title: Beliefs, Barriers, and Preferences of European Overweight Women to Adopt a Healthier Lifestyle in Pregnancy to Minimize Risk of Developing Gestational Diabetes Mellitus: An Explorative Study.
abstract: BACKGROUND
  We explored beliefs, perceived barriers, and preferences regarding lifestyle changes among overweight European pregnant women to help inform the development of future lifestyle interventions in the prevention of gestational diabetes mellitus.
  
  
  METHODS
  An explorative mixed methods, two-staged study was conducted to gather information from pregnant European women (BMI ≥ 25 kg/m2). In three European countries 21 interviews were conducted, followed by 71 questionnaires in six other European countries. Content analysis and descriptive and chi-square statistics were applied (p < 0.05).
  
  
  RESULTS
  Women preferred to obtain detailed information about their personal risk. The health of their baby was a major motivating factor. Perceived barriers for physical activity included pregnancy-specific issues such as tiredness and experiencing physical complaints. Insufficient time was a barrier more frequently reported by women with children. Abstaining from snacking was identified as a challenge for the majority of women, especially for those without children. Women preferred to obtain support from their partner, as well as health professionals and valued flexible lifestyle programs.
  
  
  CONCLUSIONS
  Healthcare professionals need to inform overweight pregnant women about their personal risk, discuss lifestyle modification, and assist in weight management. Lifestyle programs should be tailored to the individual, taking into account barriers experienced by overweight first-time mothers and multipara women.
authors.affiliation: Department of Public and Occupational Health, EMGO -Institute for Health and Care Research, VU University Medical Centre, 1081 BT Amsterdam, Netherlands.
authors.forename: Judith G M
authors.initials: JG
authors.lastname: Jelsma
authors.affiliation: Department of Health Sciences, Faculty of Earth & Life Sciences, EMGO -Institute for Health and Care Research, VU University, 1081 BT Amsterdam, Netherlands.
authors.forename: Karen M
authors.initials: KM
authors.lastname: van Leeuwen
authors.affiliation: Department of Public and Occupational Health, EMGO -Institute for Health and Care Research, VU University Medical Centre, 1081 BT Amsterdam, Netherlands.
authors.forename: Nicolette
authors.initials: N
authors.lastname: Oostdam
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bunn
authors.affiliation: Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK; Macarthur Clinical School, Western Sydney University, Campbelltown, NSW 2751, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Simmons
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Gernot
authors.initials: G
authors.lastname: Desoye
authors.affiliation: Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, 08026 Barcelona, Spain; CIBER Bioengineering, Biomaterials and Nanotechnology, Institute of Health Carlos III, 28029 Madrid, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Corcoy
authors.affiliation: Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, 08026 Barcelona, Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Adelantado
authors.affiliation: Divison of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1010 Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
authors.affiliation: Divison of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1010 Vienna, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Harreiter
authors.affiliation: KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, 3000 Leuven, Belgium.
authors.forename: Frans Andre
authors.initials: FA
authors.lastname: van Assche
authors.affiliation: KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, 3000 Leuven, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.affiliation: KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, 3000 Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.affiliation: Recherche en Santé Lawson SA, 9552 St. Gallen, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Hill
authors.affiliation: Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, 1165 Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Damm
authors.affiliation: Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, 1165 Copenhagen, Denmark.
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
authors.affiliation: Medical Faculty I, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wender-Ozegowska
authors.affiliation: Medical Faculty I, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Zawiejska
authors.affiliation: BAP Health Outcomes Research SL, 33010 Oviedo, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rebollo
authors.affiliation: Universita degli Studi di Padova, 35122 Padova, Italy.
authors.forename: Annunziata
authors.initials: A
authors.lastname: Lapolla
authors.affiliation: Universita degli Studi di Padova, 35122 Padova, Italy.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Dalfrà
authors.affiliation: Università di Pisa, 56126 Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
authors.affiliation: Università di Pisa, 56126 Pisa, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bertolotto
authors.affiliation: National University of Ireland, Galway, Ireland.
authors.forename: Fidelma
authors.initials: F
authors.lastname: Dunne
authors.affiliation: Departments of Endocrinology and Gynecology & Obstetrics, Odense University Hospital, 5000 Odense, Denmark; Faculty of Health Science, University of Southern Denmark, 5230 Odense, Denmark.
authors.forename: Dorte M
authors.initials: DM
authors.lastname: Jensen
authors.affiliation: Departments of Endocrinology and Gynecology & Obstetrics, Odense University Hospital, 5000 Odense, Denmark; Faculty of Health Science, University of Southern Denmark, 5230 Odense, Denmark.
authors.forename: Lise Lotte T
authors.initials: LL
authors.lastname: Andersen
authors.affiliation: Department of Medical Psychology, EMGO-Institute for Health and Care Research, VU University Medical Centre, 1081 BT Amsterdam, Netherlands; Department of Medical Psychology, Academic Medical Centre, 1105 AZ Amsterdam, Netherlands.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Snoek
authors.affiliation: Department of Public and Occupational Health, EMGO-Institute for Health and Care Research, VU University Medical Centre, 1081 BT Amsterdam, Netherlands; Institute of Sport Science, University of Graz, 8010 Graz, Austria.
authors.forename: Mireille N M
authors.initials: MN
authors.lastname: van Poppel
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016640:Diabetes, Gestational / Q000517:prevention & control / Q000523:psychology*; D004035:Diet Therapy / Q000523:psychology; D005060:Europe; D015444:Exercise / Q000523:psychology; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D050177:Overweight / Q000523:psychology / Q000628:therapy; D057240:Patient Preference; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires