Abstract
hospitals, health centers) was acquired from the Las Piñas City
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Abstract
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Introduction
The melamine controversy that erupted during the last quarter of
year 2008 brought people’s attention back to the debates
between breastfeeding and the use of breast milk substitutes like
commercial infant formula. This wasn’t the first time that infant
formula had caused illnesses and even deaths to infants
worldwide - hence the continuous campaign of World Health
Organization (WHO) and UNICEF along with other breastfeeding
advocates, for mothers to breastfeed their children at least until 6
months of age.
Infant feeding practices refer generally to meet the nutritional and
immunological needs of the baby. A study of infant feeding
practices was carried out on a sample of 100 mother and infant
pairs. The results revealed that only 20% of mothers in the study
currently exclusively breastfeed their babies. It also shows that
socio-economic factors like mother’s work status, marital status
and educational attainment had direct bearing on these practices.
Employed mothers tend to cease from breastfeeding their babies
and eventually stop and just resort to formula feeding as they go
back to work. The study also showed that mothers who are
married and living with their partners are more likely to
breastfeed their infants than single mothers. Those with higher
educational attainment resort more to formula feeding and mixed
feeding than those with lower educational attainment. Health care
professionals influence mothers the most when it comes to infant
feeding decisions.
Methodology
Type of Research
The type of research that will be used in this study is qualitative
research and quantitative research. Qualitative researchers aim to
gather an in-depth understanding of human behavior and the
reasons that govern such behavior. The discipline investigates the
“why” and “how” of decision making. Besides this, the researcher
will also examine the phenomenon through observations in
numerical representations and through statistical analysis. Along
with questionnaires that will be given out to respondents for the
statistical representation of the findings in the study, interviews
with the respondents and a few experts in this field will also be
conducted.
Sampling Method
The research sampling method that will be used in this study is
random sampling to obtain a more scientific result that could be
used to represent the entirety of the population. A list of all health
care facilities (maternity and lying-in clinics, public and private
Hall.
From 20 barangays, 3 will be picked through random sampling.
The health care facilities and institutions in these three barangays
will then be the target sources of respondents of the researcher.
The health care facilities and institutions will be contacted to
obtain a verbal consent to administer the questionnaire to
mothers at their places. A letter of consent will also be sent to
them along with a sample copy of the questionnaire that will be
used, as well as the protocol of the researcher. A letter was also
addressed to the City Health Officer to obtain endorsement and
consent to conduct a research in selected barangays and distribute
questionnaires to the mothers in the vicinity.
Data collection was conducted throughout the facilities‟ and
health centers‟ operating hours from Mondays through Sundays
in order to include both working and non-working mothers.
Respondents
The respondents in this research will all be coming from one single
location - Las Piñas City, specifically the randomly selected
barangays of Pamplona I, CAA/BF International and Pamplona III.
The researcher chose Las Piñas City because of the socio-
economic conditions present in the area that is relevant to the
study and also as it fits the time frame and resources of the
researcher. The randomly sampled respondents will be asked by
the researcher for consent and approval to answer the
questionnaire until the desired number of respondents which is
100 is reached. The opinion of experts will also be sought in this
research to provide explanations regarding the respondents‟
infant feeding behaviors and practices.
Questionnaire
The questionnaire requires information about the socio-economic
and demographic background of the mother. It also has questions
related to previous infant feeding practices and the birth of her
youngest infant and also regarding the baby’s general health and
age.
Statements that are perceived to be factors that influence
mothers‟ infant feeding decisions were presented. The description
of the type of infant formula given by formula and mixed feeding
mothers will also be asked in the material.
Conclusion
Majority of the mothers formula feed their child and only a
minority exclusively breastfeeds their children, especially as per
recommendation of the World Health Organization. While
majority of the mothers in this study showed a positive attitude
towards breastfeeding, most of them decided only to formula feed
due to the reasons of insufficient milk supply and work.
