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Schoeppe S, Salmon J, Williams SL, Power D, Alley S, Rebar AL, Hayman M, Duncan MJ, Vandelanotte C. Effects of an Activity Tracker and App Intervention to Increase Physical Activity in Whole Families-The Step It Up Family Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7655. [PMID: 33092219 PMCID: PMC7588994 DOI: 10.3390/ijerph17207655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 12/24/2022]
Abstract
(1) Background: Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in whole families. Further, few family-centered interventions have actively involved both parents and assessed physical activity effects separately for children, mothers and fathers. Objective: To examine the feasibility and short-term effects of an activity tracker and app intervention to increase physical activity in the whole family (children, mothers and fathers). (2) Methods: This was a single-arm feasibility study with pre-post intervention measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults; Garmin Australasia Pty Ltd., Sydney, Australia), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages and an introductory session. Parent surveys were used to assess physical activity effects measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. Objective Garmin activity tracker data was recorded to assess physical activity levels (steps, active minutes) during the intervention. (3) Results: Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all p < 0.001). In mothers, MVPA increased by 27 min/day (p < 0.001) and in fathers, it increased by 31 min/day (p < 0.001). The percentage of children meeting Australia's physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (p < 0.001). The percentage of mothers and fathers meeting Australia's physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (p < 0.001) in mothers and from 21% to 68% (p < 0.001) in fathers. The percentage of families with 'at least one child and both parents' meeting the physical activity guidelines increased from 0% to 41% (p < 0.001). Objective activity tracker data recorded during the intervention showed that the mean (SD) number of active minutes per day in children was 82.1 (17.1). Further, the mean (SD) steps per day was 9590.7 (2425.3) in children, 7397.5 (1954.2) in mothers and 8161.7 (3370.3) in fathers. (4) Conclusions: Acknowledging the uncontrolled study design, the large pre-post changes in MVPA and rather high step counts recorded during the intervention suggest that an activity tracker and app intervention can increase physical activity in whole families. The Step it Up Family program warrants further efficacy testing in a larger, randomized controlled trial.
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Affiliation(s)
- Stephanie Schoeppe
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, Geelong, VIC 3125, Australia;
| | - Susan L. Williams
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Deborah Power
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Stephanie Alley
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Amanda L. Rebar
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Melanie Hayman
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Mitch J. Duncan
- Priority Research Centre for Physical Activity and Nutrition, School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
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Atkinson L, De Vivo M, Hayes L, Hesketh KR, Mills H, Newham JJ, Olander EK, Smith DM. Encouraging Physical Activity during and after Pregnancy in the COVID-19 Era, and beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7304. [PMID: 33036326 PMCID: PMC7578931 DOI: 10.3390/ijerph17197304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 02/01/2023]
Abstract
Physical activity is known to decline during pregnancy and the postnatal period, yet physical activity is recommended during this time due to the significant health benefits for mothers and their offspring. As a result of the COVID-19 pandemic and the restrictions imposed to reduce infection rates, pregnant and postnatal women have experienced disruption not just to their daily lives but also to their pregnancy healthcare experience and their motherhood journey with their new infant. This has included substantial changes in how, when and why they have engaged with physical activity. While some of these changes undoubtedly increased the challenge of being sufficiently active as a pregnant or postnatal woman, they have also revealed new opportunities to reach and support women and their families. This commentary details these challenges and opportunities, and highlights how researchers and practitioners can, and arguably must, harness these short-term changes for long-term benefit. This includes a call for a fresh focus on how we can engage and support those individuals and groups who are both hardest hit by COVID-19 and have previously been under-represented and under-served by antenatal and postnatal physical activity research and interventions.
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Affiliation(s)
- Lou Atkinson
- School of Psychology, Aston University, Birmingham B4 7ET, UK
| | - Marlize De Vivo
- Perinatal Physical Activity Research Group (PPARG), School of Psychology and Life Sciences, Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury CT1 1QU, UK; (M.D.V.); (H.M.)
| | - Louise Hayes
- Population Health Sciences Institute (PHSI), Newcastle University, Newcastle upon Tyne NE1 7RU, UK;
| | | | - Hayley Mills
- Perinatal Physical Activity Research Group (PPARG), School of Psychology and Life Sciences, Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury CT1 1QU, UK; (M.D.V.); (H.M.)
