A verbal and visual account of the perceived influences on health-promoting behaviors among women at midlife navigating perimenopause

OBJECTIVES: Women at midlife face a heightened risk of developing long-term health conditions. Perimenopause, a life phase covering the lead-up to and first 12 months after the final menstrual period, typically impacts women at midlife, creates unique challenges and influences on health-promoting behaviors. The aim of this study was to characterise perceived influences on health-promoting behaviors (sleep, physical activity, sedentary behavior, diet) among women navigating perimenopause. METHODS: A qualitative interview study with embedded photovoice. Semi-structured interviews were conducted with women aged 45-60 years in England who reported they were navigating perimenopause. The interview questions were informed by the Theoretical Domains Framework. Responses to questions were complemented by a discussion of photographs taken by participants in the week before their interview to capture personal experiences of factors influencing health-promoting behaviors. Interview transcripts and photographs were deductively coded to the Theoretical Domains Framework domains. RESULTS: Twenty-four women participated in interviews, and 20 (83.3%) women provided 118 photographs. Most participants were aged 45-49 years (54%), reported a White British background (81%), full-time work (54%), caring responsibilities (62%), and a quarter (27%) reported living in areas rated in the lowest 50% of indices of multiple deprivation. The four most prominent domains identified in the data were social and professional role and identity, environmental context and resources, beliefs about capabilities, and beliefs about consequences. CONCLUSIONS: Health-promoting behaviors among women navigating perimenopause were influenced predominantly by individual and environmental factors. Through identifying the factors that influence healthy eating, sleep, sedentary behavior, and physical activity, we can inform intervention development, guidelines, and practical strategies in the context of the unique challenges faced by women navigating perimenopause.