{"id":2385,"date":"2023-05-15T20:33:31","date_gmt":"2023-05-15T20:33:31","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjsrh\/?p=2385"},"modified":"2023-05-20T14:12:42","modified_gmt":"2023-05-20T14:12:42","slug":"womens-needs-for-lifestyle-risk-reduction-engagement-during-the-interconception-period","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjsrh\/2023\/05\/15\/womens-needs-for-lifestyle-risk-reduction-engagement-during-the-interconception-period\/","title":{"rendered":"Women\u2019s needs for lifestyle risk reduction engagement during the interconception period"},"content":{"rendered":"

By Sharon James, Jessica Moulton<\/em>, <\/strong>Anisa Assifi, Jessica Botfield, Kirsten Black, Mark Hanson & Danielle Mazza<\/strong>\u00a0<\/em><\/p>\n

 <\/p>\n

The potential impact of lifestyle risks such as smoking, unhealthy diet, unsafe alcohol consumption, and inadequate exercise, increases with the <\/span>mother’s age and parity<\/span><\/a>. While lifestyle risks are responsible for many chronic conditions, changing lifestyle behaviours during pregnancy <\/span>can be too late to prevent some adverse pregnancy outcomes and risks to the child<\/span><\/a>. To reduce these risks to both the mother and any subsequent pregnancy, the interconception period provides an opportunity to adopt changes in lifestyle behaviours. The <\/span>interconception period refers to the time between pregnancies,<\/span><\/a> when implementation of lifestyle changes may be challenging due to time restraints, employment and caring responsibilities to consider.\u00a0 Initiatives targeting lifestyle risk reduction activities during interconception need to consider these life stage demands to support engagement.\u00a0<\/span>\u00a0<\/span><\/p>\n

Our <\/span>scoping review<\/span><\/a> sought to understand these issues.\u00a0 Following the screening of 1734 results, 33 papers were included in the review. Interconception was most commonly identified through postpartum and\/or preconception, rather than as a unique life stage. Most papers discussed lifestyle risk\/s (n=30; 91%) during postpartum, rather than preferences of women during preconception. Women\u2019s preferences for nutrition and\/or physical activity engagement were the most commonly reported lifestyle risks in the included papers (82%; n=27), where the focus was largely on weight management and gestational diabetes mellitis or type 2 diabetes mellitis. None of the included papers discussed women\u2019s perceptions of alcohol risk reduction during interconception.\u00a0<\/span>\u00a0<\/span><\/p>\n

Findings indicated the factors impacting women\u2019s engagement in lifestyle risk reduction during interconception included;\u00a0<\/span>\u00a0<\/span><\/p>\n

    \n
  1. Informational needs<\/span><\/b>. Person-centred communication and information were needed about lifestyle risk reduction benefits, chronic conditions and the risks of not changing lifestyle behaviours on mother and child. Practical advice was sought about issues such as meal planning as well as physical activity considerations.<\/span>\u00a0<\/span><\/li>\n
  2. Managing competing priorities<\/span><\/b>. Time and money impacted decisions around food access, choices and preparation as well as engagement in physical activity. The ability to prioritise lifestyle risk reduction alongside caring or family responsibilities, work and accessing health care was challenging.<\/span>\u00a0<\/span><\/li>\n
  3. Physical and mental health<\/span><\/b>. Postnatal recovery impacted the woman\u2019s ability to engage in lifestyle risk reduction activities. Postpartum mental and physical health was considered to be worse than pre-pregnancy. While women recognised that there are mental health benefits of lifestyle risk reduction through improved energy, mood, stress and motivation, this was offset by perceived capabilities in initiating behaviour change due to fatigue, breastfeeding, stress and pelvic floor dysfunction.<\/span>\u00a0<\/span><\/li>\n
  4. Self-perception and motivation.<\/span><\/b> Changes in body shape following childbirth impacted women\u2019s self-confidence and self-esteem. While returning to a pre-pregnancy body shape or looking healthier served as a motivator for lifestyle risk reduction, so too did family and social support, role modelling healthy behaviours, returning to work and setting goals. Women wanted to improve their health and prevent chronic conditions.<\/span>\u00a0<\/span><\/li>\n
  5. Access to services and professional support.<\/span><\/b> Access to transport for clinical support, physical activity or food impacted engagement in lifestyle risk reduction.<\/span> Recommendations to address this focused on flexibility and access, such as a combination of home-based and face-to-face programs that consider family routines, involve children or have childcare available, are affordable and situated close to services such as medical practices. However, the availability of health professionals, health system fragmentation and communication techniques impacted women\u2019s engagement in support for lifestyle risk reduction. The use of technology was considered a useful adjunct to this support.<\/span>\u00a0<\/span><\/li>\n
  6. Family and peer networks.<\/span><\/b> Access to peer and family support was needed to start and sustain lifestyle risk reduction activities. Family and partner support for lifestyle risk reduction removed the emotional burden of leaving the children with others so that risk reduction engagement could occur. However, environments that enabled women to make lifestyle risk improvements also occurred where, for example, these changes were made alongside domestic chore support or where behaviour change was undertaken with peers, partners or the family.<\/span>\u00a0<\/span><\/li>\n<\/ol>\n

    How can we better support women\u2019s engagement in lifestyle risk reduction during interconception?<\/span><\/b>\u00a0<\/span><\/p>\n

    Our scoping review identified a range of challenges for women to engage in lifestyle risk reduction during interconception. Some strategies to overcome these might include:<\/span>\u00a0<\/span><\/p>\n