Share This Article:

Pregnant Women’s Perceptions of Patient-Provider Communication for Health Behavior Change during Pregnancy

Abstract Full-Text HTML Download Download as PDF (Size:2662KB) PP. 672-684
DOI: 10.4236/ojog.2014.411094    5,468 Downloads   6,365 Views   Citations

ABSTRACT

Aim: The primary aim of the project was to conduct focus groups with pregnant women to examine their perceptions on patient and health care provider (HCP) communication during prenatal visits pertaining to health behavioral change. In particular, to determine what types of communication facilitate or prevent patient engagement and adherence to certain health behaviors related to smoking cessation, engagement in physical activity, healthy eating and healthy weight gain, and stress management. Methods: Participants were recruited from the obstetric and midwifery clinics at the University of Colorado Hospital. Twenty-four pregnant, English-speaking women between the ages of 18 and 46 years old, the majority of which had full health insurance coverage, participated in one of three focus groups that were conducted. The transcripts were coded for themes and patterns. Results identified numerous current practices of HCPs, facilitators and barriers in care, and patient recommendations related to effective patient-provider communication. Results: Overall many women received basic information about most health behaviors (i.e. healthy eating, physical activity, and smoking cessation) with the exception of stress management from their HCPs via their introductory information packet. However, typically there was no follow-up beyond receipt of the packet. As a result, women sought information online from numerous sources. Unfortunately, this information often conflicted with HCP provided information, as did the information provided from multiple HCPs in group care settings. A major facilitator of behavioral change pertained to building trust and rapport as it directly enhanced the perceived quality of patient-provider communication on prenatal health behaviors. Across all behaviors, women voiced the need for available resources that were credible and referenced by their HCPs. Conclusions: These findings provide a better understanding of what facilitates and prevents women from engaging in healthy behaviors during their pregnancy, in addition to improving patient and provider communication.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Leiferman, J. , Sinatra, E. and Huberty, J. (2014) Pregnant Women’s Perceptions of Patient-Provider Communication for Health Behavior Change during Pregnancy. Open Journal of Obstetrics and Gynecology, 4, 672-684. doi: 10.4236/ojog.2014.411094.

