Enablers and barriers to women's lifestyle behavior change during the preconception period: A systematic review.
Pragya KandelSiew S LimStephanie PirottaHelen SkouterisLisa J MoranBriony HillPublished in: Obesity reviews : an official journal of the International Association for the Study of Obesity (2021)
Healthy lifestyle behaviors during the preconception period are important to optimize maternal and child outcomes, including weight. However, the majority of women do not have optimal preconception lifestyle behaviors. This systematic review explored enablers and barriers to women's preconception lifestyle behaviors using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Preconception was defined as the time before conception, capturing planned and unplanned pregnancies. Medline Complete, EMBASE, PsycINFO, and CINAHL were searched for peer-reviewed, quantitative and qualitative primary studies (English, 2006-2020) that explored enablers and barriers to lifestyle behaviors (diet, physical activity, smoking, alcohol use, supplement intake). Forty-two studies (of 3406) were included, assessing supplement use (n = 37), diet (n = 10), smoking (n = 10), alcohol use (n = 8), and physical activity (n = 5). All three COM-B components were identified only for diet and supplement use. Of the 14 TDF domains, 7 were identified: knowledge, beliefs about capabilities, beliefs about consequences, goals, intentions, social support, and environmental context and resources. The presence/absence of knowledge on healthy behaviors was the most commonly assessed enabler/barrier. Future studies should explore a wider range of factors influencing preconception women's capability, opportunity, and motivation to modify their lifestyle behaviors.
Keyphrases
- physical activity
- weight loss
- pregnancy outcomes
- polycystic ovary syndrome
- systematic review
- social support
- metabolic syndrome
- body mass index
- cardiovascular disease
- healthcare
- depressive symptoms
- sleep quality
- insulin resistance
- mental health
- breast cancer risk
- randomized controlled trial
- skeletal muscle
- case control
- type diabetes
- public health
- pregnant women
- climate change
- risk assessment
- birth weight