1. Motivation, approach & engagement Experience vs. knowledge
Information-seeking about diet and physical activity during a first pregnancy: An Interpretative Phenomenological Analysis Lou Atkinsona, Rachel L Shawa, David P Frenchb a Aston University, UK b University of Manchester, UK
Background
Pregnancy is a time when women may be more motivated to improve their diet and physical activity behaviours. By contrast, a first pregnancy is a period of intense change1 and some women report wanting more information on these topics from healthcare professionals2. Both are factors which may reduce the salience and/or impact of health advice during this time.
Aim
Our study aimed to explore women’s interest in, and engagement with, advice about diet and physical activity during a first pregnancy.
Methods
Seven women participated during the second half of their first pregnancy. In-depth interviews using a broad topic guide and a short pen and paper task, to elicit views on health behaviour change during pregnancy, and on the relative importance and trustworthiness of different sources of information. Verbatim transcripts were analysed using Interpretive Phenomenological Analysis.
Findings
Two main themes were identified; ‘Pregnancy as a teachable moment’ (reported elsewhere3), and ‘Information-seeking’. Three sub-themes for ‘Information-seeking’ were identified: Motivation, approach & engagement, Wants & needs, and Experience vs. knowledge
Motivation, approach & engagement
The women’s underlying motivation for seeking or engaging with information on diet and physical activity influenced the type and amount of information they accessed, as well as how much that information influenced their behaviour.
Wants & needs
Women had distinct preferences for information and advice. These were strongly influenced by their willingness to allow their pregnancy to ‘take over’ their life.
Interest
General interest in the topic because it is relevant at that time
Information as entertainment
Check pre- existing knowledge/ beliefs
Pull vs Push
Reassurance
Behaviour is socially or medically approved
Tips
‘How’ not ‘what’
Immediate/ convenient
Guidance
Detail on what to do
Ensuring baby’s safety
Being a good pregnant woman
Personalised/ relevant
Do’s & Don’ts
Simple
Concrete
Planning & problems
Detail
Experience vs. knowledge
Whether a woman valued or trusted an information source was related to her views on the uniqueness of her own pregnancy.
Facts
Evidence or consensus
Friends & family
Discussion & Implications
Findings suggest that the picture of a first-time pregnant woman as a highly motivated, voracious seeker of health information may not be a universal reality.
Women who represented themselves as not allowing their lives to be taken over by their pregnancy showed only general interest in the topics, and obtained most of their information passively or unconsciously prior to pregnancy. These women had fewer questions, symptoms and anxieties, leading to less purposive searching and a preference for practical advice from objective sources.
In contrast, women with greater concerns or who had become more emotionally involved with their pregnancy, sought more detailed information and often interrogated multiple sources.
Most women expressed distrust for experiential information yet there were several examples of how this had influenced their behavioural choices. Midwives’ advice was universally trusted but rarely the first choice when seeking information, due to infrequent contact or not wanting to be seen as foolish or bothersome.
The salience of messages about diet and physical activity during pregnancy may need to be increased for women who are neither purposively seeking or engaging with detailed information on these topics.
Messages should be tailored and backed up by evidence or clearly from a credible source, as information perceived to be too generic or from biased sources is likely to be dismissed as irrelevant.
Know me/ my pregnancy
Opinion/ biased
Strangers/ contacts
Books
Websites
Facts/ unbiased
Don’t know me/my pregnancy
Midwives & other health professionals