Based on the results of the study, the educational attainment,
work status, marital status, and seminars in the barangay the
respondents are part of, about breastfeeding, are the significant
factors that affect the infant feeding decision of mothers in Las
Piñas City.
Majority of the mothers that served as respondents in this study
fall under the age range of 17-30 years old. More than half of
them were also college graduates while a significant number are
undergraduates and have only reached until high school. Most of
the mothers are housewives and the others remaining have full-
time jobs, part-time jobs and self-employed. A few of them are
still students. While majority of them were married, a lot were still
in a status of live-in and are single. More than half of the mothers
did not have previous children before the current one. Majority of
the respondents also have an annual gross household income that
does not exceed P50,000.
Among the several information sources namely, media through
televisions/radios and printed/published materials, the social
support system comprised of the mother’s family, friends and
other relatives and health institutions, the mothers who give their
babies infant formula are influenced the most by health care
institutions through health professionals and other health care
personnel. They influence the mothers in deciding to feed the
baby with formula and in choosing, as well, which brand of
formula is best for their babies. Mothers trust their baby’s doctor
because of their expertise in the said field hence this kind of
relation is achieved.
Mothers were overall not concerned about the possible side
effects of breastfeeding as a few were only worried as shown in
the data presented.
It can be concluded that numerous internal as well as external
factors influence a mother in making infant feeding decisions, and
a greater fraction of these is socio-economic in nature.
QUALITATIVE RESEARCH: DATA COLLECTION
Different methods are used in qualitative research. The most
common are interviews, focus group discussions, observational
methods and document analysis. Combining two or more data
collections methods, for instance interviews as well as focus
groups (‘data triangulation’) enhances the credibility of the study.
Irrespective of the data collection method applied, it is important
to keep a diary during the study, with reflections on the process
(e.g. regarding method and participant selection) and the role and
influence of the researcher (‘reflexivity’).
Read more:
Choo, E.K. et al. (2015) Qualitative research in emergency care
part I: Research Principles and common Applications. Academic
Emergency Medicine, 22: 1096-1102
Part I of a two-article series, provides an introduction to general
principles of applied qualitative health research and examples of
its common use in emergency care research, describing study
designs and data collection methods most relevant to our field,
including observation, individual interviews, and focus groups.
Table 2 in this article provides an overview of different qualitative
data collection methods with their advantages and challenges.
Ranney, M.L. et al. (2015) Interview-based Qualitative Research in
Emergency Care Part II: Data collection, Analysis and Results
Reporting. Academic Emergency Medicine, 22: 1103-1112.
Outlines the specific steps necessary to conduct a valid and
reliable qualitative research project, with a focus on interview-
based studies. These elements include building the research team,
preparing data collection guides, defining and obtaining an
adequate sample, collecting and organizing qualitative data, and
coding and analyzing the data. With a discussion on potential
ethical considerations unique to qualitative research as it relates
to emergency care research.
Example using methodological triangulation:
Sewdas, R. et al. (2017) Why older workers work beyond the
retirement age: a qualitative study. BMC Public Health, 17: 672.
This study is based on a combination of semi-structured telephone
interviews and focus groups.
Interviews
Interviews are useful to explore experiences, views, opinions, or
beliefs on specific matters. Accounts can be explored and
compared to others, to develop an understanding of the
underlying structures of beliefs (See chapter 4 in Green &
Thorogood, 2010). There are different grades of structuring the
interview: structured, semi-structured or open/in-depth,
dependent on the characteristics of structuring the interview by
the researcher. Often the researcher develops a topic list before
the start of the interview, which can be used in a flexible manner.
As the interview is a product of interaction between the
researcher and the interviewee, the setting and skills of the
researcher are of importance (e.g. the ability to build a sense of
trust (developing rapport), the way of phrasing questions, give the
interviewee room to tell a story, body language). Furthermore, it is
important to think about the type of transcription of audio tapes.
