Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

Lauren Rockliffe*, Sarah Peters, Alexander E.P. Heazell, Debbie M. Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Theoretical models have informed the understanding of pregnancy as a ‘teachable moment’ for health behaviour change. However, these models have not been developed specifically for, nor widely tested, in this population. Currently, no pregnancy-specific model of behaviour change exists, which is important given it is a unique yet common health event. This study aimed to assess the extent to which factors influencing antenatal behaviour change are accounted for by the COM-B model and Teachable Moments (TM) model, and to identify which model is best used to understand behaviour change during pregnancy.

Design: Theoretical mapping exercise.

Methods: A deductive approach was adopted; nine sub-themes identified in a previous thematic synthesis of 92 studies were mapped to the constructs of the TM and COM-B models. The sub-themes reflected factors influencing antenatal health behaviour.

Findings: All sub-themes mapped to the COM-B model constructs, whereas the TM model failed to incorporate three sub-themes. Missed factors were non-psychological, including practical and environmental factors, social influences, and physical pregnancy symptoms. In contrast to the COM-B model, the TM model provided an enhanced conceptual understanding of pregnancy as a teachable moment for behaviour change, however neither model accounted for the changeable salience of influencing factors throughout the pregnancy experience.

Conclusions: The TM and COM-B models are both limited when applied within the context of pregnancy. Nevertheless, both models offer valuable insight that should be drawn upon when developing a pregnancy-specific model of behaviour change.
Original languageEnglish
Pages (from-to)41-59
Number of pages19
JournalHealth Psychology and Behavioral Medicine
Volume10
Issue number1
Early online date30 Dec 2021
DOIs
Publication statusPublished - 1 Jan 2022

Keywords

  • COM-B
  • health behaviour
  • Pregnancy
  • psychological theory
  • teachable moment

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