{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T23:28:20Z","timestamp":1784417300452,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T00:00:00Z","timestamp":1735948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T00:00:00Z","timestamp":1735948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify the barriers and enablers in the implementation of evidence\u2010based physical activity (PA) programmes for the improvement of health outcomes among pregnant women with gestational diabetes mellitus (GDM), and to develop strategies for implementing this evidence in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed\u2010methods study was conducted, integrating a descriptive qualitative research design with a cross\u2010sectional survey. In\u2010depth interview was used to collect the views and cognitions about physical activity from medical staff, leaders and pregnant women. The qualitative data was analysed using directed content analysis, guided by the Ottaw Model of Research Use (OMRU). A self\u2010designed questionnaire, which was based on the current best evidence for physical activity during pregnancy, was administered to gather data regarding nurse\u2019 knowledge of physical activity (PA safety, managing blood glucose with PA, etc.), their management practice (timing of assessments, provision of information, etc.), as well as the knowledge levels of physical activity among pregnant women with GDM (principles of exercise, PA precautions, etc.).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 12 medical staff members and 14 pregnant women were interviewed. Ten nurses and 102 pregnant women with GDM completed the questionnaire. We generated 12 subthemes organised within three themes of the OMRU from the data, including insufficient professional autonomy, positive attitudes towards evidence implementation, shortage of nursing staff, implementation climate, etc. The average knowledge score of physical activity among nurses and pregnant women was 5 (SD 2.36) points and 5.2 (SD 1.70) points, respectively. Ten strategies for overcoming barriers and amplifying enablers for the implementation of the physical activity improvement programme for pregnant women with GDM, under the guidance of the OMRU were constructed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An accumulation of evidence, adopters and practice environment factors across the OMRU domains explains why physical activity improvement initiatives for pregnant women with GDM are hard to implement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impacts<\/jats:title>\n                    <jats:p>This study helps to recognise barriers and facilitators to physical activity improvement particularly at the evidence, potential adopter and practical environment level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient<\/jats:title>\n                    <jats:p>Healthcare workers (doctors, nurses, etc.) and pregnant women with GDM in a university hospital located in Sichuan Province.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16720","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T13:13:23Z","timestamp":1735996403000},"page":"7868-7881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Barriers and Enablers in the Implementation of Physical Activity Improvement for Pregnant Women With Gestational Diabetes Mellitus: A Mixed\u2010Methods Study"],"prefix":"10.1111","volume":"81","author":[{"given":"Yan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine Nursing West China Second University Hospital, Sichuan University  Chengdu China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University\/West, China School of Nursing Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine Nursing West China Second University Hospital, Sichuan University  Chengdu China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine Nursing West China Second University Hospital, Sichuan University  Chengdu China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0323-123X","authenticated-orcid":false,"given":"Biru","family":"Luo","sequence":"additional","affiliation":[{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education  Chengdu China"},{"name":"Department of Nursing West China Second University Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"e178","article-title":"Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion Summary, Number 804","volume":"135","author":"American College of Obstetrics and Gynecologists","year":"2020","journal-title":"Obstetrical & Gynecological Survey"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0605-9"},{"issue":"6","key":"e_1_2_12_4_1","article-title":"Exercise for Pregnant Women With Gestational Diabetes for Improving Maternal and Fetal Outcomes","volume":"6","author":"Brown J.