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The Perceived Role and Influencers of Physical Activity Among Pregnant Women From Low Socioeconomic Status Communities in South Africa
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... Despite the evidence that supports the benefits of PA during pregnancy, many pregnant women frequently report that they are unsure of the safety of exercising during pregnancy and thus reduce their PA after becoming pregnant. [28] In a recent study done in South Africa, Muzigaba et al. [28] found that although South African women are interested in participating in PA during pregnancy, many were unaware of what is safely recommended. In addition, the women reported a lack of information and advice from healthcare providers, which may explain their safety concerns for themselves and their unborn baby. ...
... Despite the evidence that supports the benefits of PA during pregnancy, many pregnant women frequently report that they are unsure of the safety of exercising during pregnancy and thus reduce their PA after becoming pregnant. [28] In a recent study done in South Africa, Muzigaba et al. [28] found that although South African women are interested in participating in PA during pregnancy, many were unaware of what is safely recommended. In addition, the women reported a lack of information and advice from healthcare providers, which may explain their safety concerns for themselves and their unborn baby. ...
... Women also frequently report discomfort, lack of free time, tiredness, pain and lack of social support as reasons for not engaging in PA during pregnancy. [28] ...
Background. A woman’s health status prior to, and during, pregnancy has been shown to influence maternal and foetal health outcomes, and therefore healthy behaviours should be encouraged to optimise weight gain during pregnancy. Discussion. Pre-gravid overweight and obesity, and excessive weight gain during pregnancy, are associated with several adverse pregnancy outcomes for the mother and the foetus. Despite the fact that physical activity during pregnancy reduces the risk of excessive gestational weight gain, physical activity levels typically decline during pregnancy. Several factors have been shown to influence physical activity during pregnancy, and preliminary data is available on identifying these factors in South African women. Conclusion. Very little is known about physical activity patterns in pregnant South African women in whom overweight and obesity is prevalent. Examining these patterns, as well as the barriers and facilitators of physical activity in this population will assist in informing future interventions. Keywords. South Africa, obesity, barriers, interventions
... Despite the evidence that supports the benefits of PA during pregnancy, many pregnant women frequently report that they are unsure of the safety of exercising during pregnancy and thus reduce their PA after becoming pregnant. [28] In a recent study done in South Africa, Muzigaba et al. [28] found that although South African women are interested in participating in PA during pregnancy, many were unaware of what is safely recommended. In addition, the women reported a lack of information and advice from healthcare providers, which may explain their safety concerns for themselves and their unborn baby. ...
... Despite the evidence that supports the benefits of PA during pregnancy, many pregnant women frequently report that they are unsure of the safety of exercising during pregnancy and thus reduce their PA after becoming pregnant. [28] In a recent study done in South Africa, Muzigaba et al. [28] found that although South African women are interested in participating in PA during pregnancy, many were unaware of what is safely recommended. In addition, the women reported a lack of information and advice from healthcare providers, which may explain their safety concerns for themselves and their unborn baby. ...
... Women also frequently report discomfort, lack of free time, tiredness, pain and lack of social support as reasons for not engaging in PA during pregnancy. [28] ...
Background. A woman's health status prior to, and during, pregnancy has been shown to influence maternal and foetal health outcomes, and therefore healthy behaviours should be encouraged to optimise weight gain during pregnancy. Discussion. Pre-gravid overweight and obesity, and excessive weight gain during pregnancy, are associated with several adverse pregnancy outcomes for the mother and the foetus. Despite the fact that physical activity during pregnancy reduces the risk of excessive gestational weight gain, physical activity levels typically decline during pregnancy. Several factors have been shown to influence physical activity during pregnancy, and preliminary data is available on identifying these factors in South African women. Conclusion. Very little is known about physical activity patterns in pregnant South African women in whom overweight and obesity is prevalent. Examining these patterns, as well as the barriers and facilitators of physical activity in this population will assist in informing future interventions.
... Added to this, previous au- thors [13] have suggested a holistic approach to prenatal care to improve physical activity compliance. In a previous South African study, Muzigaba et al. [43] suggested using instructional resources such as posters, brochures and DVDs to promote healthy behaviours within the clinic setting . Added to provision of comprehensive education, we recommend incorporating physical education workers to provide exercise programmes, and social support within the community. ...
