Evenson, K. R., Moos, M-K., Carrier, K., & Siega-Riz, A.M. (2009).Maternal Child Health Journal, 13,364-375.
Physical activity is important in the prevention and treatment of obesity, but many women reduce their physical activity during pregnancy. The purpose of this study was to examine barriers to physical activity in pregnant women, using a mixed methods approach. A total of 1535 women enrolled in the Pregnancy, Infection and Nutrition study in North Carolina responded to an open-ended question about their primary barrier to physical activity during a telephone interview. Participant responses were analyzed using content analysis and grouped using the socioecologic framework. The most commonly reported barriers were intrapersonal (85%), either health related or related to lack of time or busyness. Intrapersonal barriers (2%), neighborhood or environmental barriers (3%), and organizational barriers (0.5%) were infrequently reported. The investigators also conducted 13 focus groups with a total of 58 pregnant women. Participants discussed health related or somatic factors as significant barriers, particularly tiredness or low energy during pregnancy. They also mentioned a concern with pregnancy complications from being active. Lack of motivation and time to be active were also cited. The primary interpersonal barrier was lack of social support. Women in the focus groups suggested several strategies to help them engage in physical activity, including making it easier to be physically active at work, child care provision, changes to their neighborhood to make it convenient and safe to exercise, and social support. They also recommended affordable and trustworthy child care to promote physical activity in the postpartum period. The results of this study indicate the need for any interventions with pregnant women to focus on the woman's lack of time and on strategies to adapt physical activity to the somatic and physical changes of pregnancy. The investigators also suggest that incorporating physical activity throughout the day in a gradual and moderate intensity can be as effective as structured programs.