Read more:
Britten, N. (1995) Qualitative interviews in medical research. BMJ,
311, 251-253.
This paper provides an outline of qualitative interview techniques
and their application in medical settings. With a practical guidance
for conducting interviews.
Green, J. & Thorogood N. (2010) Qualitative Methods for Health
Research. Third Edition. London: Sage Publications.
See chapter 4 on in-depth interviews.
Gubrium, J.F. & Holstein, J.A. (2001) Handbook of Interview
Research. Context & Method. London: SAGE Publications.
This handbook offers information on different forms of
interviewing, interviewing distinctive respondents (e.g. children or
ill people), technical aspects, different analytic strategies, and the
topic of reflection and representation.
Gubrium, J.F. et al. (2012) The SAGE Handbook of Interview
Research. The Complexity of the Craft. London: SAGE Publications.
This second version of the handbook also offers information on
the logistics of interviewing, the self and other in the interview
and ethics of the interview.
Ranney, M.L. et al. (2015) Interview-based Qualitative Research in
Emergency Care Part II: Data collection, Analysis and Results
Reporting. Academic Emergency Medicine, 22: 1103-1112
Gives an outline the specific steps necessary to conduct a valid
and reliable qualitative research project, with a focus on
interview-based studies. These elements include building the
research team, preparing data collection guides, defining and
obtaining an adequate sample, collecting and organizing
qualitative data, and coding and analyzing the data. With a
discussion on potential ethical considerations unique to
qualitative research as it relates to emergency care research. Table
1 provides an outline of an Interview Guide for Focus Groups or
Semi-structured Interviews. Table 2 gives examples of qualitative
questions suitable for a topic list
Dutch reference:
Evers, J. (red.), (2007) Interviewen: kunst én kunde. Den Haag:
Boom Lemma uitgevers.
Examples:
Bakker, M. et al. (2015) Need and value of case management in
multidisciplinary ALS care: A qualitative study on the perspectives
of patients, spousal caregivers and professionals. Amyotrophic
Lateral Sclerosis and Frontotemporal Degeneration, 16(3-4), 180-
186.
Bakker, M. et al. (2016) Experiences and perspectives of patients
with post-polio syndrome and therapists with exercise and
cognitive behavioural therapy. BMC neurology, 16(1), 23-34.
Ockhuijsen, H.D.L. et al. (2014) Pregnancy After Miscarriage:
Balancing between Loss of Control and Searching for Control.
Research in Nursing & Health, 37, 267-275.
Focus group discussions
Focus group discussions are useful to examine how social
knowledge is produced. The researcher stimulates discussion in
order to examine how knowledge and ideas develop and operate
in a given group. Most of the times, a facilitator guides a
discussion about a particular topic in a group of usually 6-12
people. Some sensitive issues might be more easy discussed
within a group, although other (personal) information might be
withheld, for instance when persons are acquainted with each
other or because of hierarchical relations within the group. The
role of the facilitator is to create an open atmosphere, involve
participants in the discussion and manage this discussion. The
organization of a focus group requires careful attention. This
includes the sampling and recruitment of participants, the
composition of the topic list and how the data will be collected.
Read more:
Green, J. & Thorogood N. (2010) Qualitative Methods for Health
Research. Third Edition. London: Sage Publications.
See chapter 5 on Group Interviews.
Gubrium, J.F. & Holstein, J.A. (2001) Handbook of Interview
Research. Context & Method. London: SAGE Publications.
Offers a chapter on focus groups.
Kitzinger, J. (1994) The methodology of Focus Groups: the
importance of interaction between research participants.
Sociology of Health & Illness, 16, 1, 103-121.
This article introduces focus group methodology, explores ways of
conducting such groups and examines what this technique of data
collection can offer researchers. It concentrates on one feature
which inevitably distinguishes focus groups from one-to-one
interviews or questionnaires – namely the interaction between
research participants – and argues for the overt exploration and
exploitation of such interaction in the research process.