References

[1] Phelan, S., Phipps, M.G., Abrams, B., Darroch, F., Schaffner, A. and Wing, R.R. (2011) Randomized Trial of a Behavioral Intervention to Prevent Excessive Gestational Weight Gain: The FIT for Delivery Study. American Journal of Clinical Nutrition, 93, 772-779. http://dx.doi.org/10.3945/ajcn.110.005306
[2] Streuling, I., Beyerlein, A., Rosenfeld, E., Hofmann, H., Schulz, T. and von Kries, R. (2011) Physical Activity and Gestational Weight Gain: A Meta-Analysis of Intervention Trials. BJOG, 118, 278-284. http://dx.doi.org/10.1111/j.1471-0528.2010.02801.x
[3] Clapp, J.F. (1990) The Course of Labor after Endurance Exercise during Pregnancy. American Journal of Obstetrics Gynecology, 163, 1799-1805. http://dx.doi.org/10.1016/0002-9378(90)90753-T
[4] Misra, D.P., Strobino, D.M., Stashinko, E.E., Nagey, D.A. and Nanda, J. (1998) Effects of Physical Activity on Preterm Birth. American Journal of Epidemiology, 147, 628-635.
http://dx.doi.org/10.1093/oxfordjournals.aje.a009503
[5] Tobias, D.K., Zhang, C., ven Dam, R.M., Bowers, K. and Hu, F.B. (2011) Physical Activity before and during Pregnancy and Risk of Gestational Diabetes Mellitus: A Meta-Analysis. Diabetes Care, 34, 223-229.
[6] Sorensen, T.K., Williams, M.A., Lee, I., Dashow, E.E., Thompson, M.L. and Luthy, D.A. (2003) Recreational Physical Activity during Pregnancy and Risk of Preeclampsia. Hypertension, 41, 1273-1280. http://dx.doi.org/10.1161/01.HYP.0000072270.82815.91
[7] Poudevigne, M.S. and O’Connor, P.J. (2006) A Review of Physical Activity Patterns in Pregnancy Women and Their Relationship to Psychological Health. SportsMED, 36, 19-38.
http://dx.doi.org/10.2165/00007256-200636010-00003
[8] Gaston, A. and Cramp, A. (2011) Exercise during Pregnancy: A Review of Patterns and Determinants. Journal of Science and Medicine in Sport, 14, 299-305.
http://dx.doi.org/10.1016/j.jsams.2011.02.006
[9] USDHHS (2010) How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease.
http://www.surgeongeneral.gov/library/reports/smokingconsequences/index.html
[10] Coussons-Read, M.E., Okun, M.L. and Nettles, C.D. (2007) Psychosocial Stress Increases Inflammatory Markers and Alters Cytokine Production across Pregnancy. Brain, Behavior, and Immunity, 21, 343-250. http://dx.doi.org/10.1016/j.bbi.2006.08.006
[11] Zhang, J. and Savitz, D.A. (1996) Exercise during Pregnancy among US Women. Annals of Epidemiology, 6, 53-59. http://dx.doi.org/10.1016/1047-2797(95)00093-3
[12] Olson, C.M. (2008) Achieving a Healthy Weight Gain during Pregnancy. Annual Review of Nutrition, 28, 411-423. http://dx.doi.org/10.1146/annurev.nutr.28.061807.155322
[13] CDC (2013) Smoking Ref Website.
http://www.cdc.gov/Reproductivehealth/TobaccoUsePregnancy/index.htm
[14] Kieffer, E.C., Willis, S.K., Arellano, N. and Guzman, R. (2002) Perspectives of Pregnant and Postpartum Latino Women on Diabetes, Physical Activity and Health. Health Education & Behavior, 29, 542-556. http://dx.doi.org/10.1177/109019802237023
[15] Krans, E.E., Gearhart, J.G., Dubbert, P.M., Klar, P.M., Miller, A.L. and Replogle, W.H. (2005) Pregnant Women’s Beliefs and Influences Regarding Exercise during Pregnancy. Journal of the Mississippi State Medical Association, 46, 67-73.
[16] Furness, P.J., McSeveny, K., Adren, M.A., Garland, C., Dearden, A.M. and Soltani, H. (2011) Maternal Obesity Support Services: A Qualitative Study of the Perspectives of Women and Midwives. BMC Pregnancy and Childbirth, 11, 69.
[17] Stengel, M.R., Kraschnewski, J.L., Hwang, K. and Chuang, C.H. (2012) “What My Doctor Didn’t Tell Me”: Examining the Healthcare Provider Advice to Overweight and Obese Pregnant Women on Gestational Weight Gain and Physical Activity. Women’s Health Issues, 22, e535-e540. http://dx.doi.org/10.1016/j.whi.2012.09.004
[18] Krueger, R.A. and Casey, M.A. (2000) A Practical Guide for Applied Research. Sage Publications, Inc., California.
[19] McDaniel, R.W. and Bach, C.A. (1994) Focus Groups: A Data Gathering Strategy for Nursing Research. Nursing Science Quarterly, 7, 4-5. http://dx.doi.org/10.1177/089431849400700103