| | - James J. Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8QH, UK;
| | - Ellinor K. Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, University of London, London WC1E 7HU, UK;
| | - Debbie M. Smith
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK;
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103
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Okafor UB, Goon DT. Developing a Physical Activity Intervention Strategy for Pregnant Women in Buffalo City Municipality, South Africa: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6694. [PMID: 32937983 PMCID: PMC7557735 DOI: 10.3390/ijerph17186694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 02/06/2023]
Abstract
Despite global awareness about the importance and health benefits of physical activity (PA) during pregnancy, several studies have reported a low prevalence of PA participation among pregnant women in both developed and developing countries. This means that most pregnant women do not meet the current PA recommended guideline of 150 min of moderate intensity PA per week. The global call to prioritise PA participation levels in the general population necessitates evaluating the factors affecting PA practice. Seemingly, pregnant women mostly from low-to-middle income countries like South Africa are often predisposed to adverse pregnancy outcomes, possibly because of limited access to, and knowledge of, improved pregnancy and health outcomes as a result of PA participation. Physical activity has been sparsely studied among pregnant South African women, and specifically, there is no known study that assesses the PA levels, patterns, beliefs, sources of information, perceived benefits, barriers, attitudes of pregnant women concerning PA and exercise participation; nor one that explores the perspectives of healthcare providers regarding prenatal PA in the Eastern Cape Province. In addition, no PA intervention strategy exists to promote PA participation in the region. This study, in attempting to fill these gaps in knowledge, adopts two phases. In Phase I, a concurrent mixed-method (quantitative and qualitative) approach assesses the following factors related to PA participation in pregnant women: participation levels, beliefs, attitudes, perceived benefits, barriers to uptake and sources of information. It further ascertains if healthcare professionals are sufficiently informed about PA and if they are advising pregnant women about the need for PA participation during pregnancy. Data will be collected through a structured questionnaire, interviews and focus group discussions. Information on socio-demographic and maternal characteristics will be obtained, and the Pregnancy Physical Activity Questionnaire (PPAQ) will assess PA during pregnancy. A sample size of 384 pregnant women is the required minimum sample for an infinite population at a confidence level of 95%, a precision level of ± 5% and at a prevalence of PA or exercise during pregnancy of 50% (p < 0.05); however, a sample size larger than the minimum number necessary will be recruited to account for possible attrition and to protect against possible data loss. Data will be analysed using a multiple logistic regression to determine the factors that predict sedentary or moderate PA levels and chi-squared analysis to determine the associations between the PA levels of the participants and socio-demographic and clinical variables. The study will assess the data collected on the above-mentioned variables and draw conclusions based on patterns and themes that emerge during analysis. Phase II of the study focuses on strategy development and validation to facilitate the promotion of PA during pregnancy. The developed strategy will be validated through the application of the Delphi technique and the administration of a checklist to selected key stakeholders through organised workshops. Understanding the level and correlates of PA participation among this special population is fundamental to designing intervention strategies to enhance their understanding of, and participation in, PA and exercise. Furthermore, this study's findings will inform facility-based healthcare providers about the need to integrate health education on PA and pregnancy into antenatal and postnatal care visits in the setting.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Sciences, University of Fort Hare, 50 Church Street, East London 5201, South Africa
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa;
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104
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Effect of Evidence-Based Materials and Access to Local Resources on Physical Activity Levels, Beliefs, and Motivation During Pregnancy in a Rural Setting. J Phys Act Health 2020; 17:947-957. [PMID: 32858524 DOI: 10.1123/jpah.2019-0440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 06/14/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The purpose of this study was to determine the impact of evidence-based educational materials and access to local resources on physical activity (PA) levels, beliefs, and motivation (including self-efficacy) regarding PA during pregnancy in a rural setting. METHODS Information on PA levels (step counts, Pregnancy Physical Activity Questionnaire) and beliefs and motivation regarding PA (main surveys: Exercise Beliefs Questionnaire, Protection Motivation Theory and Health Action Process Approach) were collected between 8 and 16 weeks gestation. Women from a rural community were randomly assigned to the PA group (PAG, n = 38) or control group (n = 32). The PAG participants received an evidence-based educational brochure and access (at no charge to them) to local fitness facilities. At approximately 34 to 37 weeks gestation, baseline assessments were repeated. RESULTS Sedentary time was significantly different between groups over time, with control participants increasing sedentary time and PAG participants decreasing sedentary time (P = .04). Sixteen women (42%) in the PAG utilized the resources provided (prenatal yoga being utilized most). Postintervention, there was a significant group × time interaction for Perceived Self-Efficacy scores; scores in the PAG remained consistent with baseline values, whereas scores in the control group decreased (P = .03). CONCLUSIONS The intervention reduced sedentary time and maintained self-efficacy scores during pregnancy.
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105
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Liu N, Wang J, Chen DD, Sun WJ, Li P, Zhang W. Effects of exercise on pregnancy and postpartum fatigue: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 253:285-295. [PMID: 32916639 DOI: 10.1016/j.ejogrb.2020.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Fatigue is a common adverse experience in pregnant and postpartum women and is associated with poor outcomes and can seriously affect maternal and infant health and quality of life. However, data from existing studies are inconsistent, and no studies have examined the effects of exercise on pregnancy and postpartum fatigue. The aim of this review is to evaluate the effects of exercise on pregnancy and postpartum fatigue. STUDY DESIGN PubMed, EMBASE, Web of Science and the Cochrane Library database were used to retrieve literature. Eligible studies were clinical trials that reported the effects of exercise on pregnancy and postpartum fatigue in women. The methodological quality of the included studies was assessed using the Cochrane Collaboration Risk of Bias Assessment Tool. A fixed-effect model was used to analyse the pooled results. Subgroup analyses were used to explore sources of heterogeneity. Sensitivity analysis was used to validate the robustness of the pooled results. RESULTS Seven studies were included. The results of meta-analysis of five studies showed that exercise during pregnancy and the postpartum period may have beneficial effects on women's fatigue ([SMD = 0.29, 95 % CI (0.10, 0.47), P = 0.003]). Subgroup analyses reported that compared with the control, long exercise programmes, postpartum exercise and supervised exercise significantly improved fatigue levels. CONCLUSIONS Postpartum exercise in a supervised programme lasting more than eight weeks may be beneficial for reducing postpartum fatigue. More available data from large-scale and high-quality trials are needed to demonstrate the effects of exercise on pregnant and postpartum fatigue.
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Affiliation(s)
- Na Liu
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Jie Wang
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Dan-Dan Chen
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Wei-Jia Sun
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Ping Li
- Department of Developmental Pediatrics, the Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School of Jilin University, Changchun, Jilin Province, China.
