Understanding the pathway between work and health outcomes for women during the preconception, pregnancy, and postpartum periods through the framing of maternal obesity.

The link between work and health outcomes for preconception, pregnant, and postpartum (PPP) working women is complex. Further, innovation and enhanced understanding are required to address the work-related determinants of maternal obesity. However, workplace health promotion is not typically systems-based nor attuned to the specific needs and context of individual PPP women. We propose that to improve health outcomes for PPP women, we must understand the pathways between paid work and health for the individual woman by taking a systems-thinking approach. In this paper, we (a) outline the rationale for why the oversimplification or "dilution" of individual context may occur; (b) present a systems-informed pathway model (the "Context-Exposure-Response" Model) and overview of potential work-related impacts on health and wellbeing outcomes for PPP women using maternal obesity to provide context examples; (c) further investigate the role of motivational factors from a systems perspective; and (d) briefly examine the implications for policy, practice, and intervention design. It is anticipated that this research may act as a starting point to assist program developers, researchers, and policymakers to adopt a systems-focused perspective while contributing to the health improvement and obesity prevention of PPP women.

Using Intervention Mapping to Develop a Workplace Digital Health Intervention for Preconception, Pregnant, and Postpartum Women: The Health in Planning, Pregnancy and Postpartum (HiPPP) Portal.

Digital health interventions that specifically target working women across the preconception, pregnancy and postpartum (PPP) life stages may address the unique barriers to engaging in healthy lifestyle behaviours and self-care during this life phase. This paper describes the development of a workplace digital health intervention to promote healthy lifestyles and wellbeing for PPP women working at a community service organization in Australia. Intervention Mapping is a framework that guides program development, implementation, and evaluation. Steps 1 to 5 of Intervention Mapping methodology (needs assessment through to program implementation) were used, including identification of determinants and change objectives across socioecological levels (i.e., individual, interpersonal, and organisational) and iterative co-design and stakeholder engagement processes. The workplace digital health intervention was successfully developed and implemented as an online portal. Content included key strategies, information, and supports to promote health and wellbeing across PPP, including supporting the return to work in the postpartum period. Examples of resource pages included a parental leave checklist, process flows, Pride resources, and Aboriginal and Torres Strait Islander resources. Findings from a pilot feasibility study indicate the portal was accessible and beneficial for women in PPP life stages. The Intervention Mapping protocol may offer a valuable roadmap for collaborative design of interventions targeting PPP women's behaviour and organisational work culture. Future work is needed to evaluate whether such interventions lead to improvements in women's health and wellbeing.

'It's just the nature of the work': Barriers and enablers to the health and well-being of preconception, pregnant and postpartum working women in a community service organisation.

Poor lifestyle practices, combined with excess weight gain and weight retention during the preconception, pregnancy and postpartum periods can increase health risks for mothers and their children. Little is known about how workplaces impact the health and well-being of women of child-bearing age, particularly across work roles and settings. This qualitative descriptive study explored the enablers and barriers to the healthy lifestyle practices and well-being of women of reproductive age within an Australian community services organisation by capturing the perspectives of both the women and workplace executives. Eleven interviews were conducted with executives (n = 12), and three focus groups and three interviews were conducted with women (n = 16). Data were thematically analysed, and six main themes were identified: blurring of the role and work environment, clarity and equity in policy and entitlements, the nature of community services work, individual responsibility for health, tiered levels of support and a management-driven culture of awareness and support. Barriers included high-stress roles, work targets, sedentary work behaviours, lack of clarity around policies, funding and the emotional labour associated with community services work. Hands-on leadership, open communication, work relationships, resourcing and manager training were identified as facilitators. While findings indicate agreement between executives and the women, many executives focused on the challenges associated with pregnancy in the high-risk workplace environment and did not perceive specific barriers for those in non-frontline roles. Management education to generate an understanding of women's needs during this life stage and increased resourcing to facilitate workplace well-being would be beneficial.

Workplace Healthy Lifestyle Determinants and Wellbeing Needs across the Preconception and Pregnancy Periods: A Qualitative Study Informed by the COM-B Model.