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0260-6917(91)90009-Y"},{"issue":"2","key":"e_1_2_12_6_1","first-page":"81","article-title":"Guideline of Diagnosis and Treatment of Hyperglycemia in Pregnancy","volume":"57","author":"Chinese Medical Association","year":"2022","journal-title":"Chinese Journal of Clinical Obstetrics and Gynecology"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.11.001"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2007.04569.x"},{"issue":"5","key":"e_1_2_12_10_1","first-page":"64","article-title":"The Content Analysis of Obstacle Factors and Promoting Factors in Clinical Transformation of Evidence","volume":"29","author":"Fu Y.","year":"2022","journal-title":"Journal of Nursing"},{"issue":"3","key":"e_1_2_12_11_1","first-page":"71","article-title":"Survey on the Therapeutic Status of Gestational Diabetes Mellitus Patients","volume":"19","author":"Gai D.","year":"2021","journal-title":"Clinical Medication Journal"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-0407.12872"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04335-x"},{"key":"e_1_2_12_14_1","first-page":"6","article-title":"How to Influence Medical Practice: A Conceptual Framework","volume":"13","author":"Graham I.","year":"2006","journal-title":"Canadian Respiratory Journal"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.90.5.893"},{"issue":"18","key":"e_1_2_12_16_1","first-page":"1685","article-title":"Promoting Evidence Into Practice (12): Role of Facilitator and Facilitation","volume":"35","author":"Gu Y.","year":"2020","journal-title":"Journal of Nursing Training"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0076546"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2016.08.003"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2196\/14486"},{"issue":"3","key":"e_1_2_12_20_1","first-page":"76","article-title":"Can Physical Activity and Dietary Interventions Improve Maternal and Fetal Outcomes in Women With Gestational Diabetes Mellitus? A Systematic Review and Meta\u2010Analysis","volume":"16","author":"Hillyard M.","year":"2018","journal-title":"Evidence Based Midwifery"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-46"},{"issue":"10","key":"e_1_2_12_23_1","first-page":"879","article-title":"Problems and Countermeasures in Evidence Implementation in Clinical Nursing Practice","volume":"18","author":"Jiang Y.","year":"2021","journal-title":"Chinese Journal of Nursing Education"},{"key":"e_1_2_12_24_1","volume-title":"JBI Grades of Recommendation","author":"Joanna Briggs Institute Levels of Evidence and Grades of Recommendation Working Party","year":"2013"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145721708321005"},{"key":"e_1_2_12_26_1","volume-title":"Content Analysis: An Introduction to Its Methodology","author":"Krippendorff K.","year":"2019"},{"key":"e_1_2_12_27_1","volume-title":"Qualitative Content Analysis: Theoretical Background and Procedures","author":"Mayring P.","year":"2015"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01205-8"},{"key":"e_1_2_12_29_1","volume-title":"Qualitative Research & Evaluation Methods","author":"Patton M. Q.","year":"1990"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20362"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/216507991206000404"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13389"},{"issue":"3","key":"e_1_2_12_34_1","first-page":"26","article-title":"Application of Health Education Model Based on Knowledge Visualization in Insulin Pump Treatment of Patients With Diabetes Mellitus","volume":"29","author":"Wang X.","year":"2023","journal-title":"Journal of Qilu Nursing"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-020-0970-7"},{"key":"e_1_2_12_36_1","volume-title":"WHO Guidelines on Physical Activity and Sedentary Behaviour","author":"World Health Organization","year":"2020"},{"issue":"11","key":"e_1_2_12_37_1","first-page":"7","article-title":"Qualitative Research on Influencing Factors of Compliance on Exercise Therapy for Patients With Gestational Diabetes Mellitus","volume":"17","author":"Wu Y.","year":"2018","journal-title":"Journal of Nursing and Rehabilitation"},{"key":"e_1_2_12_38_1","first-page":"229","article-title":"Sampling Strategy of Qualitative Methodology in Public Health Field","volume":"05","author":"Ying X.","year":"2004","journal-title":"Chinese Health Resources"},{"issue":"3","key":"e_1_2_12_39_1","first-page":"356","article-title":"Application of the Best Evidence for Peripherial Venous Catheter Dressing Fixation and Replacement in Pediatric Patients","volume":"54","author":"Yu L.","year":"2019","journal-title":"Chinese Journal of Nursing"}],"container-title":["Journal of Advanced Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.16720","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jan.16720","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.16720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T05:47:20Z","timestamp":1775886440000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jan.16720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,4]]},"references-count":38,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/jan.16720"],"URL":"https:\/\/doi.org\/10.1111\/jan.16720","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JAN.16720\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v3\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16720\/v1\/decision1","asserted-by":"object"}]},"ISSN":["0309-2402","1365-2648"],"issn-type":[{"value":"0309-2402","type":"print"},{"value":"1365-2648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,4]]},"assertion":[{"value":"2024-05-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}