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.