Date of Award
Spring 2014
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Weiss, Marianne E.
Second Advisor
Frenn, Marilyn
Third Advisor
Oswald, Debra
Abstract
Aims: To explore factors that influence the process of women's engagement in postpartum weight self-management (PPWSM) behaviors (eating and physical activity). Transitions Theory and the Integrated Theory of Health Behavior Change guided the selection of salient variables including transition conditions, level of patient activation, and social facilitation, to be examined for association with PPWSM behaviors.
Background: Women who do not lose their pregnancy weight are at higher risk of being overweight or obese later in life. Little is known about what women do to self-manage the return to pre-pregnant weight and how providers can influence PPWSM.
Design: Prospective, longitudinal, correlational
Methods: 124 women completed surveys in person during the postpartum hospitalization; 91 completed a 6-week and 66 completed a 12 weeks postpartum follow-up telephone interview. Data collection occurred March through October, 2013
Results: Transition difficulty was negatively associated with patient activation for PPWSM, and patient activation was positively associated with PPWSM behaviors at 6 and 12 weeks. Social support and social influence were not significant predictors of PPWSM though women reported that perinatal providers and inpatient hospital nurses were as influential as family and friends.
Conclusion: Patients experiencing a difficult postpartum transition are likely to be less activated toward PPWSM, and those who are less activated are less likely to engage in PPWSM behaviors in the 12 weeks following their baby's birth. Perinatal care providers should begin to intentionally engage women in the immediate postpartum period to influence women's self-management efforts by using interventions targeted to their activation level.