Barriers and facilitators of midwives' physical activity behaviour in hospital and community contexts in Scotland.

Aims: To investigate barriers and facilitators of physical activity in midwives in hospital and community environments.

Design: A sequential mixed-methods approach.

Data Sources: Focus groups and subsequent questionnaire survey.

Methods: Four focus groups were conducted in urban and rural areas with community and hospital-based midwives in Scotland in 2015. Topics were based on the behaviour change theories via the Theoretical Domains Framework. Findings informed development of a questionnaire, sent to midwives in 2016 in Scottish health boards via managers, or online survey.

Results: Thirty-three midwives participated in focus groups. Workplace environmental context and resources were both barriers and facilitators. Similarly, negative social influences were barriers, whereas positive social support facilitated physical activity. The questionnaire was completed by 345 midwives. Most (90%) were physically active with high levels of activity. Commonest activities included walking, swimming and housework. Physical activity facilitators included subsidized classes and protected breaks. Barriers included tiredness, stress, family responsibilities, unpredictable breaks and shift patterns.

Conclusions: Interventions should address midwives' workplace context and resources and interpersonal factors such as stress and social support.

Impact: Midwives' high levels of overweight/obesity and stress impact on their own health and delivery of patient care. More workplace physical activity could help. We found most were physically active but identified workplace barriers and facilitators, including resources, shift patterns and breaks. Findings could help midwifery managers to recognize and reduce barriers, thereby improving midwives' physical activity in the workplace, supporting weight management and enhancing their health and well-being.