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Saidi L, Godbout PD, Morais-Savoie C, Registe PPW, Bélanger M. Association between physical activity education and prescription during prenatal care and maternal and fetal health outcomes: a quasi-experimental study. BMC Pregnancy Childbirth 2023; 23:496. [PMID: 37407926 DOI: 10.1186/s12884-023-05808-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes. METHODS This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups. RESULTS The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51-0.99), 73% lower odds of developing GHT (0.27, 0.14-0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34-0.93), and 40% lower odds of being large for gestational age (0.60, 0.36-0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12-1.94). CONCLUSIONS The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
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Affiliation(s)
- Latifa Saidi
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l 'Université, Sherbrooke, Québec, J1K 2R1, Canada.
| | - Pierre D Godbout
- School of Nursing, Université de Moncton, Campus de Shippagan, 725, Rue du Collège, Bathurst, NB, E2A 3Z2, Canada
| | - Camille Morais-Savoie
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Pavillon J-Raymond-Frenette, 50 Rue de La Francophonie St, Moncton, NB, E1A 7R1, Canada
| | - Pierre Philippe Wilson Registe
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l 'Université, Sherbrooke, Québec, J1K 2R1, Canada
| | - Mathieu Bélanger
- Department of Family and Emergency Medicine, Université de Sherbrooke, Centre de Formation Médicale du Nouveau-Brunswick, Vitalité Health Network, Pavillon J-Raymond-Frenette, 18, Avenue Antonine-Maillet, Moncton, NB, E1A 3E9, Canada
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Ruart S, Sinnapah S, Hue O, Janky E, Antoine-Jonville S. Physical activity counseling received throughout pregnancy and effect on behaviors: a quasi-experimental study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023:S1701-2163(23)00405-X. [PMID: 37263525 DOI: 10.1016/j.jogc.2023.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The objective was to examine the frequency of physical activity counseling for pregnant women over the course of their pregnancies and the effect on the women's physical activity behaviors. METHODS A quasi-experimental study was conducted in the Maternity Unit of a hospital. Seventy-two pregnant women were randomized into a control or intervention group. Counseling about physical activity was dispensed to the women in the intervention group throughout pregnancy by health professionals who had been sensitized to its importance and the recommendations. The women in the control group received the usual consultation content. The physical activity behavior of the pregnant women in the intervention group who reported receiving physical activity counseling was evaluated. The counseling and physical activity levels were evaluated by Chi2 tests and repeated measures ANOVAs, respectively. RESULTS Overall, the women received little counseling in accordance with the recommendations, although the intervention group women received this counseling more frequently (p=0.049). All women in the intervention group who reported received counseling throughout pregnancy limited their decline in physical activity compared to those in the control group. The decline in total physical activity among normal-weight and overweight pregnant women was reduced in the intervention group (respectively, p=0.043 and p=0.044). CONCLUSION Our intervention showed the effectiveness of counseling on physical activity behaviors, although the effect was observed at the end of pregnancy. Training and sensitizing for professionals should be strengthened to ensure that counseling in line with the recommendations to maintain or increase physical activity levels throughout pregnancy is provided.
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Affiliation(s)
- Shelly Ruart
- Univ Antilles, Sport Sciences Department Laboratory ACTES EA3596, Pointe-à-Pitre, Guadeloupe (France).
| | - Stéphane Sinnapah
- Univ Antilles, Sport Sciences Department Laboratory ACTES EA3596, Pointe-à-Pitre, Guadeloupe (France)
| | - Olivier Hue
- Univ Antilles, Sport Sciences Department Laboratory ACTES EA3596, Pointe-à-Pitre, Guadeloupe (France)
| | - Eustase Janky
- Gynecology, Obstetrics Department, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe (France)
| | - Sophie Antoine-Jonville
- Univ Antilles, Sport Sciences Department Laboratory ACTES EA3596, Pointe-à-Pitre, Guadeloupe (France)
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Physical Activity Beliefs and Behaviors during Pregnancy and their Association with Provider Counseling among Women in the Southern United States. PHYSICAL ACTIVITY AND HEALTH 2022. [DOI: 10.5334/paah.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Physical activity promotion in rural health care settings: A rapid realist review. Prev Med Rep 2022; 29:101905. [PMID: 35879935 PMCID: PMC9307466 DOI: 10.1016/j.pmedr.2022.101905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/17/2022] [Accepted: 07/06/2022] [Indexed: 11/22/2022] Open
Abstract
Rural communities have a unique health care and physical activity context. We conducted a rapid realist review in partnership with knowledge users. Check-ins from health care providers may lead to intervention success and are valued by participants. A method for tracking progress is an important component of interventions delivered in rural health care settings.
