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1.  Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women 
Background
Whilst there has been increasing research interest in interventions which promote physical activity during pregnancy few studies have yielded detailed insights into the views and experiences of overweight and obese pregnant women themselves. The qualitative study described in this paper aimed to: (i) explore the views and experiences of overweight and obese pregnant women; and (ii) inform interventions which could promote the adoption of physical activity during pregnancy.
Methods
The study was framed by a combined Subtle Realism and Theory of Planned Behaviour (TPB) approach. This enabled us to examine the hypothetical pathway between beliefs and physical activity intentions within the context of day to day life. The study sample for the qualitative study was chosen by stratified, purposive sampling from a previous study of physical activity measurements in pregnancy. Research participants for the current study were recruited on the basis of Body Mass Index (BMI) at booking and parity. Semi-structured, in-depth interviews were conducted with 14 overweight and obese pregnant women. Data analysis was undertaken using a Framework Approach and was informed by TPB.
Results
Healthy eating was often viewed as being of greater importance for the health of mother and baby than participation in physical activity. A commonly cited motivator for maintaining physical activity during pregnancy is an aid to reducing pregnancy-related weight gain. However, participants often described how they would wait until the postnatal period to try and lose weight. A wide range of barriers to physical activity during pregnancy were highlighted including both internal (physical and psychological) and external (work, family, time and environmental). The study participants also lacked access to consistent information, advice and support on the benefits of physical activity during pregnancy.
Conclusions
Interventions to encourage recommended levels of physical activity in pregnancy should be accompanied by accessible and consistent information about the positive effects for mother and baby. More research is required to examine how to overcome barriers to physical activity and to understand which interventions could be most effective for overweight/obese pregnant women. Midwives should be encouraged to do more to promote activity in pregnancy.
doi:10.1186/1471-2393-10-18
PMCID: PMC2879230  PMID: 20426815
2.  Quitting smoking and experience of smoking cessation interventions among UK Bangladeshi and Pakistani adults: the views of community members and health professionals 
Objective
To explore attitudes to quitting smoking and experience of smoking cessation among Bangladeshi and Pakistani ethnic minority communities.
Design
Qualitative study using community participatory methods, purposeful sampling, interviews and focus groups, and a grounded approach to data generation and analysis.
Setting
Newcastle upon Tyne, UK, 2000–2002.
Participants
53 men and 20 women aged 18–80 years, including smokers, former smokers, and smokers' relatives, from the Bangladeshi and Pakistani communities; and eight health professionals working with these communities.
Results
Motivation to quit was high but most attempts had failed. “Willpower” was the most common approach to quitting. For some, the holy month of Ramadan was used as an incentive, however few had been successful in quitting. Perceived barriers to success included being tempted by others, everyday stresses, and withdrawal symptoms. Few participants had sought advice from health services, or received cessation aids, such as nicotine replacement therapy (NRT) or buproprion. Family doctors were not viewed as accessible sources of advice on quitting. Health professionals and community members identified common barriers to accessing effective smoking cessation, including: language, religion and culture; negative attitudes to services; and lack of time and resources for professionals to develop necessary skills.
Conclusions
High levels of motivation do not seem to be matched by effective interventions or successful attempts to quit smoking among Bangladeshi and Pakistani adults in the UK. There is a need to adapt and test effective smoking cessation interventions to make them culturally acceptable to ethnic minority communities. UK tobacco control policies need to give special attention to the needs of ethnic minority groups.
doi:10.1136/jech.2005.040345
PMCID: PMC2563973  PMID: 16614330
smoking cessation; qualitative research; South Asian; Pakistani; Bangladeshi
3.  Understanding influences on smoking in Bangladeshi and Pakistani adults: community based, qualitative study 
BMJ : British Medical Journal  2003;326(7396):962.
Objective
To gain detailed understanding of influences on smoking behaviour in Bangladeshi and Pakistani communities in the United Kingdom to inform the development of effective and culturally acceptable smoking cessation interventions.
Design
Qualitative study using community participatory methods, purposeful sampling, one to one interviews, focus groups, and a grounded approach to data generation and analysis.
Setting
Newcastle upon Tyne, during 2000-2.
Participants
87 men and 54 women aged 18-80 years, smokers and non-smokers, from the Bangladeshi and Pakistani communities.
Results
Four dominant, highly inter-related themes had an important influence on smoking attitudes and behaviour: gender, age, religion, and tradition. Smoking was a widely accepted practice in Pakistani, and particularly Bangladeshi, men and was associated with socialising, sharing, and male identity. Among women, smoking was associated with stigma and shame. Smoking in women is often hidden from family members. Peer pressure was an important influence on smoking behaviour in younger people, who tended to hide their smoking from elders. There were varied and conflicting interpretations of how acceptable smoking is within the Muslim religion. Tradition, culture, and the family played an important role in nurturing and cultivating norms and values around smoking.
Conclusion
Although there are some culturally specific contexts for smoking behaviour in Bangladeshi and Pakistani adults—notably the influence of gender and religion—there are also strong similarities with white people, particularly among younger adults. Themes identified should help to inform the development and appropriate targeting of smoking cessation interventions.
What is already known on this topicSmoking is common among Bangladeshi and Pakistani men in Britain but rare among the womenSmoking is particularly common in Bangladeshi menSocioeconomic status is thought to influence smoking uptake in Bangladeshi menInfluences on smoking in South Asians in Britain are poorly understoodWhat this study addsSmoking among Pakistani and Bangladeshi men is strongly seen as socially acceptable—a “normal” part of being a manSmoking in Bangladeshi men is more deeply socially ingrained than in Pakistanis, contributing to group cohesion and identitySmoking in Bangladeshi and Pakistani women is associated with a strong sense of cultural taboo, stigma, and non-acceptanceIslam forbids addiction and intoxicants, but opinions differ on whether the Muslim religion allows smokingCulturally sensitive smoking cessation interventions for Bangladeshis and Pakistanis are needed
PMCID: PMC153853  PMID: 12727770

Results 1-3 (3)