Identification of behavioural determinants and implementation of evidence-based practice of promoting physical activity by midwives in maternity hospitals using a mixed methods approach

Despite scientific evidence on health benefits of an active lifestyle during and after pregnancy and international recommendations, healthcare professionals (HCP) do not sufficiently promote physical activity (PA) during and after pregnancy. This discrepancy between guidelines and professional practice is due to a lack of knowledge, self-confidence of HCP, and resources such as time and educational materials. Midwives did not have yet the opportunity to contribute to behavioural change programmes targeting PA, despite being involved at a pivotal time in women's lives. This mixed methods research study addresses the overall aim of understanding and explaining how PA promotion practice is linked to PA behaviour during and after pregnancy to equitably promote health. Research questions are:1) To what extent behaviour and behavioural determinants of PA promotion practice by HCP are related to women’s PA behaviour and behavioural determinants during and after pregnancy? 2) How can an existing behaviour change program be adapted and effectively implemented to influence midwives' PA promotion practice in a maternity hospital in Western Switzerland? In a mixed methods methodology, a systematic Intervention Mapping protocol will identify barriers and enablers of PA promotion practice in maternity hospitals. Subsequently, a behaviour change pilot intervention will be adapted, implemented, and evaluated among midwives. As key stakeholders, HCP, and women are directly involved in the design of the pilot intervention, we expect a change in behavioural determinants and practice of PA promotion PA by midwives. A total of 20 midwives and 150 pregnant women of maternity hospitals of Lausanne and Neuchâtel will be included. The perspective of Phase 1 and 2 is to perform a controlled explanatory study (Phase 3) to evaluate a potential change in PA levels by women associated with PA promotion practice by midwives. The completion of the Phase 3 will depend on whether funds are received or not.