Kitzinger, J. (1995) Introducing focus groups. BMJ, 311, 299-302.
This paper introduces focus group methodology, gives advice on
group composition, running the groups, and analysing the results.
Example:
Middelweerd, A. et al. (2015) What features do Dutch university
students prefer in a smartphone application for promotion of
physical activity? A qualitative approach. International Journal of
Behavioral Nutrition and Physical Activity, 12: 31.
Observational methods
Observational methods are used to understand phenomena by
studying people’s accounts and actions in an everyday context.
There are different types of observations, with various degrees of
research participation, like non-participating observation (e.g. by
using video recordings), and participant observation or
ethnography. Ethnography ‘usually involves the researcher
participating, overtly or covertly, in people’s daily lives for an
extended period of time, watching what happens, listening to
what is said, and/or asking questions through informal and formal
interviews, collecting documents and artefacts’ (Hammersley &
Atkinson, 2007: 3).
Read more
Atkinson, P. et al. (2001) Handbook of Ethnography. London: Sage
Publications
Offers chapters on various aspects of (conducting) ethnography.
Emerson, R.M., Fretz, R.I. & Shaw, L.L. (2011) Writing ethnographic
fieldnotes (2nd edition). Chicago: The University of Chicago Press.
Green, J. & Thorogood N. (2010) Qualitative Methods for Health
Research. Third Edition. London: Sage Publications
See chapter 6 on Observational Methods.
Hammersley, M. & Atkinson, P. (2007) Ethnography. Principles in
practice. Third edition. London: Routledge.
Reeves, S. & Hodges, B.D. (2008) Qualitative research
methodologies: ethnography. BMJ, 337: a1020.
This article provides background for those who will encounter this
methodology in their reading rather than instructions for carrying
out such research.
Example:
Pasman, H.R.W. et al. (2003) Feeding nursing home patients with
severe dementia: A qualitative study. Journal of Advanced
Nursing, 42, 3, 304-311.
This paper is based on participant observation by two researchers
in two Dutch nursing homes.
Document analysis
Document analysis is based on existing sources, like government
reports, personal documents, articles in newspapers, books or
medical records..
Quality procedures
Devers (1999) formulated several strategies for enhancing the
rigor of qualitative research:
Criteria Strategies
Credibility / Internal validity
Triangulation. The purpose of triangulation is to make use of
multiple data sources, investigators, methods or theory to the
extent possible to provide corroborating evidence.
Search for Disconfirming Evidence (“deviant” or “negative” cases).
Instead of ignoring cases or information that “doesn’t fit”, the
researcher actively looks for cases that do not fit the pattern and
refines the theory and working hypotheses in light of this
evidence. The researcher(s) continues this process until all cases
fit, eliminating all outliers and exceptions.
Subject Review (Also called “member checking” and “dialogue
with participants”). The researcher(s) solicits research “subject”,
group member, or participant views of the credibility of
interpretation and findings. In some cases, this strategy is also
used to increase the probability that research results will be used.
Transferability / External validity
Detailed Description of the Context, i.e. the study context, the
investigator’s role in the context and of how the context affects
the ability to answer the original research question.
Dependability / Reliability
Data Archiving/Creating an Audit Trail. The researcher(s) should
ensure the completeness and accuracy of documents (e.g.
interviews, observations, etc.) and be clear about the coding
schemes and data analysis process. Theoretically, this would allow
someone not connected with the study to review the primary
documents and coding schemes to assess whether the findings,
interpretations, and conclusions are supported.
Skeptical Peer Review. A skeptical peer-reviewer plays the role of
devil’s advocate, asking difficult questions about methods,
meanings, and interpretation of the data. This process provides an
external check on the research.
Confirmability / Objectivity
Triangulation. See description above.
Skeptical Peer Review or Audits. See above.
Search for Disconfirming Evidence or Negative Cases. See above.
