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Table 2 Evidence of midwives’ views identified in study 1 also present in the study 2 responses

From: Investigating midwives’ barriers and facilitators to multiple health promotion practice behaviours: a qualitative study using the theoretical domains framework

Key TDF domains from study 1 Study 2 supports or extends study 1 findings ( = yes or ✘ = no evidence) Details of how study 2 responses relate to study 1 barriers and facilitators
Professional role and identity Study 2 responses support those in study 1 that suggest midwives are expected to address various topics that could be targeted prior to pregnancy (b). However, unlike the study 1 findings which suggested that other health professionals could potentially address some health promotion topics prior to pregnancy, there was a suggestion in the study 2 responses that midwives could be the professional to do this (e.g. by visiting schools). There was also further evidence of the perception that the role of the midwife has evolved to incorporate a wide variety of HePPBes (b).
Beliefs about consequences Study 2 responses strengthen the findings of study 1 which suggested that midwives believed HePPBes related to weight management were most likely to have a negative impact on the midwife-woman relationship (b). Study 2 also provides further evidence of the differing beliefs that midwives have regarding how receptive women are to HePPBes (b&f).
Motivation and goals Study 2 responses support those of study 1 which demonstrated that midwives are motivated to carry out their health promotion practice (f) but competing clinical demands mean that it was a secondary goal (b).
Memory, attention and decision processes No further evidence identified.
Environmental context and resources The responses from study 2 support the findings of study 1 which outlined issues including not having enough time to address health promotion meaningfully (b), problems accessing training (b) and a lack of continuity of care (b) in influencing midwives’ HePPBes. Study 2 also identified the need for greater access to online materials which was not reported in study 1.
Social influences The findings of study 1 suggested that some midwives believed their own health status, specifically their BMI, could influence their health promotion practice by exerting social pressure. However, the responses generated by study 2 show that there is widely differing regard as to whether midwives feel their own health status has a potential impact on their health promotion practice (b&f).
Emotion Study 2 responses supported the study 1 finding that midwives’ HePPBes could potentially be influenced by the exhaustive nature of the midwifery role (b). However, study 1 did not identify the potential impact of burn-out on midwives’ own health as was suggested by the study 2 responses. This is perhaps as study 1 contained purely midwives working in a community setting only.
Behavioural regulation No further evidence identified.
Nature of the behaviour No further evidence identified.