Physical activity promotion in health care settings is poorly understood and has limited uptake among health care providers. The environmental and health care context of rural communities is unique from urban areas and may interact to influence intervention delivery and success. The aim of this rapid realist review was to synthesize knowledge related to the promotion of physical activity in rural health and social care settings. We searched Medline EBSCO, CINAHL, PsychINFO, and SPORTDiscus for relevant publications. We included qualitative or quantitative studies reporting on an intervention to promote physical activity in rural health (e.g., primary or community care) or social (e.g., elder support services) care settings. Studies without a rural focus or well-defined physical activity/exercise component were excluded. Populations of interest included adults and children in the general population or clinical sub-population. Intervention mechanisms from included studies were mapped to the Behaviour Change Wheel (capability, opportunity, motivation (COM-B)). Twenty studies were included in our review. Most interventions focused on older adults or people with chronic disease risk factors. The most successful intervention strategies leading to increased physical activity behaviour included wearable activity trackers, and check-ins or reminders from trusted sources. Interventions with mechanisms categorized as physical opportunity, automatic motivation, and psychological capability were more likely to be successful than other factors of the COM-B model. Successful intervention activities included a method for tracking progress, providing counselling, and follow-up reminders to prompt behaviour change. Cultivation of necessary community partnerships and adaptations for implementation of interventions in rural communities were not clearly described and may support successful outcomes in future studies.
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Prenatal Counseling throughout Pregnancy: Effects on Physical Activity Level, Perceived Barriers, and Perinatal Health Outcomes: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238887. [PMID: 33260471 PMCID: PMC7729670 DOI: 10.3390/ijerph17238887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 12/25/2022]
Abstract
Physical activity during pregnancy has many health benefits. However, the physical activity level is insufficient throughout pregnancy and women report perceived barriers to physical activity. This study assessed the impact of a counseling intervention offered in addition to routine pregnancy care on physical activity patterns, perceived barriers, and perinatal health outcomes. A quasi-experimental trial was conducted in the Maternity Unit of a hospital in Guadeloupe (a French department). Ninety-six pregnant women were allocated to a control or intervention group. Regular physical activity counseling was dispensed to the women in the intervention group by trained healthcare providers. The physical activity level and the perceived barriers were assessed in each trimester. Outcomes for the perinatal health of the mother and child were measured throughout pregnancy and after delivery. The perceived barriers, such as a lack of information about the health benefits and risks over the two trimesters (all p < 0.05) and insecurity related to practice throughout pregnancy (all p < 0.05), were different in favor of the intervention group. There were no significant between-group differences for the major indices of physical activity, whether measured or reported. The intervention women reported significantly more sedentary activity compared with the control group in the third trimester, 64.7 (36.4–78.7) vs. 22.7 (9.4–49.8) MET-hours/week, respectively (p < 0.001). The perinatal health outcomes for the mother and child showed no significant differences. The intervention was unable to limit the decline in physical activity or improve health outcomes. However, it was associated with an improvement in the perception of barriers. Future research should focus on interventions that have a sufficient quantitative impact on perceived barriers in order to limit physical activity decline.
