Term of Award

Fall 2025

Degree Name

Doctor of Public Health in Community Health Behavior and Education (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Department

Jiann-Ping Hsu College of Public Health

Committee Chair

Tilicia Mayo-Gamble

Committee Member 1

Dziyana Nazaruk

Committee Member 2

James Thomas

Abstract

Black women living in the rural South experience disproportionately high rates of hypertension, gestational diabetes, excessive gestational weight gain, and adverse birth outcomes. Although physical activity during pregnancy is known to improve maternal and fetal health, Black pregnant women remain less likely to meet recommended activity guidelines. This qualitative study examined the perceptions, beliefs, and multilevel factors influencing physical activity during pregnancy and the postpartum period among Black women in rural Southeast Georgia. Guided by the Health Belief Model (HBM) and Social Ecological Model (SEM), the study explored how individual, interpersonal, community, and structural conditions shaped women’s decisions, motivations, and barriers related to movement.

Semi-structured virtual interviews were conducted with Black women aged 18–35 who were currently pregnant or within 24 months postpartum. Participants were recruited through social media and community partners using purposive and snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically using a hybrid inductive–deductive approach aligned with HBM and SEM constructs.

Women defined physical activity broadly, incorporating structured exercise as well as daily caregiving labor, household responsibilities, and breastfeeding. Perceived benefits included improved labor endurance, postpartum recovery, emotional well-being, and chronic disease prevention, while fears of harming the pregnancy created uncertainty. Barriers emerged across multiple levels, including fatigue, symptoms, emotional distress, limited social support, unsafe environments, inadequate healthcare counseling, and socioeconomic constraints. Historical and ongoing inequities, including environmental neglect and medical mistrust, further shaped experiences.

Findings illustrate that physical activity engagement among rural Southern Black women is influenced by intersecting personal, cultural, social, and structural factors. Improving maternal health equity requires consistent provider counseling, accessible community and faith-based programs, inclusive digital tools, and structural investments that support safe, culturally grounded prenatal activity opportunities.

Research Data and Supplementary Material

No

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