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106
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Grenier LN, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK, Murray-Davis B. Be Healthy in Pregnancy: Exploring factors that impact pregnant women's nutrition and exercise behaviours. MATERNAL AND CHILD NUTRITION 2020; 17:e13068. [PMID: 32705811 PMCID: PMC7729656 DOI: 10.1111/mcn.13068] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/23/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
Excess gestational weight gain is associated with short‐ and long‐term pregnancy complications. Although a healthy diet and physical activity during pregnancy are recommended and shown to reduce the risk of complications and improve outcomes, adherence to these recommendations is low. The aims of this study were to explore women's view of nutrition and physical activity during pregnancy and to describe barriers and facilitators experienced in implementing physical activity and nutrition recommendations. In a substudy of the Be Healthy in Pregnancy randomized trial, 20 semistructured focus groups were conducted with 66 women randomized to the control group when they were between 16 and 24 weeks gestation. Focus groups were recorded, transcribed verbatim, coded and thematically analysed. The results indicate that women felt motivated to be healthy for their baby, but competing priorities may take precedence. Participants described limited knowledge and access to information on safe physical activity in pregnancy and lacked the skills needed to operationalize both physical activity and dietary recommendations. Women's behaviours regarding diet and physical activity in pregnancy were highly influenced by their own and their peers' beliefs and values regarding how weight gain impacted their health during pregnancy. Pregnancy symptoms beyond women's control such as fatigue and nausea made physical activity and healthy eating more challenging. Counselling from care providers about nutrition and physical activity was perceived as minimal and ineffective. Future interventions should address improving counselling strategies and address individual's beliefs around nutrition and activity in pregnancy.
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Affiliation(s)
- Lindsay N Grenier
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | | | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Olive Wahoush
- Global Health, McMaster University, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Vickers-Manzin
- Public Health Services-Healthy Families, Healthy & Safe Communities, Hamilton, Ontario, Canada
| | - Caroline Moore
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Eileen K Hutton
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Beth Murray-Davis
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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107
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Bilgin Z, Yılmaz Esencan T. Perception of physical exercise in Turkish pregnant women and affecting factors. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1790656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Zümrüt Bilgin
- Department of Midwifery, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Tuğba Yılmaz Esencan
- Department of Midwifery, Faculty of Health Sciences, Üsküdar University, Istanbul, Turkey
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108
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Wagnild JM, Pollard TM. "Sit Yourself Down": Women's Experiences of Negotiating Physical Activity During Pregnancy. QUALITATIVE HEALTH RESEARCH 2020; 30:1072-1082. [PMID: 32141381 PMCID: PMC7682526 DOI: 10.1177/1049732320909103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Approaches to understanding why physical activity (PA) tends to decline during pregnancy are generally based on individualized behavioral models, examining "barriers" or "enablers." In contrast, we used a social practice approach to explore the ways in which women negotiate PA during pregnancy within the contexts and routines of their everyday lives. Semistructured interviews were conducted with 18 pregnant women who had been classed as being at risk of gestational diabetes. We found that leisure-time physical activities were valued as pleasurable and therapeutic, but women's roles as employees and carers for others often constrained their opportunities for leisure-time PA. Women encountered others' expectations that they should sit down and slow down. This surveillance was often resisted, as women relied on "listening to the body" as a way to negotiate PA. These findings have important implications for public health strategies or interventions designed to promote PA during pregnancy.
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Affiliation(s)
- Janelle M. Wagnild
- Durham University, Durham, United Kingdom
- Janelle M. Wagnild, Department of Anthropology, Dawson Building, Durham University, South Road, Durham, DH1 3LE, UK.
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109
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Witvrouwen I, Mannaerts D, Van Berendoncks AM, Jacquemyn Y, Van Craenenbroeck EM. The Effect of Exercise Training During Pregnancy to Improve Maternal Vascular Health: Focus on Gestational Hypertensive Disorders. Front Physiol 2020; 11:450. [PMID: 32457655 PMCID: PMC7225346 DOI: 10.3389/fphys.2020.00450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/09/2020] [Indexed: 12/22/2022] Open
Abstract
Hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia, occur in up to 10% of pregnancies and are associated with increased life-long cardiovascular risk. Physical activity improves cardiovascular health in pregnancy and may lower the risk of developing hypertensive disorders of pregnancy. However, a minority of pregnant women comply with the recommended level of physical activity. Adequate knowledge on the physiological effects of exercise in healthy pregnancy could help to overcome potential barriers as pregnancy is a unique window of opportunity to improve health outcomes for both mother and child. In this mini review, we discuss structural and functional vascular adaptations during healthy and hypertensive pregnancies, we elaborate on the effects of exercise on the vasculature and review the safety and existing evidence of exercise training as preventive therapy for gestational hypertensive disorders.