Background
Despite the benefits of physical activity during pregnancy, the physiological and psychological changes that occur during this unique period may put women at greater risk of being sedentary. Lifestyle and environmental transitions have left black South African women at increased risk of physical inactivity and associated health risks. Therefore, the aim of this qualitative study was to describe the beliefs regarding physical activity during pregnancy in an urban African population.
Methods
Semi-structured interviews (n = 13) were conducted with pregnant black African women during their third trimester. Deductive thematic analysis was completed based on the Theory of Planned Behaviour. Coding and analysis was completed with the assistance of ATLAS.ti software.
Results
Participants had a mean age of 28 (19–41) years, and a mean BMI of 30 (19.6–39.0) kg/m2. Although the majority of women believed that physical activity was beneficial, this did not appear to translate into behaviour. Reported reasons for this included barriers such as pregnancy-related discomforts, lack of time, money and physical activity related education, all of which can contribute to a reduced perceived control to become active. Opportunities to participate in group exercise classes was a commonly reported facilitator for becoming active. In addition, influential role players, such as family, friends and healthcare providers, as well as cultural beliefs, reportedly provided the women with vague, conflicting and often discouraging advice about physical activity during pregnancy.
Conclusions
This study provides new theoretical insight on the beliefs of urban South African pregnant women regarding physical activity. Findings from this study suggest a holistic approach to improve physical activity compliance during pregnancy, inclusive of physical activity education and exercise opportunities within a community setting.
This study presents critical formative work upon which contextually and culturally sensitive interventions can be developed.
Background
Notwithstanding the benefits of physical activity (PA) during pregnancy, anecdotal evidence suggests ignorance, unscientific beliefs, and lack of awareness about PA among pregnant South African women.
Aim
This study examined the beliefs, perceived benefits, and sources of information on PA during pregnancy.
Methods
A cross-sectional descriptive study was employed between June and September 2019 using an interviewer-administered questionnaire with 1,082 pregnant women. These women were attending antenatal primary health–care clinics in Buffalo City, Eastern Cape, South Africa. A self-designed questionnaire solicited information on beliefs, benefits, and sources of information regarding PA during pregnancy.
Results
A majority of the participants held positive beliefs concerning PA during pregnancy. They maintained that PA was safe for mother and fetus, improved labor and delivery (93.1%), promoted energy (89.0%), and should be discontinued when tired (76.6%). Most held negative convictions that PA during pregnancy increased body temperature (64.5%) and that pregnancy was a time to rest and refrain from PA (56.5%). Predominantl sources of information received about PA during pregnancy were television, the radio, and other media (70.2%). Most participants were aware of the benefits of PA during pregnancy —— reduction in infant weight (61.4%), lessening of moodiness (90.4), and decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). An overwhelming majority affirmed that PA improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%).
Conclusion
Our findings suggested that women hold positive beliefs and perceive PA as beneficial to their health and the baby; however, they received most of their information from the Internet. Most women regarded pregnancy as a period to relax and rest. Interventions to promote PA during pregnancy are needed.
Objectives: Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy.
Design: PubMed/Medline and Web of Science databases were systematically searched using a reference period between 1986 to January/2016.
Method: A comprehensive search strategy was developed combining the following key words: (barriers OR constraints OR perceptions OR attitudes) AND (physical activity OR exercise OR motor activity) AND (pregnancy OR pregnant women OR antenatal OR prenatal). Thematic synthesis was conducted to analyze the data. A socioecological model was used to categorize the reported barriers.
Results: Twelve quantitative studies and 14 qualitative studies were included. Barriers belonging to the intrapersonal level of the socioecological model were the most reported in the studies and were categorized in five themes as follows: 1) Pregnancy-related symptoms and limitations; 2) Time constraints; 3) Perceptions of already being active, 4) Lack of motivation and 5) Mother-child safety concerns. At the interpersonal level, barriers were coded into two descriptive themes: 1) Lack of advice and information and 2) Lack of social support. Two other themes were used to summarize Environmental, Organizational and Policy barriers: 1) Adverse weather and 2) Lack of resources.
