Development of a context-specific educational intervention to enhance physical activity participation in postpartum women in Accra, Ghana

Information on physical activity levels, exercise self-efficacy and readiness, knowledge and attitude towards physical activity/exercise. An explanatory sequential mixed-methods study involving three phases at the 37 Military Hospital was conducted. In phase one, a quantitative, cross-sectional design with convenience sampling was undertaken. Various determinants of physical activity were assessed involving one hundred and forty-six postpartum women between six weeks and one year after childbirth. Questionnaires used included the International Physical Activity Questionnaire (IPAQ), the Readiness of Physical Activity Stages of Change Scale, the Self-Efficacy for Physical Activity questionnaires, and an adapted Knowledge, Attitude, and Practice of postpartum exercise survey. Phase two (qualitative study) involved a purposive sample of 20 postpartum women to explore the influencing factors of physical activity using a semi-structured interview guide through in-depth interviews. The semi-structured interview guide was developed based on findings from phase one. Results from phase one and two were then integrated via a joint display. In phase three, the Capability, Opportunity, and Motivation of Behaviour (COM-B) model and the Behavior Change Wheel (BCW) were used to design a context-specific physical educational intervention from the joint display. The modified Delphi technique was used to validate the intervention.Data analysis in phase one used the Statistical Package for Social Sciences software version 27 to compute relevant descriptive and inferential statistics, with significance at p-value ≤ 0.05. Audiotaped interviews were transcribed verbatim from phase two and thematically analysed. In phase three, a four-point Likert scale was used to rank each item of the developed intervention in two Delphi rounds. A consensus of 80% agreement was required to incorporate an item in the intervention. In addition, a kappa test determined stability between rounds.

本数据集涵盖身体活动水平、运动自我效能与准备度，以及针对身体活动/运动的认知与态度相关信息。本研究于第37军事医院开展，为解释性序列混合方法研究，共分为三个阶段。
第一阶段采用横断面研究设计结合便利抽样方法，纳入146名分娩后6周至1年的产后妇女，评估身体活动的各类影响因素。所用问卷包括国际身体活动问卷（International Physical Activity Questionnaire, IPAQ）、身体活动改变阶段准备度量表、身体活动自我效能量表，以及改编版产后运动认知、态度与实践调查问卷。
第二阶段为质性研究，选取20名产后妇女作为目的性样本，基于第一阶段的研究结果编制半结构化访谈提纲，通过深度访谈探究身体活动的影响因素。随后通过联合展示法整合第一、第二阶段的研究结果。
第三阶段基于联合展示的结果，采用行为能力、机会与动机（Capability, Opportunity, and Motivation of Behaviour, COM-B）模型与行为改变轮（Behavior Change Wheel, BCW）设计情境适配性体育教育干预方案，并使用改良德尔菲法对该干预方案进行验证。
第一阶段数据分析采用社会科学统计软件包（Statistical Package for Social Sciences）27.0版本，计算相关描述性与推断性统计量，显著性水平设定为p值≤0.05。第二阶段的录音访谈资料经逐字转录后进行主题分析。第三阶段通过两轮德尔菲法，采用4点李克特量表对所编制干预方案的各条目进行评分，需达到80%的同意率方可将条目纳入干预方案；此外通过kappa检验评估两轮评分的稳定性。