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Affiliation(s)
- Isabel Witvrouwen
- Research Group Cardiovascular Diseases, Department of Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Dominique Mannaerts
- Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Antwerp, Belgium.,Department of Obstetrics and Gynaecology, Antwerp University Hospital, Antwerp, Belgium
| | - An M Van Berendoncks
- Research Group Cardiovascular Diseases, Department of Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Yves Jacquemyn
- Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Antwerp, Belgium.,Department of Obstetrics and Gynaecology, Antwerp University Hospital, Antwerp, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, Department of Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
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110
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Zhu G, Qian X, Qi L, Xia C, Ming Y, Zeng Z, Liu Y, Yang Y, Zhang M, Zhang H. The intention to undertake physical activity in pregnant women using the theory of planned behaviour. J Adv Nurs 2020; 76:1647-1657. [PMID: 32153052 DOI: 10.1111/jan.14347] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/06/2020] [Accepted: 03/03/2020] [Indexed: 02/06/2023]
Abstract
AIM To identify the intention of Chinese pregnant women to undertake physical activity (PA) using the theory of planned behaviour. DESIGN A cross-sectional survey. METHODS From April - October 2017, a cross-sectional questionnaire was completed by 746 pregnant women from the Health Birth Cohort in Wuhan, China. The theory of planned behaviour variables as well as sociodemographic characteristics was recorded, and the Pregnancy PA Questionnaire was together used to assess their PA during pregnancy. RESULTS Only 11.3% of the women met the international guideline. The intention to undertake PA was found it to be positive in 63.9% of pregnant women. Structural equation modelling analysis revealed that behavioural attitudes, subjective norms, and perceived behavioural control (PBC) influenced PA by directly influencing the behaviour intention. Both behavioural attitude and subjective norms influenced PA by indirectly affecting the behaviour. Overall, the model described 60% variance of the behavioural intention to undertake PA during pregnancy. CONCLUSION PBC was confirmed to be a prominent factor in determining behavioural intention to undertake PA during pregnancy. Pregnant women should be helped and appropriately guided by health providers to overcome barriers to PA. EFFECT This study investigates the effect of perceived behavioural control (PBC) on the intention to undertake physical activity (PA). The findings suggest that nurses' and midwives' attention should be focused on how to promote the improvement of perceived behavioural control ability of pregnant women to improve pregnant women's PA intention. The attitude of pregnant women on taking up PA and their ability to control behaviours can be improved with support from family or healthcare providers.
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Affiliation(s)
- Gangjiao Zhu
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Xiangzi Qian
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Ling Qi
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Chang Xia
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yu Ming
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Zhi Zeng
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yuanxia Liu
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yan Yang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Mengtian Zhang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Hongling Zhang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
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111
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Timmermans YEG, van de Kant KDG, Krumeich JSM, Zimmermann LJI, Dompeling E, Kramer BW, Maassen LLJ, Spaanderman MAE, Vreugdenhil ACE. Socio-ecological determinants of lifestyle behavior of women with overweight or obesity before, during and after pregnancy: qualitative interview analysis in the Netherlands. BMC Pregnancy Childbirth 2020; 20:105. [PMID: 32050934 PMCID: PMC7017483 DOI: 10.1186/s12884-020-2786-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/03/2020] [Indexed: 01/28/2023] Open
Abstract
Background Maternal overweight and obesity are related to several health risks in the periods before, during and after pregnancy including a higher risk of gestational diabetes mellitus, preeclampsia and preterm birth. At the same time, women’s daily life quickly changes in these periods. Therefore, we hypothesize that the value of determinants of lifestyle behavior within different levels of the socio-ecological model differ accordingly and influence lifestyle behavior. These dynamics of determinants of lifestyle behavior in the periods before, during and after pregnancy are unexplored and therefore evaluated in this study. These insights are needed to offer appropriate guidance to improve lifestyle in women of childbearing age. Methods Individual semi-structured interviews were conducted before, during or after pregnancy in 26 women with overweight or obesity living in the Netherlands. Questions covered all levels of the socio-ecological model, i.e. intrapersonal, interpersonal, institutional and environmental/societal. All interviews were transcribed and coded. Results Determinants at all levels of the socio-ecological model were perceived as relevant by women of childbearing age. Various determinants were mentioned including knowledge of a healthy lifestyle, social support, access to customized lifestyle guidance, and distance to healthy lifestyle supporting activities. The importance women attributed to determinants differed between the periods before, during and after pregnancy. Before pregnancy, child’s wellbeing as motivator for adopting a healthy lifestyle was mentioned less frequently than during and after pregnancy. Women described that the interplay and balance between determinants varied on a daily basis, and not merely per period. This was often expressed as fluctuation in energy level per day which influences their willingness to put effort in making healthy choices. Conclusions Findings of this study confirm the importance of determinants at multiple socio-ecological levels for shaping lifestyle behavior in women of childbearing age. The findings add to current insights that the perceived importance of determinants and their interplay differ before, during and after pregnancy. They influence lifestyle behavior decisions, not only per period but even on a daily basis, in particular in this phase of life. This perspective can be helpful in optimizing lifestyle guidance for women of childbearing age in order to prevent perinatal complications.
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Affiliation(s)
- Y E G Timmermans
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - K D G van de Kant
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,School for Public Health and Primary Health Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - J S M Krumeich
- School for Public Health and Primary Health Care (CAPHRI), Maastricht University, Maastricht, the Netherlands.,Department of Health Ethics and Society, Maastricht University, Maastricht, the Netherlands
| | - L J I Zimmermann
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - E Dompeling
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,School for Public Health and Primary Health Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - B W Kramer
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - L L J Maassen
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - M A E Spaanderman
- School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands.,Department of Gynecology & Obstetrics, MUMC+, Maastricht, the Netherlands
| | - A C E Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands. .,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
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Halili L, Liu RH, Weeks A, Deonandan R, Adamo KB. High maternal self-efficacy is associated with meeting Institute of Medicine gestational weight gain recommendations. PLoS One 2019; 14:e0226301. [PMID: 31826008 PMCID: PMC6905531 DOI: 10.1371/journal.pone.0226301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/23/2019] [Indexed: 11/20/2022] Open
Abstract
Objective Fetal exposure to an intrauterine environment affected by maternal obesity and excessive gestational weight gain increases the likelihood of infants born large for gestational age and childhood obesity. This study examined behavioural factors and lifestyle practices associated with women’s perceived attainability of meeting the 2009 Institute of Medicine (IOM) weight gain guidelines. Methods Cross-sectional data were collected from pregnant (n = 320) and postpartum (n = 1179) women who responded to the validated Canadian Electronic Maternal (EMat) health survey. Consenting women completed the survey through REDCap™ a secure, web-based data capture platform. Multiple logistic regression analyses were used to evaluate correlates associated with meeting or not meeting IOM recommendations. Odds ratios (ORs) were adjusted for relevant behavioural and sociodemographic covariates. Results There were no significant differences between adjusted and unadjusted ORs for self-efficacy, barriers, and facilitators to weight gain during pregnancy. Women who reported worry regarding weight gain were significantly less likely to meet IOM guidelines (OR = 0.48, 95% CI = 0.33–0.69). Perceived controllability of behaviour was significantly associated with meeting IOM guidelines. An internal locus of control for weight gain was associated with an increased odds of meeting guidelines when women perceived to be in control of their weight gain (OR = 1.75, 95% CI = 1.29–2.37), healthy and exercised (OR = 1.91, 95% CI = 1.34–2.71), and when no barriers to healthy weight gain were perceived (OR = 1.43, 95% CI = 1.04–1.95); whereas, an external locus of control in which women viewed weight gain as beyond their control, was associated with a significantly reduced odds of achieving guidelines (OR = 0.58, 95% CI = 0.39–0.88). Conclusions Self-efficacy and perceived controllability of behaviour are key factors to consider when developing pregnancy-specific interventions to help women achieve guideline-concordant weight gain and ensure the downstream health of both mother and infant.
