Development of a theoretical model of 'teachable moments' to support lifestyle behaviour change during pregnancy

怀孕（以及之后不久的一段时间）一直被视为“受教育的时刻”。也就是说，在这个时期，妇女特别有动力改变生活方式，例如更健康地饮食、参加体育活动、戒烟、减少饮酒。其他健康行为是针对怀孕的（例如母乳喂养）。在这个时候做出这些改变所涉及的心理机制尚不清楚。新出现的证据表明，医疗保健专业人员发现，这一次支持妇女改变行为是具有挑战性的，而促进改变的机会往往被错过。也缺乏对怀孕作为教育时刻的理论理解。了解怀孕期间健康行为的变化对一些妇女特别重要，因为怀孕期间可能是她们获得保健服务的唯一时间（例如，黑人和少数民族群体，社会经济地位较低的群体）。对这些妇女来说，怀孕提供了一个独特的机会，鼓励那些不仅可能影响母亲健康，而且可能影响其家庭和未来怀孕的行为。该博士课程的总体目标是确定与怀孕期间健康行为改变有关的机制，并对怀孕这一可教时刻产生更清晰的理论认识。在第一年，学生将进行系统的审查，以巩固现有的关于怀孕期间健康行为改变的文献，并确定可教时刻的心理成分。据此，一项纵向研究将在大量孕妇和产后期间测量社会认知和健康行为。对妇女（包括不同的BME和社会经济群体）及其保健专业人员进行的定性访谈研究将调查这些群体中的沟通障碍和促进行为改变的因素。从一开始就将建立一个利益相关者小组（孕妇和助产士），以帮助制定和完善研究问题和方法。调查结果将分发给学术界和公众。

Pregnancy (and the period shortly afterwards) has been viewed as a 'teachable moment'. That is, a time when women are particularly motivated to make lifestyle changes e.g. eat more healthily, take up physical activity, stop cigarette smoking, reduce alcohol intake. Additional healthy behaviours are pregnancy-specific (e.g. breast-feeding). The psychological mechanisms involved in making these changes at this time are poorly understood. Emerging evidence reveals healthcare professionals find it challenging to support women to make behaviour changes this time and opportunities to facilitate changes are frequently missed. There is also a lack of theoretical understanding of pregnancy as a teachable moment. Understanding health behaviour change during pregnancy is particularly important for some women as pregnancy may be the only time they engage with health services (e.g. black and minority ethnic groups, those with a low socio-economic status). For these women pregnancy provides a unique opportunity to encourage behaviours that can potentially impact, not only on the health of the mother, but also her family and future pregnancies. The overall aim of this PhD is to identify mechanisms involved in health behaviour change during pregnancy and produce a clearer theoretical understanding of pregnancy as a teachable moment. During the first year the student will conduct a systematic review to consolidate the existing literature on health behaviour changes in pregnancy and identify psychological components of teachable moments. Informed by this, a longitudinal study will measure social cognition and health behaviours in a large sample of pregnant women and into the postpartum period. A qualitative interview study with women (including different BME and socioeconomic groups) and their healthcare professionals will investigate communication barriers and facilitators to behaviour change in these groups. From the outset a stakeholder group (pregnant women & midwives) will be set up to help develop and refine the research questions and methodologies. Findings will be disseminated to academic and public audiences.