”I have not been doing it because of my fear of something happening”. Exploring Perspectives on Healthy Dietary Behavior and Physical Activity in Mexican Pregnant Women and Healthcare Professionals – A Qualitative Study

Background: Mexico has some of the world’s highest prevalence rates of overweight, obesity, and non-communicable diseases. Existing efforts to address rising incidence rates have shown limited effectiveness. Timely health-promoting initiatives to break the curve are urgently needed. Pregnancy is considered one of the most important phases during the life course for health in both women and offspring. Maternal weight, diet, and physical activity during pregnancy affect the mother’s and offspring’s health. Despite the importance of obtaining and engaging in healthy behaviors during pregnancy to prevent overweight, obesity, and non-communicable diseases, little is known about which factors impact these behaviors among pregnant women in Mexico. Aim: This study explored perspectives on factors impacting healthy dietary behaviors and physical activity in pregnancy from pregnant women and healthcare professionals in Mexico. Methods: We conducted semi-structured interviews with 11 pregnant women and 12 healthcare professionals working in prenatal care. Data were analyzed using qualitative content analysis in a stepwise inductive approach. Results: Three overall themes emerged, classifying factors at the individual, relational, and healthcare system levels. At the individual level, challenges with lack of time and competing priorities, as well as knowledge of healthy dietary behaviors and physical activity were identified. On the relational level, influencing factors encompassed financial, social, and emotional support, along with descriptive norms. At the healthcare system level, guidelines for physical activity during pregnancy and the quality of care were discerned. Conclusion: The study identified factors impacting healthy dietary behaviors and physical activity in pregnancy in Mexico. Important considerations for future interventions include addressing socio-cultural norms around healthy dietary behavior and physical activity in pregnancy and involvement of the pregnant women’s families, closest social networks, and the healthcare professionals working at the prenatal care unit