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Affiliation(s)
- Lyra Halili
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Rebecca H. Liu
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ashley Weeks
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Raywat Deonandan
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
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113
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Huberty J, Green J, Gold KJ, Leiferman J, Cacciatore J. An iterative design process to develop a randomized feasibility study and inform recruitment of minority women after stillbirth. Pilot Feasibility Stud 2019; 5:140. [PMID: 31798941 PMCID: PMC6882004 DOI: 10.1186/s40814-019-0526-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 11/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Yearly, approximately 25,000 US women experience stillbirth and African American women have a 2.2 fold increased risk of stillbirth compared with white women. After stillbirth, women are subject to a sevenfold increased risk of post-traumatic stress compared with women after a live-birth. This paper presents findings from phase one of a National Institutes of Health funded, two-phase feasibility study to examine an online yoga intervention to reduce symptoms of post-traumatic stress in mothers after stillbirth. An iterative design was used to (1) inform the development of the online yoga intervention and (2) inform recruitment strategies to enroll minority women into phase two. METHODS Ten mothers (N = 5 stillbirth moms with no yoga experience, N = 5 nonstillbirth moms with yoga experience) participated in a series of online yoga videos (N = 30) and were assessed for self-compassion (SC) and emotional regulation (ER) before and after each video. An independent group of five minority women who had experienced stillbirth were interviewed about cultural barriers to recruitment and perceptions/opinions of yoga. A mean was calculated for SC and ER scores for each video at pre- and post-time points. The percent change of the mean difference between pre-post SC and ER scores were used to select videos for phase two. Videos with a negative change score or that had a 0% change on SC or ER were not used. A combination of deductive and inductive coding was used to organize the interview data, generate categories, and develop themes. RESULTS Five of the 30 tested yoga videos were not used. An additional 12 videos were developed, filmed, and used in the prescription for phase two. Topics from interview findings included perceived benefits/barriers of and interest in yoga, preferred yoga environment, suggested recruitment methods, content of recruitment material, and recommended incentives. CONCLUSIONS Online yoga may be beneficial for improving emotional regulation and self-compassion, but further testing is needed. Additionally, minority women express interest in online yoga but suggest that researchers apply culturally specific strategies regarding methods, content of material, and incentives to recruit minority women into a study.
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Affiliation(s)
- Jennifer Huberty
- College of Health Solutions, Arizona State University, 500 N. 3rd St., Phoenix, AZ 85004 USA
| | - Jeni Green
- College of Health Solutions, Arizona State University, 500 N. 3rd St., Phoenix, AZ 85004 USA
| | - Katherine J. Gold
- Department of Family Medicine, Department of Obstetrics & Gynecology, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213 USA
| | - Jenn Leiferman
- Colorado School of Public Health, University of Colorado Denver, 13001 E. 17th Place, B119 Bldg 500, Room E3341, Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Joanne Cacciatore
- School of Social Work, Arizona State University, 411 N. Central 8th Floor, Phoenix, AZ 85004 USA
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114
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The Feasibility and Efficacy of a Behavioral Intervention to Promote Appropriate Gestational Weight Gain. Matern Child Health J 2019; 23:1604-1612. [PMID: 31541375 DOI: 10.1007/s10995-019-02812-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Nearly half of all women gain above gestational weight gain (GWG) recommendations. This study assessed the feasibility and efficacy of a pilot behavioral intervention on GWG and physical activity behaviors. METHODS Women (n = 45) 14-20 weeks gestation enrolled in a behavioral intervention. Physicians 'prescribed' the intervention to low risk patients. The intervention included self-monitoring, support, and optional walking groups. Process evaluation measures regarding usage and acceptability of study components were obtained. Physical activity was objectively measured at baseline and 35 weeks. The percentage of participants with appropriate GWG was calculated. Control data was obtained from the same clinic where participants were recruited. RESULTS Overall, the intervention was acceptable to participants; attrition was low (6.7%), weekly contact was high (87%), and self-monitoring was high (Fitbit worn on 82% of intervention weeks; weekly weighing on 81%). Facebook (40% of weeks) and study website use (19%) was low, as was walking group attendance (7% attended a single group). Participants reported a lack of discussions about the study with their physician. Results showed no significant difference between intervention and control participants in the percentage who gained excess weight (p = 0.37). There was a significant decrease in moderate-to-vigorous physical activity in intervention participants (p < 0.0001). DISCUSSION Continued efforts for promoting physical activity and appropriate GWG are needed. Although acceptable, the intervention was not efficacious. Trainings for, or input from prenatal healthcare providers on how to best encourage and support patients' engagement in healthy behaviors, such as PA, are warranted.
