Contents lists available at ScienceDirect Midwifery journal homepage: www.elsevier.com/locate/midw The views of first time mothers completing an intervention to reduce postpartum weight retention: A qualitative evaluation of the mums OnLiNE study Paige van der Pligt, PhD ⁎ , Kylie Ball, PhD, Kylie D. Hesketh, PhD, David Crawford, PhD, Megan Teychenne, PhD, Karen Campbell, PhD Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Australia ARTICLE INFO Keywords: Postpartum Mothers Qualitative Intervention Maternal Weight ABSTRACT Background: maternal postpartum weight retention (PPWR) has implications for short and long term weight- related health of both the mother and child. Little is known about how mothers perceive they may be best supported to achieve a healthy postpartum weight and healthy lifestyle behaviours. Evaluating existing postpartum weight focussed intervention strategies is an important step in the planning of future programs aimed at supporting new mothers. Aim: to describe the perspectives of women who completed the mums OnLiNE pilot intervention, regarding the acceptability and effectiveness of a program which aimed to limit PPWR and promote healthy diet and physical activity behaviours in new mothers. Method: descriptive qualitative research methods utilising semi-structured interview questions to explore new mothers’ views regarding their participation in the mums OnLiNE intervention were used. All women who completed the intervention were invited to participate in one-on-one interviews via telephone. Interviews were digitally recorded and transcribed verbatim. Data were analysed utilising thematic analysis for common, emerging themes. Findings: twelve women participated in the interviews. Six main themes including program usefulness, intervention components, walking, self-monitoring, barriers and challenges and future recommendations described women's views of the mums OnLiNE intervention. Women felt well supported being part of the program and their reported awareness of healthy eating increased. Telephone support was the most valued and helpful component of the intervention and the smartphone application for self-monitoring was used more often than the website. Walking was by far the most preferred activity as it was considered enjoyable and achievable and some reported that their incidental walking increased as a result of being part of the program. Lack of time and motivation were the main barriers to participation in the program. Suggestions for future programs included encouraging group support and mother-baby exercise sessions. Conclusion: women perceived the mums OnLiNE intervention to be useful in promoting a healthy lifestyle and valued the support provided. Whilst barriers to participation in healthy lifestyle programs exist, well planned interventions which consider time constraints of new mothers, utilize one-on-one support and offer social engagement with other new mothers may further support women in their attainment of healthy postpartum weight and lifestyle behaviours. Introduction Maternal postpartum weight retention (PPWR) has implications for weight related health of the mother and the child in both the short and long term. Increased body mass index (BMI) from one pregnancy to the next is associated with increased risk of multiple, serious obstetric (Wolfe and Gross, 1994; Edwards et al., 1996; Lu et al., 2001; Sebire et al., 2001; Roberts and Lain, 2002; O’Brien et al., 2003; Kuhlmann et al., 2008; Ramachenderan et al., 2008; Addo, 2011; Dodd et al., 2011) and neonatal outcomes (Lucas et al., 1988; Cedergren and Kallen, 2003; Watkins et al., 2003; Cedergren and Källén, 2005; Chu et al., 2007; Rankin et al., 2010; Ruager-Martin et al., 2010; Tennant et al., 2011) during subsequent http://dx.doi.org/10.1016/j.midw.2017.09.013 Received 14 November 2016; Received in revised form 13 September 2017; Accepted 17 September 2017 ⁎ Corresponding author. E-mail addresses: p.vanderpligt@deakin.edu.au (P. van der Pligt), kylie.ball@deakin.edu.au (K. Ball), kylie.hesketh@deakin.edu.au (K.D. Hesketh), david.crawford@deakin.edu.au (D. Crawford), megan.teychenne@deakin.edu.au (M. Teychenne), karen.campbell@deakin.edu.au (K. Campbell). Midwifery 56 (2018) 23–28 0266-6138/ Crown Copyright © 2017 Published by Elsevier Ltd. All rights reserved. MARK