Conclusion: A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions.
Background: Physical activity (PA) during pregnancy provides physical and psychological benefits for mother and child. U.S. guidelines recommend ≥30 min of moderate exercise for healthy pregnant women most days of the week; however, most women do not meet these recommendations. Theory assists in identifying salient determinants of health behavior to guide health promotion interventions; however, the application of theory to examine PA among pregnant women has not been examined cohesively among multiple levels of influence (e.g., intrapersonal, interpersonal, neighborhood/environmental, and organizational/political). Subsequently, this systematic review aims to identify and evaluate the use of health behavior theory in studies that examine PA during pregnancy.
Methods: Articles published before July 2014 were obtained from PubMed and Web of Science. Inclusion criteria applied were: (1) empirically-based; (2) peer-reviewed; (3) measured factors related to PA; (4) comprised a pregnant sample; and (5) applied theory. Fourteen studies were included. Each study's application of theory and theoretical constructs were evaluated.
Results: Various theories were utilized to explain and predict PA during pregnancy; yet, the majority of these studies only focused on intrapersonal level determinants. Five theoretical frameworks were applied across the studies—all but one at the intrapersonal level. Few determinants identified were from the interpersonal, neighborhood/environmental, or organizational/political levels.
Conclusion: This systematic review synthesized the literature on theoretical constructs related to PA during pregnancy. Interpersonal, community, and societal levels remain understudied. Future research should employ theory-driven multi-level determinants of PA to reflect the interacting factors influencing PA during this critical period in the life course.
Purpose: Malnutrition, presenting as obesity in women and under-nutrition in children, is a prevalent problem in the squatter communities of Cape Town. Food habits are determined by a complex matrix of economic, social and cultural factors which need to be understood by health professionals prior to the implementation of strategies to improve the nutritional status of this community. This qualitative study is designed to explore the perceptions of overweight black women in Cape Town, with underweight infants, about the culturally acceptable body size for women and children.
about the likely outcomes of the behavior and the evaluations of these outcomes (behavioral beliefs), beliefs about the normative expectations of others and motivation to comply with these expectations (normative beliefs), and beliefs about the presence of factors that may facilitate or impede performance of the behavior and the perceived power of these factors (control beliefs). In their respective aggregates, behavioral beliefs produce a favorable or unfavorable attitude toward the behavior; normative beliefs result in perceived social pressure or subjective norm; and control beliefs give rise to perceived behavioral control. In combination, attitude toward the behavior, subjective norm, and perception of behavioral control lead to the formation of a behavioral intention. As a general rule, the more favorable the attitude and subjective norm, and the greater the perceived control, the stronger should be the person's intention to perform the behavior in question. Finally, given a sufficient degree of actual control over the behavior, people are expected to carry out their intentions when the opportunity arises. Intention is thus assumed to be the immediate antecedent of behavior. However, because many behaviors pose difficulties of execution that may limit volitional control, it is useful to consider perceived behavioral control in addition to intention. To the extent that perceived behavioral control is veridical, it can serve as a proxy for actual control and contribute to the prediction of the behavior in question. The following figure is a schematic representation of the theory.