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115
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St-Laurent A, Lardon É, Babineau V, Ruchat SM. Reproductive history, maternal anxiety and past physical activity practice predict physical activity levels throughout pregnancy. Prev Med Rep 2019; 16:100992. [PMID: 31788414 PMCID: PMC6879977 DOI: 10.1016/j.pmedr.2019.100992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/15/2019] [Accepted: 09/15/2019] [Indexed: 12/02/2022] Open
Abstract
We compared physical activity (PA) levels between pregnant women who conceived naturally (NC) or after fertility treatments (FT) and determined factors predicting prenatal moderate-to-vigorous intensity physical activity (MVPA). The study was conducted in Trois-Rivières (Canada) between October 2015 and July 2018. MVPA and anxiety levels were assessed at each trimester of pregnancy (TR1, TR2 and TR3) using an accelerometer and the State-Trait Anxiety Inventory, respectively. Sociodemographic and reproductive history data were self-reported or collected from medical files. Repeated measures analysis of variance and regression analyses were conducted. Ninety-six women were included in the analyses (58 NC and 38 FT). MVPA levels and daily step counts decreased significantly throughout pregnancy (time effect: F = 28.68, p < 0.0001 and F = 39.18, p < 0.0001, respectively), but NC and FT women presented similar MVPA and daily step counts (no group effect). The decline in PA practice throughout pregnancy was similar in both groups (no interaction effect). At TR1, State (β = −0.272, p = 0.012) and Trait (β = −0.349, p = 0.001) anxiety and past PA (β = 0.483, p < 0.0001) were correlated with MVPA. Past MVPA was also correlated with MVPA at TR2 (β = 0.595, p < 0.0001) and TR3 (β = 0.654, p < 0.0001). Past PA was the strongest predictors of MVPA levels at TR1, TR2, and TR3, predicting 17% (p = 0.0002), 34% (p < 0.0001) and 42% (p < 0.0001), respectively. Overall, our findings suggest that MVPA practice throughout pregnancy is built on past PA practice. Therefore, to be effective at promoting PA throughout pregnancy, obstetric health care providers and fitness professionals should reinforce the importance of being active as early as possible during pregnancy.
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Affiliation(s)
- Audrey St-Laurent
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Émeline Lardon
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Institut Franco-Européen de Chiropraxie, Paris, France
| | - Véronique Babineau
- Department of Obstetrics and Gynaecology, Centre intégré universitaire de santé et de services sociaux de la Mauricie et- du-Centre-du-Québec, affiliated to the University of Montreal, Trois-Rivières, Quebec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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MacAulay S, Lagan BM, Casson K. Planning, implementation and evaluation of antenatal weight management programmes: What are the key components? A mixed methods study. Midwifery 2019; 79:102545. [PMID: 31627087 DOI: 10.1016/j.midw.2019.102545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/01/2019] [Accepted: 09/29/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide an understanding of the influential components required for the planning, delivery and evaluation of antenatal weight management programmes for women who are overweight or obese. DESIGN Two phase sequential explanatory mixed methods design comprising of an online survey and one-to-one telephone interviews. SETTING AND PARTICIPANTS All UK maternity services (n = 168) and local government councils (n = 417). FINDINGS From the 378 responses, 49 maternity services and 28 local government councils reported having an antenatal weight management programme. Of the 62 responses that specified BMI as an inclusion criterion only two-fifths (40.3% n = 25) adhered to the recommended threshold to include women with a BMI ≥30 kg/m2. Although having a multi-disciplinary team was identified as fundamental when planning a programme, only 20.6% (n = 14/68) of the programmes involved service users during the planning phase. How the programme was communicated to a woman was a key factor which determined whether she partook in the programme or not. Having administrative support and staff with expertise in data collection were essential when evaluating a programme. Staff having protected time was identified as important when planning, delivering and evaluating a programme. Three overarching themes were identified from the individual interviews (n = 14) 'choices and decisions', 'demands and resources' and 'engagement and disengagement'. KEY CONCLUSIONS National guidelines recommendations regarding service user involvement when planning programmes and the BMI threshold used for inclusion are not being met. In addition to having adequate time, personnel and finances, successful programmes are dependent on the confidence and communication skills of midwives to raise the issue of obesity with these women at the booking appointment. Without staff having the time and necessary knowledge and skills, evaluation, and hence demonstrating programme impact, will likely remain difficult. Organisational support is needed to release resources to plan, deliver and evaluate these programmes. Strategic communication strategies are needed to promote the programme to both women and staff within organisations. Future programmes need to ensure there is engagement with service users from the planning of the programme through to evaluation.
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Affiliation(s)
- Sarah MacAulay
- School of Nursing/Institute of Nursing & Health Research, Ulster University, Belfast, County Antrim, Northern Ireland BT37 0QB, United Kingdom; Wales Cancer Network, 1st Floor, River House, Bridge Court, Cardiff, Wales CF15 9SS, United Kingdom.
| | - Briege M Lagan
- School of Nursing/Institute of Nursing & Health Research, Ulster University, Belfast, County Antrim, Northern Ireland BT37 0QB, United Kingdom.
| | - Karen Casson
- School of Nursing/Institute of Nursing & Health Research, Ulster University, Belfast, County Antrim, Northern Ireland BT37 0QB, United Kingdom.
