Women with overweight or obesity preparing for pregnancy are commonly given weight management information but limited direction to implement. Motivational interviewing (MI) is a person-centred, collaborative approach used to facilitate behaviour change and may be a useful approach to support pre-conception lifestyle change.
To evaluate health coaching using a MI approach for behaviour change for women with overweight or obesity in the pre-conception period and explore challenges/barriers encountered.
Data were obtained from 100 women (mean age: 32 years, mean BMI: 32.9 kg/m2) enrolled in a pre-conception randomised controlled trial (Begin Better RCT; ACTRN12621000128897), who were offered up to ten, individualised MI health coaching sessions over the six-month intervention period (intervention group). Coaching was provided over the phone, virtually or in person by trained staff. For each session, the prevailing challenges and barriers were recorded. The median (IQR) number of health coaching sessions, and mean (±SD) duration and interval between sessions was calculated, and the most prevalent challenges/barriers determined. To evaluate health coaching acceptability an 8 question survey (5-point Likert scale) was provided to women after the intervention.
Women attended 6 (IQR=3) health coaching sessions, averaging 20.4 ± 7.32 minutes per session and 153.1 ± 48.77 minutes in total over the six month intervention period. The average interval between sessions was 25.8 ± 6.03 days. Women strongly agreed that they felt supported and understood (74%) and that they liked the accountability (74%), guidance (69%), planning (65%), motivation (69%), and increased confidence (67%). The three most common challenges/barriers reported were lack of time (124/500), other (including sickness, doing ok) (80/500) or establishment of healthy habits (74/500).
Health coaching using a MI approach was acceptable to women pre-conception and assisted in identifying and addressing common barriers to health behaviours. Future research establishing the fidelity of this approach will enhance this intervention reliability.