Reflective Journal Keeping by the Researcher. Because the
researcher is the research instrument in qualitative research, he or
she should keep journal notes on how his or her personal
characteristics, feelings, and biases may be influencing the work
and how he or she tries to manage them to the extent possible.
Read more:
Devers, K.J. (1999) How Will We Know “Good” Qualitative
Research When We See It? Beginning the Dialogue in Health
Services Research. Health Services Research, 34 (5): 1153-1188.
The purpose of this article is to lay the foundation for an explicit
review of, and dialogue about, the criteria that should be used to
evaluate qualitative health services research.
Frambach, J.M. et al. (2013) AM Last Page: Quality Criteria in
Qualitative and Quantitative Research. Academic Medicine. 88; 4:
552.
This page provides an overview of quality criteria in qualitative
research and a number of techniques that researchers can use to
meet these.
Mays, N. & Pope, C. (2000) Assessing quality in qualitative
research. BMJ, 320: 50-52.
This article outlines two views of how qualitative methods might
be judged and argues that qualitative research can be assessed
according to two broad criteria: validity and relevance.
Responsibilities and ethics
It is important to carefully reflect on and think about ethical
dilemmas related to the practice of qualitative research as well as
responsibilities of the researchers, especially regarding
respondents. These are for instance related to informed consent,
protecting the privacy of respondents or dealing with different
stakeholders. Please consult the guideline on privacy. For specifics
in a study, contact the privacy offi
Collecting Data in Qualitative Research
Very often data collecting takes place in a defined time period and
qualitative data analysis is viewed as a next step in the research
process after all data have been collected and transcribed.
Researchers forego many opportunities and miss out on some of
the great advantages of qualitative research – flexibility and
adaptation – when they handle their project like this. Sometimes
there is no way around it as organizational matters or cooperation
within a team won’t allow for a process where data collection and
analysis go hand in hand. But when you are free to plan your
project and your time frame is sufficient; then I recommend the
grounded theory method of data collection. This does not mean
that you conduct a grounded theory study; you just take
advantage of one of the general procedures of research that they
and others before them have described (see for example Blumer,
1969). Strauss (1987/1991) writes about the triad of the research
process: data collection followed by coding and memo writing.
Both, codes and memos guide the search for new data and can
lead to more coding and more memo writing. In later phases of
the research project, it is not unusual that the researcher goes
back to already analyzed data, revises coding and refines memos.
Coding and memo writing continues until the end. When the
researcher has the feeling that the achieved level of data
integration is not sufficient and there are gaps in the data, new
data may even be collected in the process of report writing.
Transcribing and analyzing data early has the advantage of being
able to adjust interview questions, asking about new and different
aspects that first have come up in the interviews; questions that
are truly grounded in the field and not based on your desktop
research. Especially novices learn a lot when first transcribing
data. Then they realize what went well in the interview and what
didn’t work out. They get a better picture of themselves as
interviewer and can also improve their own interview skills. Taking
it a step further beginning with coding, discovering first
preliminary linkages in the data adds further information that
supports and helps you in the continuing data collection process.
Above I mentioned the time frame. When you only have three
months to complete your research project from start to finish, it
may be difficult to implement the dialectic process of data
collection and analysis. But you could at least try to fit in the
transcription during the phase of data collection. Analysis begins
while you transcribe and this is at least something you can take as
input with you into the next interview.
Abstract
Background
Whilst there has been increasing research interest in interventions
which promote physical activity during pregnancy few studies
have yielded detailed insights into the views and experiences of
overweight and obese pregnant women themselves. The
qualitative study described in this paper aimed to: (i) explore the
views and experiences of overweight and obese pregnant women;
and (ii) inform interventions which could promote the adoption of
physical activity during pregnancy.
