Mothabeng, Diphale Joyce2025-03-022025-03-022025-042024-12*A2025http://hdl.handle.net/2263/101291https://doi.org/10.25403/UPresearchdata.28513436Thesis (PhD (Physiotherapy))--University of Pretoria, 2024.Background: Globally, challenges exist in physical activity participation among women after childbirth. This is a public health concern due to negative health outcomes of physical inactivity such as cardiovascular diseases. Although, interventions have been developed, most are not culturally sensitive and unsuitable for postpartum women in low-and-middle income countries such as Ghana. In the African context, postpartum women are exposed to a myriad of factors affecting their physical activity participation. Hence, it’s necessary to understand these factors to be able to design an intervention tailored for them. This study examined the context and determinants of physical activity participation and designed an educational intervention to improve participation in physical activity among postpartum women. Methods: 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), Readiness of Physical Activity Stages of Change Scale, 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 Behaviour 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 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. Results: In phase one postpartum women recorded low physical activity levels, low levels regarding general knowledge about exercise and a low level of exercise self-efficacy and readiness. Additionally, results revealed that postpartum women had a good attitude towards participation in physical activity. In phase two, major barriers identified included inadequate social support, inadequate information and sociocultural barriers. On the other hand, perceived facilitators identified were knowledge about benefits of exercise and presence of social support. Results from both phases were integrated via a joint display and linked onto the BCW and COM-B model to identify factors to design the educational intervention. Consequently, a 28-item educational intervention was developed and accepted by all experts during the validation process. Conclusion: Various determinants influenced physical activity participation among postpartum women. Cognisance of these results were used to design a novel and context-specific educational intervention to promote physical activity among postpartum women.en© 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.UCTDSustainable Development Goals (SDGs)Postpartum womenPostpartum periodLifestyleEducational interventionPhysical activityExerciseThesisu21820717https://doi.org/10.25403/UPresearchdata.28513436