the sources of such knowledge. Data were analyzed with the constant comparative method. Prior to the focus group, each woman was invited to complete a telephone survey to collect demographic information and responses to a 13-item CVD knowledge questionnaire. Means and frequency procedures were used to analyze demographic information. Fifty women participated in nine focus group interviews. Participants possessed basic knowledge of CVD risk factors and preventive strategies, such as basic guidelines and recommendations for healthy diet and physical activity in pregnancy. However, women often receive incomplete guidance from obstetric providers, and women, therefore, desired more information on these topics. Some gaps were filled by nurses and nutritionists. Women also sought information from female friends and relatives. Incorrect knowledge was demonstrated in all groups and led to less healthful behaviors in some cases. Underserved pregnant women have basic knowledge about healthy lifestyle and CVD prevention behaviors; however important gaps and misinformation exist.Maternal and Child Health Journal 02/2015; DOI:10.1007/s10995-015-1693-2 · 2.24 Impact Factor
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ABSTRACT: This study was conducted to identify factors that influenced stress, healthy eating and physical activity among low-income overweight or obese pregnant women. We conducted seven focus groups with 96 low-income overweight and obese pregnant women. Common themes were identified from audio tapes and transcripts. Women said that poor communication affected their relationships with spouses or significant others. They were frustrated or upset with significant others for three key reasons: failure to understand or listen to the pregnant women's pregnancy concerns, refusal to be helpful when asked and being overly concerned with the woman's safety. Most women said that they were emotional and took naps throughout the day after becoming pregnant. Many withdrew from their social interactions. They also faced numerous challenges that made healthy eating more difficult, e.g., craving for unhealthy foods and eating foods for comfort. To eat healthier, some reminded themselves to avoid overeating or stop eating in the car. Women were not physically active because of tiredness, lack of motivation, inadequate social support, or bad weather. Some stayed physically active to prevent excessive pregnancy weight gain and have an easier labor. Women equivocally said weighing themselves to manage weight would add to their stress and make them feel more depressed. When designing interventions to help low-income overweight and obese pregnant women avoid excessive pregnancy weight gain, it is important to include information and practical advice on stress management, emphasizing effective communication skills with significant others and helping them plan effective ways to manage negative feelings.Maternal and Child Health Journal 08/2014; DOI:10.1007/s10995-014-1605-x · 2.24 Impact Factor