Methods
The study was framed by a combined Subtle Realism and Theory
of Planned Behaviour (TPB) approach. This enabled us to examine
the hypothetical pathway between beliefs and physical activity
intentions within the context of day to day life. The study sample
for the qualitative study was chosen by stratified, purposive
sampling from a previous study of physical activity measurements
in pregnancy. Research participants for the current study were
recruited on the basis of Body Mass Index (BMI) at booking and
parity. Semi-structured, in-depth interviews were conducted with
14 overweight and obese pregnant women. Data analysis was
undertaken using a Framework Approach and was informed by
TPB.
Results
Healthy eating was often viewed as being of greater importance
for the health of mother and baby than participation in physical
activity. A commonly cited motivator for maintaining physical
activity during pregnancy is an aid to reducing pregnancy-related
weight gain. However, participants often described how they
would wait until the postnatal period to try and lose weight. A
wide range of barriers to physical activity during pregnancy were
highlighted including both internal (physical and psychological)
and external (work, family, time and environmental). The study
participants also lacked access to consistent information, advice
and support on the benefits of physical activity during pregnancy.
Conclusions
Interventions to encourage recommended levels of physical
activity in pregnancy should be accompanied by accessible and
consistent information about the positive effects for mother and
baby. More research is required to examine how to overcome
barriers to physical activity and to understand which interventions
could be most effective for overweight/obese pregnant women.
Midwives should be encouraged to do more to promote activity in
pregnancy.
Keywords
Physical Activity Healthy Eating Normative Belief Control Belief
Topic Guide
These keywords were added by machine and not by the authors.
This process is experimental and the keywords may be updated as
the learning algorithm improves.
Background
An increasing proportion of women in the UK are obese or
overweight at the start of their pregnancy [1, 2]. This may result in
adverse consequences for the immediate and longer-term health
of the mother and child [3, 4]. In light of this, pregnancy is
emerging as a priority area for interventions which aim to address
the obesity epidemic. Pregnancy is a unique and critical period in
the life course for women and, consequently, they may be more
receptive to behaviour change interventions [5]. Physical activity
promotion is a key component of weight control interventions [6]
as it has beneficial effects on glucose metabolism. It has also been
suggested that this may improve pregnancy outcomes
independent of weight [7]. National guidance in the UK
recommends at least 30 minutes of moderate intensity activity a
day throughout pregnancy for most women [8, 9]. However,
research has highlighted that pregnant women often have low
total physical activity levels [10] and that these tend to reduce
further in the later stages of pregnancy [11].
There is a dearth of information regarding women's attitudes to
physical activity in pregnancy. A small number of studies have
highlighted significant barriers to participation, including lack of
time, lack of facilities (including childcare) and physical barriers
[12, 13, 14, 15]. Indeed it has been found that some women
perceive physical activity to be an unsafe behaviour when
pregnant [16, 17]. However, few studies have offered detailed
insights into the views and experiences of overweight and obese
women themselves. This paper provides qualitative insights into
how overweight and obese pregnant women living in the UK feel
about physical activity in pregnancy within the context of their day
to day lives. The findings highlight the barriers and motivators
which surround physical activity in pregnancy, the conflicting
advice and information which women receive during pregnancy,
and which criteria should be considered when designing effective
interventions for physical activity in pregnancy.
Methods
Theoretical Framework
The study was framed by a theoretical approach which combined
both Subtle Realism [18] and the Theory of Planned Behaviour
(TPB). This combined approach enabled an examination of the
hypothetical pathway between beliefs and physical activity
intentions within the context of a woman's day to day life. The
Subtle Realism approach [18] stipulates that the social world does
exist independently of individual subjective understandings, but is
only accessible to us via research participants' interpretations
[19]. The TPB is a psychological model widely used in the design of
behaviour change interventions [20]. The TPB approach stipulates
that intentions predict behaviour, and that three sets of beliefs
mediate behavioural intentions in relation to the following criteria:
(i) behavioural beliefs, i.e. attitudes based on perceived benefits
and harms, (ii) control beliefs, i.e. perceptions relating to control
over necessary resources and support to engage in the relevant
behaviour; and (iii) normative beliefs i.e. subjective norms,
determined by perceptions of the views of others. Using a
combined TPB and Subtle Realism approach it was possible to
examine women's views and experiences within the context of
their day to day concerns and priorities.
