Beliefs, Barriers, and Preferences of European Overweight Women to Adopt a Healthier Lifestyle in Pregnancy to Minimize Risk of Developing Gestational Diabetes Mellitus: An Explorative Study
Table 2
Interview questions and corresponding questionnaire statements and answers.
Interview questions
Interview answers ()
Statements questionnaire
% agreement ()
Remarks given by participants ()
Risk perception and perceived importance
Are you familiar with GDM, the consequences and risks associated with it?
Most are informed but not extensively
Nobody ever talked about the consequences of gestational diabetes with me
62
Would you have appreciated if someone had done so? Yes (46); No (4); Only if I had developed GDM (3)
How high do you estimate your own risk for developing GDM?
Different risk perceptions were reported
I think I have a high risk for developing GDM
57
Why do you think so? (over) weight (26); (family) history (G)DM (20); Unhealthy lifestyle (6); My doctor said so (4)
Why don’t you think so? Healthy diet and enough exercise (8); Normal test results (7); No (family) history DM/problems (7); Don’t know anything about GDM (3)
How important is GDM prevention to you?
Almost all women think this is important
I would go to great length to prevent GDM
92
How could you prevent GDM? Healthy nutrition (59); More physical activity (32); Lose weight (7)
How important is your health for you? How did this change during your pregnancy?
All indicate health of baby most important
A healthy lifestyle is very important at this moment
94
Is this different from before you were pregnant? No (31) Yes (32) Yes, but I can do less (back pain) and I am eating more (5)
Important to eat the correct food
Already during pregnancy I feel responsible for the health of my baby
100
No remarks
How did your weight change over the past years and how does this affect you? Do you mind people telling you that you are overweight?
Most were struggling with their weight for years, but prefer a more advocate approach from health provider
I would not mind health providers telling me I am overweight
79
No remarks
Barriers and perceived self-efficacy
What do you think is a healthy diet during pregnancy? Is this difficult for you to follow? What makes this difficult?
A healthy diet in pregnancy does not differ from a diet in general.
It is not difficult to maintain a healthy diet during pregnancy
49
In which situations is this difficult? Cravings/hungry (22); Social occasions (10)
Being busy, social gatherings, cravings and the notion to eat for two made it harder than usual
In my surroundings it is common for pregnant women to eat and snack more than usual
62
Is this extra difficult? no (24); yes (17); sometimes (3)
How physically active were you before you became pregnant, how did this change during your pregnancy?
Most participants stopped dangerous sports and participated in less intensive activities
I have not changed my exercise/physical activity habits during pregnancy
38
What has changed? Less physical activity (walking, running, cycling, swimming) (25); More physical activity (walking, swimming) (12) Changed the type of activity (5)
What makes it hard for you to become or stay physically active during your pregnancy? And what will make you stop?
Tiredness, being to busy and physical problems are the most frequently mentioned barriers which make it harder than usual to stay physically active
I will stop with physical activity when I develop physical complaints
80
What will make you stop? Complaints of pain (hard belly, back-, pelvic-, abdomen-, muscle-, leg pain) (30); Tiredness/exhausted (11); Bad for baby (9); Doctors advice (6); Heart problems/headache/migraine (5); Blood loss (2)
I am too tired to be physically active
46
No comments
I have too little time to be physically active
34
What other practical barriers keep you from physical activity? Other children/childcare (19); Motivation/Dislike of physical activity/Laziness (9); Work (6); Costs (6)
Preferences
How should we encourage pregnant women to take part in a prevention program?
Most women thought guidance, weight control and support research were reasons to participate in a prevention program
I find aiming for weight control in pregnancy more appealing than the prevention of gestational diabetes
37
In favour of weight control: Both equally important (1); Weight control prevents GDM (4) Weight is a bigger problem (4); Weight control is simpler (2)
In favour of GDM: Both equally important (15); GDM more important (9); GDM more dangerous for baby (3); More afraid of developing GDM (2); Focusing on GDM affects weight (2)
How should an intervention program look like? Do you have preference regarding guidance? Communication channels? What should definitely be included?
Talking about weight problems and addressing physical activity and healthy eating should be included in a prevention program
It motivates me if another person checks my diet and my weight regularly
76
No remarks
I would like to talk to a health provider, coach or dietician about my weight problems
86
No remarks
What motivates you to become physically active and eat more healthily?
Support from partner and regular appointments with friends/others
I feel better if I am physically active
92
No remarks
Thinking of the consequences and feeling good afterwards
It is important for me that my partner supports me
91
No remarks
Would you need help with healthy eating and physical activity in pregnancy and what kind of help would you appreciate?
Dietary advice from a dietician would be appreciated, regarding what (not) to eat and weight management
During pregnancy I would appreciate having personal support for having a healthy diet
71
How? Face-to-face (dietician, physician, obstetrician) (39); Internet (12); Telephone (11)
What were reasons for you to seek help regarding weight related issues?
They knew what to do regarding weight control in general but not specifically during pregnancy
I know what I have to do to lose weight in general, but I don’t know how to control my weight during pregnancy
44
Why is it different for you in pregnancy? Responsible for health of baby (8); More hunger (7); Difficult to do physical activity (6); Difficult to follow a diet (4); You don’t notice, because of growth of baby (3); I don’t know (3)
I know where pregnant women can get help with weight control in my surrounding/neighbourhood
30
No remarks
DM refers to diabetes mellitus; GDM refers to gestational diabetes mellitus. DM/problems refers to no family history of DM or problems with DM.
