What Barriers Thwart Postpartum Women’s Physical Activity Goals During a 12-Month Intervention? A Process Evaluation of the Nā Mikimiki Project

Abstract

Approximately 70% of new mothers do not meet national guidelines for moderate-to-vigorous physical activity (MVPA). The Nā Mikimiki (“the active ones”) Project (2008–2011) was designed to increase MVPA among women with infants 2–12 months old. Participants’ barriers to exercising and achievement of specific MVPA goals were discussed during telephone counseling calls over 12 months. Healthy, inactive women (n = 115, mean age = 31 ± 5 years, infants’ mean age = 5.5 ± 3 months; 80% racial/ethnic minorities) received a total of 17 calls over 12 months in three phases. During Phase 1 weekly calls were made for a month, in Phase 2 biweekly calls were made for 2 months, and in Phase 3 monthly calls were made for 9 months. Across all phases, the most frequent barriers to achieving MVPA goals were: time/too busy (25%), sick child (11%), and illness (10%). Goals for MVPA minutes per week were achieved or surpassed 40.6% of the time during weekly calls, 39.9% during biweekly calls, and 42.0% during monthly calls. The least likely MVPA goals to be achieved (p < 0.04) were those which the woman encountered and for which she failed to overcome the barriers she had previously anticipated would impair her improvement of MVPA. This process evaluation demonstrated that telephone counseling somewhat facilitated the resolution of barriers and achievement of MVPA goals; thus, if clinical settings adopted such methods, chronic disease risks could be reduced in this vulnerable population of new mothers.

KEYWORDS:

• postpartum
• physical activity
• goal setting
• racial/ethnic minority
• barriers

Additional information

Funding

The project described was supported by NIH Award Numbers CA115614 and CA115614-03S1 from the National Cancer Institute. Dr. Woekel was funded by R25 postdoctoral training grant CA090956 at the University of Hawaii Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Trial Registration: Clinical Trials.gov number: NCT00810342.