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

多学科研究组织MovingThings Motherhood与母亲们举办了研讨会，强调恐惧对怀孕的影响，以及不同文化背景的女性的体力活动(PA)行为。孕妇和母亲之间存在着巨大的文化多样性。到2020年，英格兰和威尔士出生的60万婴儿中，约有29%是非英国出生的母亲，少数民族母亲怀孕的后果包括增加妊娠期糖尿病和产后肥胖的风险。解剖学上的变化和对母亲身份的要求可能会导致对评判的恐惧和对PA的担忧。众所周知，PA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PA指南，而且有限的研究优先考虑少数民族母亲对影响PA参与的社会文化话语的叙述。保持活跃的一个障碍可能包括医疗保健专业人员提供的信息不明确，从而导致恐惧。少数民族妇女也最有可能报告身体不活跃，因为以前的调查结果表明，她们认为卫生服务在文化上不适合提供保健服务。该跨学科项目旨在确定女性在怀孕期间经历PA和恐惧的文化差异，并了解如何支持更多的女性。它将与代表性不足的妇女和卫生保健专业人员合作解决知识不平衡问题，进展并跨越ESRC(平等、多样性和包容性)和MRC的战略优先事项；MRC是一个跨理事会的项目。跨学科的方法对于理解NHS如何通过借鉴公共卫生、心理学和社会学的知识和研究方法，有效地支持女性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和医疗保健体验有什么不同？不同种族和不同PA水平之间的恐惧有何差异？这些恐惧通常发生在什么时候？不同文化背景的女性与NHS关键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妇产科将为招聘相关的医疗保健专业人员提供一个职位，以绘制产妇保健地图，并提供到政策制定者的链接。黑人母亲的问题，一个全国性的组织，将为母亲提供招聘，支持研究问题设计，并提供一个职位。Dope Black Mom是布里斯托尔的一个当地社区组织，参与联合制作研究问题和招募母亲。方法该项目将采用数据收集(工作包1-4)和分析的混合方法(定量和定性)。这些程序将受到关键理论框架的影响：心理赋权、自决理论和害怕判断。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：在1-2个月的时间里，探索不同文化背景的母亲和关键卫生专业人员在PA上的恐惧经历的日记。(定性分析--手册和NVivo)。参与者：不同文化背景的孕妇和主要卫生专业人员(10-20岁)。工作包3：半结构化访谈和以日记为基础的焦点小组。一场口头讨论，指出个人经历中可能存在的文化差异。(定性分析--手册和NVivo)。参与者：工作包2工作包4：测试西南地区跨文化的恐惧、动机、心理健康和幸福感之间的关系的调查。调查是与以前的参与者共同制作的，并在网上分发给孕妇、母亲和卫生专业人员。(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)