[20] US Department of Health and Human Services (2008) Physical Activity Guidelines for Americans. Services. US Department of Health and Human Services, Washington DC.
[21] ACOG (2002) Committee Opinion #267: Exercise during Pregnancy and Postpartum Period. Obstetrics & Gynecology, 99, 171-173. http://dx.doi.org/10.1016/S0029-7844(01)01749-5
[22] Carroll, J.K., Antognoli, E. and Flocke, S.A. (2011) Evaluation of Physical Activity Counseling in Primary Care Using Direct Observation of the 5As. Annals of Family Medicine, 9, 416-422.
http://dx.doi.org/10.1370/afm.1299
[23] Leiferman, J.A., Gutilla, M., Paulson, J.F. and Pivarnik, J. (2012) Antenatal Physical Activity Counseling among Healthcare Providers. Open Journal of Obstetrics and Gynecology, 2, 346-355.
http://dx.doi.org/10.4236/ojog.2012.24073
[24] Bauer, P.W., Broman, C.L. and Pivarnik, J.M. (2004) Exercise and Pregnancy Survey for Health Care Providers. MSSE, 36, S113.
[25] Johnson, J., Clifton, R.G., Roberts, J.M., Myatt, L., Hauth, J.C., Spong, C.Y., et al. (2013) Pregnancy Outcomes with Weight Gain above or below the 2009 Institute of Medicine Guidelines. Obstetrics & Gynecology, 121, 969-975. http://dx.doi.org/10.1097/AOG.0b013e31828aea03
[26] Nohr, E.A., Vaeth, M., Baker, J.L., Sorenson, T.I.A., Olsen, J. and Rasmussen, K.M. (2008) Combined Associations of Pre-Pregnancy Body Mass Index and Gestational Weight Gain with the Outcome of Pregnancy. American Journal of Clinical Nutrition, 87, 1750-1759.
[27] Duthie, E.A., Drew, E.M. and Flynn, K.E. (2013) Patient-Provider Communication about Gestational Weight Gain among Nulliparous Women: A Qualitative Study of the View of Obstetricians and First-Time Pregnant Women. BMC Pregnancy and Childbirth, 13, 231-240. http://dx.doi.org/10.1186/1471-2393-13-231
[28] Zhu, P., Huang, W., Hao, J.H., Huang, K., Jiang, X.M. and Tao, F.B. (2013) Time-Specific Effect of Prenatal Stressful Events on Gestational Weight Gain. International Journal of Gynecology and Obstetrics, 122, 207-211. http://dx.doi.org/10.1016/j.ijgo.2013.04.007
[29] Lobel, M., Cannella, D.L., Graham, J.E., DeVincent, C., Schneider, J. and Meyer, B.A. (2008) Pregnancy-Specific Stress, Prenatal Health Behaviors, and Birth Outcomes. Health Psychology, 27, 604-615. http://dx.doi.org/10.1037/a0013242
[30] ACOG (2006) ACOG Committee Opinion No 343: Psychosocial Risk Factors: Perinatal Screening and Intervention. Obstetrics and Gynecology, 108, 468-477.
[31] Fiore, M.C., Baker, T.B., et al. (2008) Treating Tobacco Use and Dependence.
[32] Emanuel, E.J. and Emanuel, L.L. (1992) Four Models of the Physician-Patient Relationship. JAMA, 267, 2221-2226. http://dx.doi.org/10.1001/jama.1992.03480160079038
[33] Raine, R., Cartwright, M., Richens, Y., Mahamed, Z. and Smith, D. (2010) A Qualitative Study of Women’s Experiences of Communication in Antenatal Care: Identifying Areas for Action. Maternal and Child Health Journal, 14, 590-599. http://dx.doi.org/10.1007/s10995-009-0489-7
[34] Novick, G. (2009) Women’s Experience of Prenatal Care: An Integrative Review. Journal of Midwifery & Women’s Health, 54, 226-237. http://dx.doi.org/10.1016/j.jmwh.2009.02.003
[35] Huberty, J., Dinkel, D., Beets, M.W. and Coleman, J. (2013) Describing the Use of Internet for Health, Physical Activity, and Nutrition Information in Pregnant Women. Maternal and Child Health Journal, 17, 1363-1372. http://dx.doi.org/10.1007/s10995-012-1160-2
[36] Aittasalo, M., Pasanen, M., Fogelholm, M., Kinnunen, T.I., Ojala, K. and Luoto, R. (2008) Physical Activity Counseling in Maternity and Child Health Care—A Controlled Trial. BMC Women’s Health, 8, 14. http://dx.doi.org/10.1186/1472-6874-8-14
[37] Stotland, N.E., Gilbert, P., Bogetz, A., Harper, C.C., Abrams, B. and Gerbert, B. (2010) Preventing Excessive Weight Gain in Pregnancy: How Do Prenatal Care Providers Approach Counseling? Journal of Women’s Health, 19, 807-814. http://dx.doi.org/10.1089/jwh.2009.1462

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.