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

一个多学科研究小组-母亲运动组织为母亲举办了讲习班，强调恐惧对怀孕和体育活动行为的影响。孕妇和母亲的文化差异很大。2020年，英格兰和威尔士60万新生儿中约有29%是非英国出生的母亲，少数民族母亲怀孕的后果包括妊娠糖尿病和产后肥胖的风险增加。解剖学上的变化和母性的要求会导致对判断的恐惧和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%的准妈妈符合PA指南，并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。积极活动的障碍可能包括医疗保健专业人员提供的信息不明确，导致恐惧。少数民族妇女也最有可能报告身体不活跃，当以前的调查结果表明，他们的保健服务的看法是文化上不适合PA提供。该跨学科项目旨在确定妇女在怀孕期间对PA和恐惧的经历中的文化差异，并了解如何为更多的妇女提供支持。它将协同解决知识与代表性不足的妇女和卫生保健专业人员的不平衡问题，推进和跨越ESRC（平等，多样性和包容性）和MRC的战略优先事项;一个跨理事会项目。一个跨学科的方法是至关重要的了解如何NHS可以有效地支持健康和适当的身体活动的妇女通过怀孕及以后，通过借鉴知识和研究方法，从公共卫生，心理学和society.Research问题妇女的PA和医疗保健的经验，跨文化的差异是什么？不同种族群体和不同PA水平之间的恐惧有何不同？这些恐惧通常发生在什么时候？与文化多样性妇女的主要NHS利益攸关方的关系如何影响她们的恐惧，观念，健康行为和护理？合作皇家联合医院NHS妇产科将提供专职医疗保健专业人员招聘，安置映射产妇护理，并提供与政策制定者的联系。黑人母亲的问题，一个全国性的团体，将提供母亲招聘，支持研究问题设计，并提供安置。毒品黑妈妈是布里斯托的一个当地社区团体，参与共同制作研究问题和招募母亲。该项目将使用混合方法（定量和定性）的方法收集数据（工作包1-4），并进行分析。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：范围审查总结有关妇女的经验和身体，心理和行为后果的恐惧在怀孕期间的证据。工作包2：日记探索恐惧的经验，对PA，文化多样性的母亲和关键的卫生专业人员，超过1-2个月。（定性分析-手动和NVivo）。参会人员：不同文化背景的孕妇和主要保健专业人员（10-20）。口头讨论，指出个人经历中可能存在的文化差异。（定性分析-手动和NVivo）。参会人员：工作包2工作包4：调查测试西南地区不同文化中恐惧、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调查，并在线分发给孕妇、母亲和保健专业人员。（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)