• Adriana Di Stefano, Stephanie Godard, and Jackie Bellaire.
• Family physician in Toronto, Ont.
• Can Fam Physician. 2021 Jul 1; 67 (7): e188e196e188-e196.

ObjectiveTo assess counseling practices for gestational weight gain (GWG) among primary care providers (PCPs) at 2 clinics to identify barriers and potential health interventions for patients from diverse cultural backgrounds.DesignQualitative interviews with data analyzed for emerging themes using a modified grounded theory method.SettingInterviews at the South East Toronto Family Health Team and Flemingdon Health Centre in Toronto, Ont, from September 2016 to February 2018.ParticipantsFamily practice obstetric providers and pregnant patients.MethodsSemistructured interviews and focus groups were audiorecorded and transcribed. Analysis used a constant comparative approach to identify themes.Main FindingsPatients had a limited understanding of risks associated with excessive GWG and reported infrequent weight counseling by PCPs. Patients at the South East Toronto Family Health Team had high health literacy and were proactive in seeking health information but had difficulty navigating reliable resources. Patients at Flemingdon Health Centre had lower health literacy and more passive interactions with PCPs, relying on family advice and cultural practices to inform health behaviour. Barriers for this group included social isolation and limited funds. Both groups desired increased proactive health counseling and resources. Physicians were knowledgeable about excessive GWG and reported counseling their patients, although patient retention and limited time were barriers.ConclusionHealthy lifestyle in pregnancy is an important but underemphasized topic in antenatal care owing to barriers faced by patients and physicians, with unique socioeconomic considerations. This gap provides an opportunity to increase education of patients and providers and to develop patient-centred weight management interventions. By contrasting patient groups, our study reflected the importance of addressing social determinants of health in comprehensive care.Copyright © the College of Family Physicians of Canada.

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