Overweight and obesity present health risks for mothers and their children. Reaching women during the key life stages of preconception and pregnancy in community settings, such as workplaces, is an ideal opportunity to enable health behavior change. We conducted five focus groups with 25 women aged between 25 and 62 years in order to investigate the determinants of healthy lifestyle behaviors, weight management, and wellbeing needs during the preconception and pregnancy periods in an Australian university workplace. Discussions explored women's health and wellbeing needs with specific reference to workplace impact. An abductive analytical approach incorporated the capability, opportunity, and motivation of behavior (COM-B) model, and four themes were identified: hierarchy of needs and values, social interactions, a support scaffold, and control. Findings highlight the requirement for greater organization-level support, including top-down coordination of wellbeing opportunities and facilitation of education and support for preconception healthy lifestyle behaviors in the workplace. Interventionists and organizational policy makers could incorporate these higher-level changes into workplace processes and intervention development, which may increase intervention capacity for success.

The effect of workplace lifestyle programmes on diet, physical activity, and weight-related outcomes for working women: A systematic review using the TIDieR checklist.

Physical activity and healthy diets are essential for the prevention of obesity and chronic disease that disparately impact women compared with men. Given the number of women engaged in the workforce, workplace interventions could improve lifestyle behaviours and health outcomes for women. This systematic review aimed to identify intervention characteristics of lifestyle programmes or organizational policy changes in the workplace associated with improved diet, physical activity, or weight-related outcomes for working women using the template for intervention description and replication (TIDieR) checklist. Seven databases were searched for controlled studies published up to March 2019 that included a workplace diet and/or physical activity intervention. From 5,318 identified records, 20 studies (23 articles and 26 intervention arms) were included. Data were extracted on diet, physical activity, weight-related outcomes, and TIDieR components. Findings indicated that group delivery may improve physical activity outcomes, and a high number of sessions may benefit weight-related outcomes for physical activity interventions. Mixed interventions that included tailoring and input from non-healthcare professionals may also enhance physical activity. In contrast, the role of mixed interventions in improving diet and weight-related outcomes was less clear. Overall, workplace health programmes were effective at improving lifestyle behaviours for working women.

Women in the Workplace: Promoting Healthy Lifestyles and Mitigating Weight Gain during the Preconception, Pregnancy, and Postpartum Periods.

Overweight and obesity before, during, and after pregnancy are associated with adverse outcomes for mothers and their offspring. Workplaces have been identified as important settings for improving health and wellbeing. However, the value of workplace interventions for women across the reproductive life stages has yet to be realized. This paper aims to explore the potential of workplaces to facilitate healthy lifestyle behaviors, prevent further weight gain, and devise tailored interventions for working women, specifically during the preconception, pregnancy, and postpartum periods. Workplaces can be used to engage women, including preconception women, who are detached from clinical settings. Potential benefits of workplace health promotion for women and employers include improved employee wellbeing, productivity, and corporate competitiveness. However, workplaces also need to overcome implementation barriers such as activity scheduling and availability. A systems approach may address these barriers. Consequently, designing and implementing workplace health promotion interventions to meet the specific needs of working women of reproductive age will necessitate collaboration with a range of key stakeholders across all stages of intervention design. Given that these women make up a considerable proportion of the workforce, workplaces can help optimize the health status of employees and prevent excess weight gain during the preconception, pregnancy, and postpartum periods.

How lifestyle factors and their associated pathogenetic mechanisms impact psoriasis.

BACKGROUNDS AND AIMS: Psoriasis is a skin disorder affecting approximately 2-3% of the global population. While research has revealed a strong genetic component, there are few studies exploring the extent to which lifestyle factors influence psoriasis pathogenesis. The aim of this review was to describe the role of lifestyle factors as both a potential cause and treatment for psoriasis. The review also examines the underlying mechanisms through which these lifestyle factors may operate. METHODS: This narrative review aims to incorporate current knowledge relating to both lifestyle and pathogenetic factors that contribute to and alleviate psoriasis presentation. Studies reporting the effect of an inflammatory diet and potential dietary benefits are reported, as well as insights into the effects of stress, smoking and alcohol, insulin resistance and exercise. RESULTS: Poor nutrition and low Omega 3 fatty acid intake, likely combined with fat malabsorption caused by gut dysbiosis and systemic inflammation, are associated with psoriasis. The data strongly suggest that improvements to disease severity can be made through dietary and lifestyle interventions and increased physical activity. Less conclusive, although worthy of mention, is the beneficial effect of bile acid supplementation. CONCLUSIONS: Lifestyle interventions are a promising treatment for psoriasis and its associated co-morbidities. However, gaps and inadequacies exist within the literature, e.g. methodology, absence of a unified scoring system, lack of controlled clinical data and lack of studies without simultaneous usage of biologics or alternative therapies. Future directions should focus on high quality cohort studies and clinical trials.