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Burton C, Doyle E, Humber K, Rouxel C, Worner S, Colman R, Palmer S. The biopsychosocial barriers and enablers to being physically active following childbirth: a systematic literature review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1632049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Catherine Burton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Emily Doyle
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Kariss Humber
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Camille Rouxel
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Steffany Worner
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Shea Palmer
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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118
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Walton LM, Raigangar V, Abraham MS, Buddy C, Hernandez M, Krivak G, Caceras R. Effects of an 8-week pelvic core stability and nutrition community programme on maternal health outcomes. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 24:e1780. [PMID: 31038256 DOI: 10.1002/pri.1780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/03/2019] [Accepted: 03/17/2019] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Women, during the antenatal and post-partum period, report pelvic, low back pain, stress and urge urinary incontinence, colorectal dysfunction, and other co-morbidities that negatively affect health-related quality of life. Exercise and nutrition are important considerations for improving maternal health in this period. PURPOSE The purpose of this study was to examine the effects of a community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling over an 8-week period on pelvic floor and urinary distress (UDI), prolapse and colorectal distress for antenatal and post-partum women with limited access to health care, and low socio-economic resources from a Midwestern Region of the United States. MATERIALS AND METHODS Purposive sample of 35 females, ages 18-44, were recruited for this prospective, preintervention to postintervention study, following ethical approval from Institutional Review Board and voluntary written consent from participants. The Health History Questionnaire, SF-36, Food Frequency Questionnaire, report of pelvic organ prolapse dysfunction (POPDI), colorectal-anal dysfunction (CRADI), and UDI as measured by the Pelvic Floor Distress Inventory (PFDI) were completed before and after intervention. RESULTS Thirty-five women (n = 35) 18 to 44 years old (mean age of 22.72 ± 3.45 years) completed the study. A significant difference was found from preintervention to postintervention scores means for PFDI total scores, CRADI individual scores, and UDI individual scores (p < .05). POPDI scores decreased preintervention to postintervention but were not significant. A significant improvement in healthy nutrition and breastfeeding postintervention was also found (z = 3.21, p = .001). Further analysis showed significant, but weak, correlation between parity and POPDI (r = .366, p = .033); between parity and UDI (r = .384, p = .03); and between parity and PFDI (r = .419, p = .014). DISCUSSION Our study found a significant reduction in pelvic floor dysfunction, urinary, and colorectal-anal distress symptoms and improvement in breastfeeding and healthy nutrition following an 8-week community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling.
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Affiliation(s)
- Lori Maria Walton
- Department of Physiotherapy, University of Sharjah/College of Health Sciences, Sharjah, United Arab Emirates
| | - Veena Raigangar
- Department of Physiotherapy, University of Sharjah/College of Health Sciences, Sharjah, United Arab Emirates
| | - Mini Sara Abraham
- Department of Nursing, University of Sharjah, Sharjah, United Arab Emirates
| | - Cherisse Buddy
- Department of Physical Therapy, Andrews University, Berrien Springs, Michigan
| | - Magaly Hernandez
- Department of Physical Therapy, Andrews University, Berrien Springs, Michigan
| | - Gretchen Krivak
- Department of Physical Therapy, Andrews University, Berrien Springs, Michigan
| | - Rose Caceras
- Department of Physical Therapy, Andrews University, Berrien Springs, Michigan
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Kinser P, Jallo N, Thacker L, Aubry C, Masho S. Enhancing Accessibility of Physical Activity During Pregnancy: A Pilot Study on Women's Experiences With Integrating Yoga Into Group Prenatal Care. Health Serv Res Manag Epidemiol 2019; 6:2333392819834886. [PMID: 30993148 PMCID: PMC6449809 DOI: 10.1177/2333392819834886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction: Health guidelines suggest that pregnant women should participate in daily physical
activity, yet rarely do they meet these guidelines. Means to enhance accessibility of
physical activity for pregnant women are required, and yoga has been suggested as a
possible method to enhance women’s sense of confidence and competence with physical
activity. In this pilot study, our primary aim is to evaluate pregnant women’s
perceptions about their lived experience of an intervention which integrates a
low-intensity form of physical activity, yoga, into prenatal care; our secondary aim is
to evaluate changes in participants’ self-efficacy for physical activity and time spent
in physical activity over time. Methods: Held in an outpatient obstetrics department of an urban hospital system in the United
States, this pilot study enrolled 16 pregnant women to participate in the intervention
throughout their pregnancy. We explored participants’ lived experience of the
intervention using qualitative methods (phenomenology). Means, variances, and
covariances were calculated for the 2 measures (self-efficacy and time spent in physical
activity) over the intervention period. Results: Qualitative findings from focus groups suggest that it is acceptable for prenatal yoga
to be integrated into group prenatal care classes and women reported increased
confidence with physical activity during pregnancy. Participants did not consider the
intervention to fit within the traditional definition of exercise. Women reported
increased amounts of time spent in physical activity from baseline to the end of
pregnancy, but there were no statistically significant changes in self-efficacy over
time. Discussion: The integration of gentle physical activity into the group prenatal care model warrants
further attention for potential benefits with regard to maternal physical and mental
wellness.
