A Qualitative Study of Factors Affecting Pregnancy Weight Gain in African American Women

University of South Carolina, 921 Assembly St., Suite 318, Columbia, SC, 29208, USA, .
Maternal and Child Health Journal (Impact Factor: 2.24). 04/2012; 17(3). DOI: 10.1007/s10995-012-1011-1
Source: PubMed


African Americans and overweight or obese women are at increased risk for excessive gestational weight gain (GWG) and postpartum weight retention. Interventions are needed to promote healthy GWG in this population; however, research on exercise and nutritional barriers during pregnancy in African American women is limited. The objective of this qualitative study is to better inform intervention messages by eliciting information on perceptions of appropriate weight gain, barriers to and enablers of exercise and healthy eating, and other influences on healthy weight gain during pregnancy in overweight or obese African American women. In-depth interviews were conducted with 33 overweight or obese African American women in Columbia, South Carolina. Women were recruited in early to mid-pregnancy (8-23 weeks gestation, n = 10), mid to late pregnancy (24-36 weeks, n = 15), and early postpartum (6-12 weeks postpartum, n = 8). Interview questions and data analysis were informed using a social ecological framework. Over 50 % of women thought they should gain weight in excess of the range recommended by the Institute of Medicine. Participants were motivated to exercise for personal health benefits; however they also cited many barriers to exercise, including safety concerns for the fetus. Awareness of the maternal and fetal benefits of healthy eating was high. Commonly cited barriers to healthy eating include cravings and availability of unhealthy foods. The majority of women were motivated to engage in healthy behaviors during pregnancy. However, the interviews also uncovered a number of misconceptions and barriers that can serve as future intervention messages and strategies.

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Available from: Kara M. Whitaker, Jan 21, 2015
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    • "Other studies have identified misperceptions about the risks and benefits of exercise during pregnancy (Evenson and Bradley, 2010; Goodrich et al., 2013; Padmanabhan et al., 2015). While it appears the health benefits of proper nutrition are better understood, women consistently cite many barriers to healthy eating, including lack of self-control in response to cravings (Goodrich et al., 2013; Sui et al., 2013; Padmanabhan et al., 2015). Some data also suggest there may be racial or ethnic differences in how women view these topics, particularly for weight gain and exercise (Groth and Kearney, 2009; Evenson and Bradley, 2010; Brooten et al., 2012; Groth et al., 2012; Sui et al., 2013). "
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    ABSTRACT: Objective: To describe African American and White women's perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race. Design: Qualitative interview study. Setting: Two Ob/Gyn clinics in South Carolina, USA. Participants: Thirty pregnant women (15 African American, 15 White) between 20 and 30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese). Findings: White women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby's health. The primary cited barrier of healthy eating was the high cost of fresh produce. Key conclusions and implications for practice: Several knowledge gaps as well as race differences were identified in women's perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimise health outcomes.
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    ABSTRACT: Prepregnancy body mass index and excessive gestational weight gain (GWG) are associated with adverse maternal and infant outcomes. Because stress contributes to obesity and eating behaviors, stress reduction interventions during pregnancy may be a novel way to influence GWG, positively affect maternal and infant outcomes, and address the obesity epidemic intergenerationally. Our research team is developing a mindfulness-based stress reduction and nutrition intervention for low-income, overweight and obese pregnant women, with healthy GWG as the primary outcome measure. To inform development of the intervention, we conducted focus groups with our target population. Focus group transcripts were analyzed for themes related to sources and importance of stress, relationship between stress and eating, and motivation for a stress reduction pregnancy intervention. Fifty-nine low-income pregnant women from the San Francisco Bay Area participated in focus groups and completed a questionnaire. The vast majority of women (80%) reported experiencing significant stress from a variety of sources and most recognized a relationship between stress and eating in their lives. This at-risk population seems to be extremely interested in a stress reduction intervention to support healthy GWG during pregnancy. The women in our groups described high levels of stress and a desire for programs beyond basic dietary recommendations. These findings inform practitioners and policymakers interested in pregnancy as a "window of opportunity" for behavior change that can affect the metabolic and weight trajectory both for women and their offspring.
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