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Understanding health behaviour in pregnancy and infant feeding intentions in low-income women from the UK through qualitative visual methods and application to the COM-B (Capability, Opportunity, Motivation - Behaviour) model

Grant, Aimee ORCID:, Morgan, Melanie, Mannay, Dawn ORCID: and Gallagher, Dunla 2019. Understanding health behaviour in pregnancy and infant feeding intentions in low-income women from the UK through qualitative visual methods and application to the COM-B (Capability, Opportunity, Motivation - Behaviour) model. BMC Pregnancy and Childbirth 19 , 56. 10.1186/s12884-018-2156-8

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Background: Health behaviours during pregnancy and the early years of life have been proven to affect long term health, resulting in investment in interventions. However, interventions often have low levels of completion and limited effectiveness. Consequently, it is increasingly important for interventions to be based on both behaviour change theories and techniques, and the accounts of pregnant women. This study engaged with pregnant women from deprived communities, to understand their subjective experiences of health in pregnancy. Methods: The study adopted a women-centred ethos and recruited a purposive sample of ten pregnant women, who lived in deprived areas and were on low incomes. Participants engaged with three creative techniques of visual data production (timelines, collaging and dyad sandboxing), followed by elicitation interviews. One participant only engaged in the initial activity and interview, resulting in a total of 28 elicitation interviews. This in-depth qualitative approach was designed to enable a nuanced account of the participants’ thoughts, everyday experiences and social relationships. Data were deductively coded for alcohol, smoking and infant feeding and then mapped to the COM-B model (Capability, Opportunity, Motivation – Behaviour). Results: Five participants had experience of smoking during pregnancy, four had consumed alcohol during pregnancy, and all participants, except one who had exclusively formula fed her child, disclosed a range of infant feeding experiences and intentions for their current pregnancies. Considerable variation was identified between the drivers of behaviour around infant feeding and that related to abstinence from tobacco and alcohol during pregnancy. Overall, knowledge and confidence (psychological capability), the role of partners (social opportunity) and support from services to overcome physical challenges (environmental opportunity) were reported to impact on (reflective) motivation, and thus women’s behaviour. The role of the public in creating and reinforcing stigma (social opportunity) was also noted in relation to all three behaviours. Conclusions: When designing new interventions to improve maternal health behaviours it is important to consider the accounts of pregnant women. Acknowledging pregnant women’s subjective experiences and the challenges they face in negotiating acceptable forms of motherhood, can contribute to informed policy and practice, which can engage rather than isolate potential user groups.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Centre for Trials Research (CNTRR)
Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > H Social Sciences (General)
H Social Sciences > HM Sociology
H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Uncontrolled Keywords: pregnancy, antenatal, smoking, alcohol, infant feeding, breastfeeding, qualitative, visual methods, creative methods, COM-B Model
Publisher: BioMed Central
ISSN: 1471-2393
Funders: Wellcome Trust
Date of First Compliant Deposit: 20 December 2018
Date of Acceptance: 16 December 2018
Last Modified: 06 May 2023 22:18

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