Background: Covid-19 triggered the rapid roll-out of mass social distancing behavioural measures for infection control. Pregnant women were categorised as ‘at risk’ requiring extra vigilance with behavioural guidelines. Their understanding and ability to adhere to recommendations was unknown. Objectives: To complete a behavioural analysis of the determinants of recommended social distancing behaviour in pregnant women, according to the ‘capability, opportunity, motivation and behaviour’ (‘COM-B’) model to inform the development of recommendations/materials to support pregnant women in understanding and adhering to behavioural guidelines. Design: Qualitative interview study with pregnant women in the Bristol area (UK). Methods: Semi-structured telephone/videoconference interviews were conducted following a topic guide informed by the COM-B model, transcribed verbatim and subjected to framework analysis. Infographic materials were iteratively produced with stakeholder consultation, to support pregnant women. Results: Thirty-one women participated (selected for demographic range). Women reported adhering to social distancing recommendations and intended to continue. COM-B analysis identified gaps in understanding around risk, vulnerability, and the extent of required social distancing, as well as facilitators of social distancing behaviour (e.g. social support, motivation to stay safe, home environment/resources). Additional themes around detrimental mental health effects and changes to maternity healthcare from the social distancing measures were identified. Infographic resources (plus midwife report) addressing women’s key concerns were produced and disseminated. Conclusions: The COM-B model provided useful details of determinants of pregnant women’s adherence to social distancing behaviours. The confusion of what being ‘at risk’ meant and varying interpretation of what was expected indicates a need for greater clarity around categories and guidance. The loss of maternity care and negative mental health effects of social distancing suggest a growing area of unmet health needs to be addressed in future.
Bibliographical noteFunding Information:
This work was supported by the Elizabeth Blackwell Institute, University of Bristol, the Wellcome Trust ISSF3 grant 204813/Z/16/Z and the Economic and Social Research Council ES/T501840/1. The funders were not directly involved in the design of the study, the collection, analysis and interpretation of data nor in writing the manuscript. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
The authors would like to thank the pregnant women who agreed to be interviewed for this study and who contributed to the infographic development. We would like to thank the University of Bristol's Health Psychology and Interventions Group (HPIG) for their feedback on our results.?We would also like to thank the midwives at North Bristol NHS Trust and University Hospitals Bristol and Weston for their contributions to the infographic development and dissemination. Transcription services were provided by Adrienne Dunn. REDCap support was provided by Alison Horne, University of Bristol. Infographic development was provided by Hanna Oakes from Oakshed.
Transcription services were provided by Adrienne Dunn. REDCap support was provided by Alison Horne, University of Bristol. Infographic development was provided by Hanna Oakes from Oakshed.
© 2021, The Author(s).
- Behavioral research
- Health-related behavior
- Infection control
- Maternal health services
- Pregnant women
- Qualitative research
- Social distance