Table 2 Barriers and enablers to physical activity for Women with diagnosis of GDM collected from the PPI groups
COM-B component | Theme | Example of Enablers | Example of Barriers |
|---|---|---|---|
Psychology capability – knowledge or psychological skills, strength or stamina to engage in the necessary mental process | Limited specific knowledge of PA benefits, types of PA in pregnancy and PA resources in GDM Safety concerns | Awareness of the types of activity to perform; reassurance activity can be started gradually Awareness of specific benefits to blood glucose control and reducing weight gain. Information from a source in which they had confidence . Instructions for the specific exercise, what type of activity ‘am I ok to do’. Understanding the importance of activity in the treatment of GDM | So much information on the internet, difficulty knowing what to trust. Lack of confidence to start a new exercise and fear of causing harm |
Physical capability – physical skill, strength, stamina | Pregnancy symptoms (pain, nausea, lack of energy, tiredness) | Exercise can improve symptoms ‘I would always feel better once had been for a walk’ | ‘Had nausea in the 1st Trimester, I completely stopped doing all activity’ |
Social opportunity – Opportunity afforded by interpersonal influences, social cues and cultural norms that influence the way we think | Partners & family support Work & childcare Support from Classes | Social support ‘Since the diagnosis my partner has been more supportive and is almost dragging me out for walks’ Zoom and Facebook instruction classes were really helpful’ | Difficulties with Work, Childcare and maintaining consistency |
Physical Opportunity – Opportunity afforded by the environment involving time, resources, location, cues physical affordance | Finding Time for activity Finding local activity Weather | Online classes and home exercises have been really helpful especially in lockdown – ‘I am more comfortable to exercise at home and can fit in with my schedule’ Activity groups close to home | ‘Finding the time when you have look after a two-year-old all day’ ‘Exercising in daylight hours, you just don’t feel like going out for a walk in the dark’ Having the time and adapting around children |
Reflective Motivation – Reflective process involving plans (self-conscious intentions) and evaluations (beliefs about what is good and bad) | For Health of the Baby and reducing the risk of complication Intention: GDM was a prompt to start to activity | Every pregnancy is different, depends on the person and the time in the pregnancy Baby Health and Responsibility ‘Concerns about the baby and doing everything I can’ & It isn’t about me it is about my baby’ Getting a diagnosis of GDM – has been ‘prompt for me to review my activity level’ ‘Activity is now even more important to my health since the diagnosis of GDM’ Desire to be in good shape for labour, want to be active for the future, ‘Doing some activity made me feel better.’ | Mind-set: ‘you get into a comfortable zone and that a change to the routine will stress you out’ Habit: ‘Had a sense that I did not need to be active’ |
Automatic Motivation – automatic processes involving emotional reactions, desires (wants and needs) impulses inhibitions drive states and reflex responses | Desire Worry and fear | Having high blood sugar levels can prompt me to do activity Worry: ‘about the health of the baby and that I am doing everything I can’ Worry of having to go onto medication |