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Tinius R, Nagpal TS, Edens K, Duchette C, Blankenship M. Exploring Beliefs About Exercise Among Pregnant Women in Rural Communities. J Midwifery Womens Health 2020; 65:538-545. [PMID: 32277590 DOI: 10.1111/jmwh.13080] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Women who are pregnant in rural communities are disproportionally impacted by obesity and sedentary behavior, and this could be related to having negative beliefs about exercise during pregnancy, leading to inactivity. The purpose of this study was to identify self-reported beliefs about exercise among pregnant women in a rural community. METHODS Pregnant participants (N = 70) between 8 and 16 weeks' gestation were recruited from an obstetric clinic serving a rural population. An open-ended questionnaire addressing beliefs about exercise and based on the constructs of the theory of planned behavior was administered. Descriptive survey results were analyzed by calculating means and frequencies. Open-ended responses were assessed by inductive content analysis. RESULTS Commonly reported advantages of exercise during pregnancy included improved perinatal health outcomes and weight management. Commonly reported disadvantages included an increase in fatigue and concerns for maternal and fetal safety. Common facilitators of exercise included access to resources, free time or a decrease in demands from work, and support systems including family and friends. Common barriers to exercise included a lack of time, physical changes including feelings of nausea and fatigue, and lack of access to resources. DISCUSSION This study was the first to report beliefs about exercise during pregnancy in a rural setting. Responses in the current study suggest potential gaps in knowledge of evidence-based information regarding physical activity during pregnancy. Beliefs as well as reported barriers and facilitators of physical activity during pregnancy were similar those reported in other populations. In addition, access to resources (or lack of) appears to be an important facilitator (or barrier) among women in rural settings; thus, developing strategies designed to overcome this barrier, specifically in rural areas, is critically important. Future intervention strategies need to be tailored specifically to the needs of women living in rural areas.
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Affiliation(s)
- Rachel Tinius
- Exercise Science Program, School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky
| | - Taniya Singh Nagpal
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Canada
| | - Kolbi Edens
- Exercise Science Program, School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky
| | - Cathryn Duchette
- Exercise Science Program, School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky
| | - Maire Blankenship
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, Kentucky
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Lindqvist M, Persson M, Mogren I. "Longing for individual recognition" - Pregnant women's experiences of midwives' counselling on physical activity during pregnancy. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 15:46-53. [PMID: 29389501 DOI: 10.1016/j.srhc.2017.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/26/2017] [Accepted: 12/09/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aims to explore among pregnant women were their experiences of lifestyle counselling provided by a midwife in antenatal care, addressing health promotion with special focus on physical activity during pregnancy, and factors influencing the trustworthiness of counselling conducted by a midwife. METHODS This qualitative study collected data from 14 pregnant, primiparous or multiparous women in gestational week 35-36 using in-depth interviews. The data were collected in Sweden in 2015. Qualitative content analysis was applied. RESULTS The theme "Longing for fulfilment of individual needs and expectations" emerged during analysis, including four categories; "Being exposed to unsatisfying counselling"; "Appreciating supportive and trustworthy counselling"; "Wrestling with cultures", and "Dealing with physical activity in daily life". The results indicated that some participants experienced limited counselling that was characterized by lack of knowledge, support, and trustworthiness in the midwife. Other participants reported valuable encouragement and support by the midwife. Participants were longing for individual recognition instead of receiving general advice on physical activity that was designed for all pregnant women. CONCLUSIONS Individual counselling on physical activity during pregnancy based on the participant's individual needs was desired. On the contrary, the participants could experience the midwife as having her own agenda, insufficient knowledge and primarily focusing on medical surveillance. There is a need of increased level of knowledge among midwives in antenatal care, regarding lifestyle and lifestyle change during pregnancy. This may enhance promotion of a healthy lifestyle for the pregnant woman during counselling.
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Affiliation(s)
- Maria Lindqvist
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 87 Umeå, Sweden.
| | | | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 87 Umeå, Sweden.
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Gilbert PA, Laroche HH, Wallace RB, Parker EA, Curry SJ. Extending Work on Rural Health Disparities: A Commentary on Matthews and Colleagues' Report. J Rural Health 2017; 34:119-121. [PMID: 28397970 DOI: 10.1111/jrh.12241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Helena H Laroche
- Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Susan J Curry
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa
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