TY - JOUR
T1 - Understanding health behaviour in pregnancy and infant feeding intentions in low-income women from the UK through qualitative visual methods and application to the COM-B (Capability, Opportunity, Motivation-Behaviour) model
AU - Grant, Aimee
AU - Morgan, Melanie
AU - Mannay, Dawn
AU - Gallagher, Dunla
PY - 2019/2/12
Y1 - 2019/2/12
N2 - Abstract
Background: Health behaviours during pregnancy and the early years of life have been proven to affect long term
health, resulting in investment in interventions. However, interventions often have low levels of completion and
limited effectiveness. Consequently, it is increasingly important for interventions to be based on both behaviour
change theories and techniques, and the accounts of pregnant women. This study engaged with pregnant women
from deprived communities, to understand their subjective experiences of health in pregnancy.
Methods: The study adopted a women-centred ethos and recruited a purposive sample of ten pregnant women,
who lived in deprived areas and were on low incomes. Participants engaged with three creative techniques of
visual data production (timelines, collaging and dyad sandboxing), followed by elicitation interviews. One participant
only engaged in the initial activity and interview, resulting in a total of 28 elicitation interviews. This in-depth qualitative
approach was designed to enable a nuanced account of the participants’ thoughts, everyday experiences and social
relationships. Data were deductively coded for alcohol, smoking and infant feeding and then mapped to the COM-B
model (Capability, Opportunity, Motivation – Behaviour).
Results: Five participants had experience of smoking during pregnancy, four had consumed alcohol during pregnancy,
and all participants, except one who had exclusively formula fed her child, disclosed a range of infant feeding
experiences and intentions for their current pregnancies. Considerable variation was identified between the drivers of
behaviour around infant feeding and that related to abstinence from tobacco and alcohol during pregnancy. Overall,
knowledge and confidence (psychological capability), the role of partners (social opportunity) and support from
services to overcome physical challenges (environmental opportunity) were reported to impact on (reflective)
motivation, and thus women’s behaviour. The role of the public in creating and reinforcing stigma (social opportunity)
was also noted in relation to all three behaviours.
AB - Abstract
Background: Health behaviours during pregnancy and the early years of life have been proven to affect long term
health, resulting in investment in interventions. However, interventions often have low levels of completion and
limited effectiveness. Consequently, it is increasingly important for interventions to be based on both behaviour
change theories and techniques, and the accounts of pregnant women. This study engaged with pregnant women
from deprived communities, to understand their subjective experiences of health in pregnancy.
Methods: The study adopted a women-centred ethos and recruited a purposive sample of ten pregnant women,
who lived in deprived areas and were on low incomes. Participants engaged with three creative techniques of
visual data production (timelines, collaging and dyad sandboxing), followed by elicitation interviews. One participant
only engaged in the initial activity and interview, resulting in a total of 28 elicitation interviews. This in-depth qualitative
approach was designed to enable a nuanced account of the participants’ thoughts, everyday experiences and social
relationships. Data were deductively coded for alcohol, smoking and infant feeding and then mapped to the COM-B
model (Capability, Opportunity, Motivation – Behaviour).
Results: Five participants had experience of smoking during pregnancy, four had consumed alcohol during pregnancy,
and all participants, except one who had exclusively formula fed her child, disclosed a range of infant feeding
experiences and intentions for their current pregnancies. Considerable variation was identified between the drivers of
behaviour around infant feeding and that related to abstinence from tobacco and alcohol during pregnancy. Overall,
knowledge and confidence (psychological capability), the role of partners (social opportunity) and support from
services to overcome physical challenges (environmental opportunity) were reported to impact on (reflective)
motivation, and thus women’s behaviour. The role of the public in creating and reinforcing stigma (social opportunity)
was also noted in relation to all three behaviours.
KW - Alcohol
KW - Antenatal
KW - Breastfeeding
KW - COM-B model
KW - Creative methods
KW - Infant feeding
KW - Pregnancy
KW - Qualitative
KW - Smoking
KW - Visual methods
UR - http://www.scopus.com/inward/record.url?scp=85061350481&partnerID=8YFLogxK
U2 - 10.1186/s12884-018-2156-8
DO - 10.1186/s12884-018-2156-8
M3 - Article
C2 - 30744581
AN - SCOPUS:85061350481
SN - 1471-2393
VL - 19
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
M1 - 56
ER -