{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:14:03Z","timestamp":1787015643921,"version":"build-2736575974"},"reference-count":73,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine factors that facilitate and impede healthy dietary behavior modification in patients with gestational diabetes mellitus (GDM). Additionally, it sought to assess the strength of the evidence for these factors and offer insights into promoting positive behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses reporting standards. We searched seven databases in February 2023 to include qualitative studies related to patients with GDM that explored their perceptions of and changes in healthy eating behaviors. Two researchers independently screened the articles, assessed their quality, extracted data, and coded the factors using the theoretical domain framework. For the factors involved, we performed a meta\u2010synthesis based on their frequency and assigned a confidence level to determine their level of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 32 of the 536 extracted articles. Barriers identified by high levels of evidence include: \u201cEnvironmental context and resources,\u201d \u201cSocial influences,\u201d \u201cKnowledge,\u201d \u201cEmotion,\u201d and \u201cSocial\/professional roles and Identity.\u201d The facilitators identified by high levels of evidence include the following: \u201cBeliefs about consequences,\u201d \u201cSocial influences,\u201d \u201cEnvironmental context and resources,\u201d \u201cSkill,\u201d and \u201cMemory, attention, and decision processes.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta\u2010synthesis highlights that healthy eating behavior change is influenced by the interaction of factors at different levels of individuals, organizations, and sociocultural environments. Furthermore, we established a framework that displayed the associations between these factors, giving prominence to those with higher levels of evidence. This framework will aid researchers in identifying priority areas for intervention and facilitating the implementation of high\u2010quality strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.16294","type":"journal-article","created":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T21:57:26Z","timestamp":1745186246000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors influencing healthy dietary behavior changes among patients with gestational diabetes mellitus during pregnancy: A meta\u2010synthesis using the theoretical domains framework"],"prefix":"10.1111","volume":"51","author":[{"given":"Qianqian","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nursing The Affiliated Hospital of Qingdao University  Qingdao 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