Regular physical activity is associated with improved physiological, metabolic and psychological parameters, and with reduced risk of morbidity and mortality. Current recommendations aimed at improving the health and wellbeing of nonpregnant subjects advise that an accumulation of >= 30 minutes of moderate physical activity should occur on most, if not all, days of the week. Regardless of the specific physiological changes induced by pregnancy, which are primarily developed to meet the increased metabolic demands of mother and fetus, pregnant women benefit from regular physical activity the same way as nonpregnant subjects. Changes in submaximal oxygen uptake ((V) over dotO(2)) during pregnancy depend on the type of exercise performed. During maternal rest or submaximal weight-bearing exercise (e.g. walking, stepping, treadmill exercise), absolute maternal (V) over dotO(2) is significantly increased compared with the nonpregnant state. The magnitude of change is approximately proportional to maternal weight gain. When pregnant women perform submaximal weight-supported exercise on land (e.g. level cycling), the findings are contradictory. Some studies reported significantly increased absolute (V) over dotO(2), while many others reported unchanged or only slightly increased absolute (V) over dotO(2) compared with the nonpregnant state. The latter findings may be explained by the fact that the metabolic demand of cycle exercise is largely independent of the maternal body mass, resulting in no absolute (V) over dotO(2) alteration. Few studies that directly measured changes in maternal maximal (V) over dotO(2) ((V) over dotO(2max)) showed no difference in the absolute (V) over dotO(2max) between pregnant and nonpregnant subjects in cycling, swimming or weight-bearing exercise. Efficiency of work during exercise appears to be unchanged during pregnancy in non-weight-bearing exercise. During weight-bearing exercise, the work efficiency was shown to be improved in athletic women who continue exercising and those who stop exercising during pregnancy. When adjusted for weight gain, the increased efficiency is maintained throughout the pregnancy, with the improvement being greater in exercising women. Regular physical activity has been proven to result in marked benefits for mother and fetus. Maternal benefits include improved cardiovascular function, limited pregnancy weight gain, decreased musculoskeletal discomfort, reduced incidence of muscle cramps and lower limb oedema, mood stability, attenuation of gestational diabetes mellitus and gestational hypertension. Fetal benefits include decreased fat mass, improved stress tolerance, and advanced neurobehavioural maturation. In addition, few studies that have directly examined the effects of physical activity on labour and delivery indicate that, for women with normal pregnancies, physical activity is accompanied with shorter labour and decreased incidence of operative delivery. However, a substantial proportion of women stop exercising after they discover they are pregnant, and only few begin participating in exercise activities during pregnancy. The adoption or continuation of a sedentary lifestyle during pregnancy may contribute to the development of certain disorders such as hypertension, maternal and childhood obesity, gestational diabetes, dyspnoea, and pre-eclampsia. In view of the global epidemic of sedentary behaviour and obesity-related pathology, prenatal physical activity was shown to be useful for the prevention and treatment of these conditions. Further studies with larger sample sizes are required to confirm the association between physical activity and outcomes of labour and delivery.
Objective: To explore the perception among black South African women that people who are thin are infected with HIV or have AIDS. Setting: Khayelitsha, an urban township in Cape Town. Subjects: 513 women aged 18-65 years. Methods: This was an exploratory study employing both quantitative and qualitative research methodology. Data were collected in two phases. The first phase involved collecting quantitative data among 513 participants. During the second phase, qualitative data were collected in a purposely selected sub-sample of 20 women. For the qualitative data collection, participants were shown eight body figures, ranging from thin to obese, and asked to choose a figure representing the ideal figure, a preferred figure and a figure thought to symbolise health. They were also invited to choose a figure that they thought represented a person infected with HIV or who had AIDS. They had the option of saying that they did not associate any of the figures with people infected with HIV or who had AIDS. Weight and height measurements were also taken. After the quantitative analysis was completed, focus group discussions explored perceptions about body image and the relation to HIV among purposely selected participants. Data were summarised by content based on questions discussed. Results: Sixty-nine per cent of the participants associated a thin figure with a person infected with HIV, or who had AIDS. Only 10.2% thought the thin figure symbolised health. Fifty per cent preferred a normal-weight figure, while 34.2% thought that normal weight symbolised health. Only 2% thought that people in the normal-weight category were infected with HIV or had AIDS. Thirty-four per cent preferred to be overweight and 31% thought that being overweight symbolised health. None of the participants thought the overweight figure represented people infected with HIV or who had AIDS. Only 8% preferred the obese figure. The results of the qualitative data analysis suggested that participants preferred to be overweight and at risk of acquiring cardiovascular diseases, rather than being thin and stigmatised as a person infected with HIV or who had AIDS. Conclusion: This study revealed that the stigma associated with HIV and AIDS may undermine strategies for prevention of chronic noncommunicable diseases among urban black South African women.
Examines the effects of physical activity on depression and anxiety, discussing the scientific strength of studies on physical activity, depression, and anxiety against the standards of science accepted in epidemiology with a focus on the independence, consistency, dose-response gradient, and biological plausibility of the evidence. (Author/SM)