Exploring fear in healthcare and physical activity engagement: perspectives of culturally diverse pregnant women, mothers, and health professionals

多学科研究小组“母婴流动”（MovingthroughMotherhood）与母亲们举行了研讨会，强调恐惧对怀孕的影响，以及对不同文化背景的女性进行体育活动（PA）行为的影响。孕妇和母亲之间存在着巨大的文化多样性。2020年，在英格兰和威尔士出生的60万新生儿中，约有29%是由非英国出生的母亲所生，少数民族母亲怀孕的后果包括妊娠期糖尿病和产后肥胖的风险增加。解剖上的改变和母性的要求会导致对判断的恐惧和PA的担忧。众所周知，计划生育可以改善大多数女性的怀孕体验，但只有不到11%的孕妇符合计划生育指南，而且有限的研究优先考虑了少数民族母亲对影响计划生育参与的社会文化话语的叙述。健康护理专业人员提供的不明确的信息可能会导致恐惧。少数民族妇女也最有可能报告缺乏运动，这与以前的调查结果表明她们认为保健服务在文化上不适合提供保健服务有关。该跨学科项目旨在确定女性在怀孕期间PA和恐惧经历中的文化差异，并了解如何支持更多的女性。它将与代表性不足的妇女和保健专业人员合作解决知识不平衡问题，推进和跨越ESRC（平等、多样性和包容）和MRC的战略优先事项；一个跨委员会的项目。通过借鉴公共卫生、心理学和社会学的知识和研究方法，跨学科的方法对于理解NHS如何有效地支持妇女在怀孕期间及以后的健康和适当的身体活动至关重要。研究问题：不同文化的女性PA和医疗保健经历有什么不同？恐惧在不同种族和不同PA水平之间有何不同？这些恐惧通常发生在什么时候？不同文化背景的女性与NHS主要利益相关者的关系如何影响她们的恐惧、认知、健康行为和护理？合作皇家联合医院NHS产科将提供联合医疗保健专业人员招聘，安置产妇护理地图，并提供与政策制定者的联系。“黑人母亲的问题”（Black Mother's Matter）是一个全国性组织，它将为招募母亲提供帮助，支持研究问题的设计，并提供安置机会。Dope Black Moms是布里斯托尔当地的一个社区组织，参与联合制作研究问题和招募母亲。方法该项目将使用混合方法（定量和定性）的方法进行数据收集（工作包1-4）和分析。这一过程将受到关键理论框架的影响：心理授权、自决理论和对判断的恐惧。工作包1：范围审查总结与怀孕期间恐惧的妇女经历和身体、心理和行为后果有关的证据。工作包2：日记探索不同文化的母亲和主要卫生专业人员在PA上的恐惧经历，超过1-2个月。（定性分析-手册和NVivo）。参与者：不同文化背景的孕妇和主要保健专业人员（10-20）。工作包3：半结构化访谈和焦点小组扩展日记。口头讨论，指出个人经历中可能存在的文化差异。（定性分析-手册和NVivo）。工作包2工作包4：调查测试西南地区不同文化的恐惧、动机、心理健康和幸福感之间的关系。与以前的参与者共同制作的调查，并在线分发给孕妇、母亲、卫生专业人员。（SPSS定量分析）

MovingthroughMotherhood, a multidisciplinary research group, held workshops with mothers who emphasised the influence of fear on pregnancy and physical activity (PA) behaviours on culturally diverse women. There is large cultural diversity amongst pregnant women and mothers. Roughly 29% of 600,000 births in England and Wales were to non-UK born mothers in 2020, and consequences of pregnancy for ethnic minority mothers include increased risk of gestational diabetes mellitus and obesity postpartum. Anatomical changes and requirements of motherhood can lead to fear of judgement and PA concerns. PA is known to improve the pregnancy experience for most women, but less than 11% of expectant mothers meet PA guidelines, and limited research prioritises ethnic minority mothers' narratives of socio-cultural discourses impacting PA participation. A barrier to being active is likely to include unclear information provided by healthcare professionals leading to fear. Ethnic minority women are also most likely to report being physically inactive, concerning when previous findings have shown their perceptions of health services to be culturally incompetent for PA provision. The interdisciplinary project aims to identify cultural differences in women's experiences of PA and fear during pregnancy and understand how more women can be supported. It will collaboratively address imbalance of knowledge with under-represented women and health care professionals, progressing and straddling the strategic priorities of the ESRC (Equality, Diversity, and Inclusion) and MRC; a cross-council project. An interdisciplinary approach is critical to understand how the NHS can effectively support wellbeing and appropriate physical activity of women through pregnancy and beyond, by drawing on knowledge and research methods from public health, psychology, and sociology.Research questions What are the differences in women's PA and healthcare experiences across cultures?How does fear differ across ethnic groups and between different PA levels? When do these fears usually occur? How does the relationship with key NHS stakeholders of culturally diverse women impact their fear, perceptions, health behaviours, and care? CollaborationRoyal United Hospitals NHS Maternity department will provide allied health care professionals for recruitment, a placement to map maternity care and provide links to policy makers.Black Mother's Matter, a national group, will provide mothers for recruitment, support research question design, and provide a placement. Dope Black Moms are a local community group in Bristol, involved in co-producing research questions and recruiting mothers. MethodsThe project will use a mixed-methods (quantitative and qualitative) approach of data collection (work packages 1-4), and analysis. The procedures will be influenced by key theoretical frameworks: Psychological Empowerment, Self-determination Theory and Fear of judgment. Work package 1: Scoping reviewSummarising the evidence relating to women's experiences and physical, psychological, and behavioural consequences of fear during pregnancy. Work Package 2: Diaries Exploring fear experiences on PA, of culturally diverse mothers and key health professionals, over 1-2 months. (Qualitative analysis- manual and NVivo). Participants: Culturally diverse pregnant women and key health professionals (10-20).Work Package 3: Semi-structured interviews and focus groups Extending on diaries. A verbal discussion drawing out possible cultural differences in personal experiences. (Qualitative analysis- manual and NVivo). Participants: Work package 2 Work Package 4: Survey Testing the relationship between fear, motivation, psychological health, and wellbeing across cultures in southwest. Survey co-produced with previous participants and distributed online to pregnant women, mothers, health professionals. (Quantitative SPSS analysis)