The Web of Risk Factors for Excessive Gestational Weight Gain in Low Income Women
The Web of Risk Factors for Excessive Gestational Weight Gain in Low Income Women
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DOI：
10.1007/s10995-012-0979-x
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发表时间：
2013-02-01
影响因子：
2.3
通讯作者：
Olson, Christine M.
中科院分区：
文献类型：
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作者：
Paul, Keriann H.;Graham, Meredith L.;Olson, Christine M.
本研究的目的是深入了解与妊娠体重增加 (GWG) 相关的问题，包括高收入和低收入女性的一般健康、饮食和体力活动，并阐明增加妊娠体重增加过多风险的社会生态和心理社会风险因素。我们对 18-35 岁的高收入孕妇（n = 4 组）和低收入孕妇（n = 5 组）进行了 9 个焦点小组讨论，按照讨论指南讨论健康、GWG、饮食和身体活动。使用持续比较方法来编码焦点小组笔记并确定新出现的主题。主题在行为预测的综合模型中进行分类。与高收入女性相比，低收入女性的体重指数更高，有更多的孩子，并且是非裔美国人。低收入女性报告的饮食和体育活动行为比高收入女性更有可能促进正能量平衡。两组女性所描述的基本行为、功效和规范信念解释了大部分行为。经历多种风险因素可能会导致（1）在怀孕期间发生一些与体重无关的行为变化；（2）持有更多促进体重增加的信念而不是维持体重的信念。这些因素可能会抑制饮食和身体活动行为和/或促进能量平衡的行为改变，并综合起来导致 GWG 过多。低收入女性面临着体重增加过多的多种风险因素，成功的干预措施以防止体重增加过多和与怀孕相关的体重增加需要认识到复杂的影响网络。
The objective of this study is to gain an in-depth understanding of issues related to gestational weight gain (GWG) including general health, diet, and physical activity among high and low income women and to elucidate socio-ecological and psychosocial risk factors that increase risk for excessive GWG. We conducted 9 focus groups with high (n = 4 groups) and low (n = 5 groups) income pregnant women aged 18-35 years to discuss health, GWG, diet and physical activity following a discussion guide. The constant comparative method was used to code focus group notes and to identify emergent themes. Themes were categorized within the integrative model of behavioral prediction. Low income women, in contrast to high income women, had higher BMIs, had more children, and were African American. Diet and physical activity behaviors reported by low income women were more likely to promote positive energy balance than were those of high income women. The underlying behavioral, efficacy, and normative beliefs described by both groups of women explained most of these behaviors. Experiencing multiple risk factors may lead to (1) engaging in several behavior changes during pregnancy unrelated to weight and (2) holding more weight gain-promoting beliefs than weight maintaining beliefs. These factors could inhibit diet and physical activity behaviors and/or behavior changes that promote energy balance and in combination, result in excessive GWG. Low income women experience multiple risk factors for excessive GWG and successful interventions to prevent excessive GWG and pregnancy related weight gain will need to recognize the complex web of influences.