Study participants
Ethical approval was given by the Durham and Tees Valley 2 Rec
(Ref:07/H0908/53), and written informed consent was obtained
from the study participants. The sampling frame consisted of 65
women participating in a feasibility study of physical activity
measurement methods. Inclusion criteria for the previous study
were: (i) any woman booking with a normal, singleton pregnancy,
(ii) a measured body mass index (BMI) at booking (in the first
trimester) greater than or equal to 25 kg/m2 (i.e. overweight or
obese), (iii) adequate verbal and written English and (iv) older
than 16 yrs. Of the women participating in the measurement
study, around 40% were obese, 47% were nulliparous (no previous
children), 93% were white, 76% were employed at recruitment
and 33% were educated to degree level. These women agreed to
wear an accelerometer for seven days at two or three time points
during pregnancy and to complete two different physical activity
questionnaires at each data collection. The measurement study
was designed to compare self report and objective measurement
methods in pregnant women during normal daily activities.
experiences using a flexible and responsive approach [19].
Interviews were audio-recorded at the participant's home, with
participant permission, and lasted between 45-55 minutes. The
topic guide included the following prompts to elicit participant
views and experiences: (i) what a 'healthy lifestyle' means and its
relative relevance for pregnancy; (ii) physical activity in pregnancy
(the benefits, barriers and influences); (iii) healthy lifestyle
interventions in pregnancy and the improvements that could be
made.
Data analysis was undertaken using a Framework Approach to
manage, describe and explore the original data in relation to the
underlying TPB [19]. The interview transcripts were indexed and
mapped on the basis of recurring themes. The synthesised data
were examined to identify explanatory accounts, and preliminary
typologies were developed [19].
It is important that researchers reflexively examine their research
as "knowledge is produced in specific circumstances and that
those circumstances shape it in some way" (Rose, 1997, p.305)
[23]. For the research design and analysis phases of the study
there were three checks on validity (i) A topic guide was used to
ensure a similar range of topics was discussed with each
participant. (ii) In order to ensure the reliability of the study's
coding framework two members of the research team (ZW and JB)
read five of the interviews and agreed the coding framework and
(iii) A topic guide was used to ensure a similar range of topics was
discussed with each participant. Although only a small number of
interviews were conducted, data saturation (i.e. where no new
themes were emerging) was achieved after only 12 interviews and
confirmed with the two final interviews.
Results
The findings are presented according to the analytical typologies:
(i) behavioural beliefs and attitudes, (ii) control beliefs and (iii)
normative beliefs. Verbatim quotes from the study participants
are labelled in terms of their age, whether they were overweight
(BMI 25-30 kg/m2) or obese (BMI over 30 kg/m2) and whether
they were nulliparous (NP) or multiparous (MP).

Previous research has highlighted that weight and family size may
influence physical activity participation in non-pregnant women
[21, 22]. Thus, a stratified purposive sample [19] for the current
study was undertaken according to BMI and parity. These criteria
allowed some diversity in the sample and thus a broad range of
women's experiences was explored. Of the 22 women invited to
participate in the study, 14 agreed to be interviewed. All of the 8
women who declined to be interviewed, or were not contactable,
were in the obese category (BMI 30 kg/m2 or more). Reasons
given for non-participation included chronic health problems and
time constraints. The final sample of 14 interviewees included
eight who were obese and eight who were in their first pregnancy.
Thirteen were white, thirteen were employed and five were
educated to degree level. All women were interviewed in late
pregnancy.

Data collection and analysis

Semi-structured, in-depth interviews based on a topic guide were

used to enable a detailed exploration of women's views and