title: Patient and Provider Perceptions of Weight Gain, Physical Activity, and Nutrition Counseling during Pregnancy: A Qualitative Study.
abstract: OBJECTIVE
  This study investigated patient and provider perceptions of weight gain, physical activity, and nutrition counseling during prenatal care visits.
  
  
  METHODS
  Individual qualitative interviews were conducted with 30 pregnant women between 20 and 30 weeks gestation (15 African American, 15 White) and 11 prenatal care providers (5 attending physicians, 5 residents, 1 nurse practitioner) in 2014.
  
  
  RESULTS
  The majority of patients and providers reported receiving or giving advice on weight gain (87% and 100%, respectively), physical activity (87% and 91%), and nutrition (100% and 91%) during a prenatal visit. Discussion of counseling content was largely consistent between patients and providers. However, counseling was limited and not fully consistent with current weight gain, physical activity, or dietary guidelines during pregnancy. Most patients viewed provider advice positively, but some wanted more detailed information. Providers discussed many barriers to lifestyle counseling, including lack of time, inadequate training, concern about the sensitivity of the topic, lower education or income level of the patient, cultural differences, and lack of patient interest.
  
  
  CONCLUSIONS
  Providers discussed weight gain, physical activity, and nutrition during prenatal care visits and patients accurately recalled this advice. However, counseling was limited and not fully consistent with guidelines. Future studies are needed to develop and evaluate the efficacy of interventions to help providers overcome perceived barriers and more effectively counsel women on weight and healthy lifestyles during pregnancy.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: whitaker@umn.edu.
authors.forename: Kara M
authors.initials: KM
authors.lastname: Whitaker
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia, South Carolina; Prevention Research Center, University of South Carolina, Columbia, South Carolina.
authors.forename: Sara
authors.initials: S
authors.lastname: Wilcox
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina.
authors.forename: Jihong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia, South Carolina; Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia, South Carolina.
authors.forename: Russell R
authors.initials: RR
authors.lastname: Pate
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003376:Counseling; D004032:Diet; D005260:Female; D005865:Gestational Age; D006801:Humans; D007407:Interviews as Topic; D009043:Motor Activity; D009752:Nutritional Status; D009765:Obesity / Q000517:prevention & control; D010353:Patient Education as Topic; D010465:Perception; D010817:Physician-Patient Relations; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care; D036301:Qualitative Research; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain