Postpartum Weight Management Study: Low income women's preferences and opinions regarding healthy lifestyle choices in the postpartum period

Background: Postpartum weight retention (PPWR) leads to increased rates of maternal and childhood obesity. No current guidelines or programs exist to serve high-risk low-income women. Objective: Gain practical insight into low-income women's preferences and opinions regarding a proposed PPWR intervention. Methods: Focus groups composed of staff and clients (n=17) of a community-based organization were conducted at three sites. Women were asked open-ended questions about the four intervention components: 1) motivational text messages 2) baby carriers and pedometers promoting at-home physical activity 3) increased social support 4) healthy eating and breastfeeding education sessions. The discussion was audio recorded, transcribed verbatim, and entered into Nvivo data analysis software for coding by two investigators to identify overarching themes. Results: By self-report, average age (SD) was 26.4 (5.1) years, 76.5% were African American, 23.5% Hispanic, 58.8% multiparous and average BMI 28.1 (4.4) (kg/m2). Forty-seven percent were Medicaid recipients and 29% had no health insurance coverage. The investigators identified ten themes. Most participants commented upon the themes: 1) need for positive social support 2) lack of time and motivation as barriers 3) texting providing a helpful reminder 4) health of the baby and family as motivation 5) need for improved knowledge. Conclusions: Practical insight gained from focus groups together with health-behavior theory strengthens the design of the proposed intervention. As hypothesized, the intervention should focus on providing motivation and positive social support, and tangible tools to help women implement existing knowledge of healthy behaviors and thereby promote sustainable healthy change.