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Affiliation(s)
- Patricia Kinser
- Department of Family and Community Health Nursing, Virginia Commonwealth University School of Nursing, Richmond, VA, USA
| | - Nancy Jallo
- Department of Family and Community Health Nursing, Virginia Commonwealth University School of Nursing, Richmond, VA, USA
| | - Leroy Thacker
- Department of Biostatistics, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Christine Aubry
- Virginia Commonwealth University School of Nursing, Richmond, VA, USA
| | - Saba Masho
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
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120
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Birtwistle SB, Ashcroft G, Murphy R, Gee I, Poole H, Watson PM. Factors influencing patient uptake of an exercise referral scheme: a qualitative study. HEALTH EDUCATION RESEARCH 2019; 34:113-127. [PMID: 30307496 DOI: 10.1093/her/cyy038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 09/21/2018] [Indexed: 06/08/2023]
Abstract
Exercise referral schemes aim to increase physical activity amongst inactive individuals with or at risk of long-term health conditions. Yet many patients referred to these schemes (by health professionals) fail to take up the exercise opportunities on offer. Understanding factors influencing uptake to exercise referral schemes may help improve future attendance. Using the Socio-Ecological Model as a framework, this qualitative study aimed to explore factors influencing uptake to an exercise referral scheme based in the North West of England. Semi-structured interviews were conducted with referred patients (n = 38) about their reasons for referral, interactions with referring health professionals, events following referral and ideas to improve future uptake. Data were analysed thematically and mapped onto the constructs of the Socio-Ecological Model. Factors reported to influence uptake included intrapersonal (past PA experiences, motivation, competing priorities), interpersonal (scheme explanations, support) and organizational influences (scheme promotion, communication between service, cost). Whilst several intrapersonal-level factors influenced patient decisions to uptake the exercise referral scheme, modifiable interpersonal and organizational factors were identified as potential targets for intervention. Recommendations are made for improving awareness of exercise referral schemes and for enhancing communication between referring practitioners, patients and referral scheme staff.
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Affiliation(s)
- S B Birtwistle
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - G Ashcroft
- School of Natural Sciences and Psychology, Liverpool John Moores University, UK
| | - R Murphy
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - I Gee
- Public Health Institute, Liverpool John Moores University, UK
| | - H Poole
- School of Natural Sciences and Psychology, Liverpool John Moores University, UK
| | - P M Watson
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
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121
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Dayyani I, Terkildsen Maindal H, Rowlands G, Lou S. A qualitative study about the experiences of ethnic minority pregnant women with gestational diabetes. Scand J Caring Sci 2019; 33:621-631. [DOI: 10.1111/scs.12655] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Ida Dayyani
- School of Midwifery University College Nordjylland Aalborg Denmark
| | | | - Gillian Rowlands
- Department of Public Health Aarhus University Aarhus Denmark
- Institute of Health and Society New Castle University New Castle UK
| | - Stina Lou
- Defactum – Public Health and Health Services Research Central Denmark Region Aarhus Denmark
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122
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Krzepota J, Sadowska D, Biernat E. Relationships between Physical Activity and Quality of Life in Pregnant Women in the Second and Third Trimester. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122745. [PMID: 30563083 PMCID: PMC6313753 DOI: 10.3390/ijerph15122745] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/01/2018] [Accepted: 12/03/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The problem of an inadequate level of physical activity (PA) is important in the context of its relationship with the quality of life (QoL) of pregnant women. The aim of this study was to analyze the relationships between PA and QoL among pregnant women. METHODS The study analyzed 346 questionnaires filled in by pregnant women (157 in the second trimester and 189 in the third). The tool used for assessment of PA was the Pregnancy Physical Activity Questionnaire-Polish version (PPAQ-PL). The quality of life (QoL) was assessed by the World Health Organization Quality of Life Questionnaire-short form (WHOQoL-Bref). The results obtained from the PPAQ-PL and WHOQoL-Bref questionnaires for women in the second and third trimesters of pregnancy and intergroup differences were analyzed. RESULTS There was a significant correlation in the group of women in the second trimester of pregnancy between quality of life in the physical health domain and the intensity and type of physical activity. The women who rated their quality of life higher in this domain declared higher energy expenditures (EE) associated with vigorous activity (R = 0.159, p ≤ 0.05), as well as with occupational activity (R = 0.166; p ≤ 0.05) and sport/exercise activity (R = 0.187; p ≤ 0.05). In women in the third trimester, higher EE related to sport/exercise activity coincided with higher assessments of the overall quality of life (R = 0.149, p ≤ 0.05) and general health (R = 0.170, p ≤ 0.05). In the case of the psychological domain (R = 0.161, p ≤ 0.05) and social relationship domain (R = 0.188; p ≤ 0.05) of QoL, positive correlations occurred with EE related to vigorous activity. In contrast, high assessment of physical health domain coincided with higher EE related to occupational activity (R = 0.174; p ≤ 0.05). CONCLUSIONS Our study makes an important contribution to knowledge concerning the correlations between PA and QoL in pregnancy. The results suggest the need for improvement in prenatal care and promotion of PA programs for pregnant women.
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Affiliation(s)
- Justyna Krzepota
- Department of Physical Culture and Health Promotion, University of Szczecin, al. Piastów 40b, blok 6, 71-065 Szczecin, Poland.
| | - Dorota Sadowska
- Department of Physiology, Institute of Sport-National Research Institute, ul. Trylogii 2/16, 01-982 Warsaw, Poland.
| | - Elżbieta Biernat
- Department of Tourism, Collegium of World Economy, Warsaw School of Economics, al. Niepodległości 162, 02-554 Warsaw, Poland.
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Harrison A. Critically Appraised Papers: An aerobic and resistance exercise program can improve glycaemic control in women with gestational diabetes mellitus [commentary]. J Physiother 2018; 64:124. [PMID: 29510898 DOI: 10.1016/j.jphys.2018.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 01/29/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Anne Harrison
- Department of Physiotherapy, Werribee Mercy Hospital, Melbourne, Australia
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