title: Enablers of and barriers to making healthy change during pregnancy in overweight and obese women.
abstract: BACKGROUND
  High Body Mass Index (BMI) during pregnancy is associated with an increased risk of adverse health outcomes. Making healthy change during pregnancy is beneficial, especially for overweight and obese women.
  
  
  OBJECTIVE
  The aim of this study was to explore the barriers and enablers identified by overweight and obese women that preclude and facilitate making healthy change during pregnancy.
  
  
  METHODS
  Twenty-six women who were overweight or obese during pregnancy were interviewed at 28 weeks gestational age. Interviews were transcribed verbatim and the analysis is based on the thematic analysis methodology.
  
  
  RESULTS
  The core concept of "being pregnant" indicated women consider this specific time as both a reason not to make healthy change as well as a motivation for change. Overweight and obese women cited the following barriers to making healthy change during pregnancy: physiological (e.g. pregnancy complications and tiredness); emotional (e.g. preference and mood); cognitive (e.g. lack knowledge); interpersonal (e.g. lack support); and environmental (e.g. availability of healthy choice). Similar enablers were identified by overweight and obese women: physiological (e.g. relief of pregnancy symptoms); emotional (e.g. approval and commitment); cognitive (e.g. knowledge and belief); interpersonal (e.g. family support); and environmental (e.g. help from others). More barriers than enablers were given, indicating that women were more sensitive to barriers than the enablers for making healthy change. Factors viewed by some women as barriers were viewed as enablers by others.
  
  
  CONCLUSIONS
  When designing interventions to promote healthy eating and physical activity during pregnancy, individually focused interventions must be implemented in conjunction with environmental-level interventions to facilitate behaviour change.
authors.affiliation: The Robinson Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, South Australia.
authors.forename: Zhixian
authors.initials: Z
authors.lastname: Sui
authors.affiliation: School of Psychology, University of Adelaide, South Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Turnbull
authors.affiliation: The Robinson Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, South Australia ; Department of Perinatal Medicine, Women's and Babies Division, Women's and Children's Hospital, South Australia.
authors.forename: Jodie
authors.initials: J
authors.lastname: Dodd
keywords: Pregnancy; healthy change; overweight