Testing the Integrated Theory of Health Behaviour Change for postpartum weight management

Abstract

AIM: This is a report of a correlational study to test the Integrated Theory of Health Behaviour Change within the context of postpartum weight self-management including the impact of race/ethnicity and weight classification. BACKGROUND: Women experiencing childbirth face increasing challenges to manage their weight postpartum. Little is known about women's weight self-management during the complex physiological and psychosocial transition of the postpartum period. METHODS: Data were collected during the birth hospitalization and 4 months postbirth during 2005 and 2006. A quota sample of 250 postpartum women using two strata, race/ethnicity and prepregnant weight classification, were enrolled; 179 women completed the follow-up survey. A survey questionnaire measured concepts from the Integrated Theory of Health Behaviour Change concepts, including knowledge and beliefs (self-efficacy, outcome expectancy and goal congruence), self-regulation skills and abilities, and social facilitation (social support and social influence) and the proximal outcome of weight retention. Factor analysis identified 5 factors consistent with the theoretical concepts that accounted for 47·1% of total survey variance. RESULTS: Model testing using path analysis explored the relationship among factors. The final model explained 25·7% of the variance in self regulation at 4 months, but did not explain weight retention. The contribution of select concepts to total variance was different for Caucasian and African American women, but not by weight classification. CONCLUSIONS: Findings support use of theoretical concepts and relationships to understand postpartum weight self-management. The different relationships among concepts in Caucasian and African American women should be considered in planning targeted postpartum weight self-management interventions.

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