Excess Gestational Weight Gain in Low-Income Overweight and Obese Women: A Qualitative Study
Excess Gestational Weight Gain in Low-Income Overweight and Obese Women: A Qualitative Study
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DOI：
10.1016/j.jneb.2015.05.011
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发表时间：
2015-09-01
影响因子：
2.6
通讯作者：
Whigham, Leah D.
中科院分区：
文献类型：
--
作者：
Anderson, Cynthie K.;Walch, Tanis J.;Whigham, Leah D.
目的：研究低收入超重和肥胖妇女妊娠期体重增加（GWG）的相关因素。设计：定性研究。设置：社区围产期中心。参与者：八个妇女焦点小组（黑人= 48%，非西班牙裔白色人= 41%，西班牙裔人= 10%）在妊娠前半期（n = 12）和妊娠后半期（n = 10）或产后（n = 7），2与妇产科医生（n = 9）。感兴趣的现象：障碍和促进健康饮食和GWG在不同层次的社会生态模型：例如，个人，人际，和organization.Analysis：编码指南是基于社会生态模型。转录本由3名研究人员编码的共同主题。结果：在个人层面上，知识/技能和渴望是最常见的障碍。在人际关系层面，家人和朋友的影响力最大。在组织层面，妇女、婴儿和儿童特别补充营养方案和诊所具有影响力。在社区一级，最经常讨论的问题是缺乏交通工具。在政策层面，围绕妇女、婴儿和儿童特别补充营养方案的复杂政策和社会污名是障碍。与会者一致认为，理想的干预办法应包括由同行推动的支助小组，并由专家提供信息。妇产科医生感到不舒服，因为时间的限制，其他优先事项，并缺乏training.Conclusions和影响：有多层次的公共卫生机会，以促进健康的GWG咨询患者GWG。营养专家和妇产科医生之间需要更好的沟通。
Objective: Examine factors implicated in gestational weight gain (GWG) in low-income overweight and obese women.Design: Qualitative study.Setting: Community-based perinatal center.Participants: Eight focus groups with women (black = 48%, white non-Hispanic = 41%, and Hispanic = 10%) in the first half (n = 12) and last half of pregnancy (n = 10) or postpartum (n = 7), 2 with obstetrician-gynecologists (n = 9).Phenomenon of Interest: Barriers and facilitators to healthy eating and GWG within different levels of the Social Ecological Model: for example, intrapersonal, interpersonal, and organizational.Analysis: Coding guide was based on the Social Ecological Model. Transcripts were coded by 3 researchers for common themes. Thematic saturation was reached.Results: At an intrapersonal level, knowledge/skills and cravings were the most common barriers. At an interpersonal level, family and friends were most influential. At an organizational level, the Special Supplemental Nutrition Program for Women, Infants, and Children and clinics were influential. At the community level, lack of transportation was most frequently discussed. At a policy level, complex policies and social stigma surrounding the Special Supplemental Nutrition Program for Women, Infants, and Children were barriers. There was consensus that ideal intervention approaches would include peer-facilitated support groups with information from experts. Obstetrician-gynecologists felt uncomfortable counseling patients about GWG because of time constraints, other priorities, and lack of training.Conclusions and Implications: There are multilevel public health opportunities to promote healthy GWG. Better communication between nutrition specialists and obstetrician-gynecologists is needed.