Testing the integrated theory of health behaviour change for postpartum weight management

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.

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.

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.

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.

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.