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Guo P, Rivera DE, Dong Y, Deshpande S, Savage JS, Hohman EE, Pauley AM, Leonard KS, Downs DS. Optimizing behavioral interventions to regulate gestational weight gain with sequential decision policies using hybrid model predictive control. Comput Chem Eng 2022; 160. [PMID: 35342207 PMCID: PMC8951772 DOI: 10.1016/j.compchemeng.2022.107721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Excessive gestational weight gain is a significant public health concern that has been the recent focus of control systems-based interventions. Healthy Mom Zone (HMZ) is an intervention study that aims to develop and validate an individually-tailored and "intensively adaptive" intervention to manage weight gain for pregnant women with overweight or obesity using control engineering approaches. This paper presents how Hybrid Model Predictive Control (HMPC) can be used to assign intervention dosages and consequently generate a prescribed intervention with dosages unique to each individuals needs. A Mixed Logical Dynamical (MLD) model enforces the requirements for categorical (discrete-level) doses of intervention components and their sequential assignment into mixed-integer linear constraints. A comprehensive system model that integrates energy balance and behavior change theory, using data from one HMZ participant, is used to illustrate the workings of the HMPC-based control system for the HMZ intervention. Simulations demonstrate the utility of HMPC as a means for enabling optimized complex interventions in behavioral medicine, and the benefits of a HMPC framework in contrast to conventional interventions relying on "IF-THEN" decision rules.
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Laying the Foundation for Pregnancy Physical Activity Profiling: A Framework for Providing Tailored Physical Activity Advice and Guidance to Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115996. [PMID: 34204932 PMCID: PMC8199782 DOI: 10.3390/ijerph18115996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/11/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to examine the predictive utility of the theory of planned behaviour (TPB) in explaining pregnant women’s physical activity (PA) intentions and behaviour and to scrutinise the role of past behaviour within this context. Pregnant women (n = 89) completed the pregnancy physical activity questionnaire (PPAQ) and newly developed TPB questionnaire on two separate occasions during their pregnancy. Analyses were carried out in relation to three scenarios. Firstly, when considering the original TPB, intention emerged as the strongest determinant of pregnant women’s PA behaviour. Secondly, controlling for past behaviour attenuated the influence of intention and perceived behavioural control on behaviour, with neither of the original variables providing a unique influence. Finally, the addition of past behaviour added significantly to the prediction of intention with the model as a whole, explaining 85% of the variance in pregnant women’s PA intention, and with past behaviour uniquely contributing 44.8% of the variance. Pregnancy physical activity profiling based on intention and behaviour status is subsequently introduced as a novel and practical framework. This provides healthcare professionals with the opportunity and structure to provide tailored advice and guidance to pregnant women, thereby facilitating engagement with PA throughout motherhood.
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Adaptive, behavioral intervention impact on weight gain, physical activity, energy intake, and motivational determinants: results of a feasibility trial in pregnant women with overweight/obesity. J Behav Med 2021; 44:605-621. [PMID: 33954853 DOI: 10.1007/s10865-021-00227-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Interventions have modest impact on reducing excessive gestational weight gain (GWG) in pregnant women with overweight/obesity. This two-arm feasibility randomized control trial tested delivery of and compliance with an intervention using adapted dosages to regulate GWG, and examined pre-post change in GWG and secondary outcomes (physical activity: PA, energy intake: EI, theories of planned behavior/self-regulation constructs) compared to a usual care group. Pregnant women with overweight/obesity (N = 31) were randomized to a usual care control group or usual care + intervention group from 8 to 2 weeks gestation and completed the intervention through 36 weeks gestation. Intervention women received weekly evidence-based education/counseling (e.g., GWG, PA, EI) delivered by a registered dietitian in a 60-min face-to-face session. GWG was monitored weekly; women within weight goals continued with education while women exceeding goals received more intensive dosages (e.g., additional hands-on EI/PA sessions). All participants used mHealth tools to complete daily measures of weight (Wi-Fi scale) and PA (activity monitor), weekly evaluation of diet quality (MyFitnessPal app), and weekly/monthly online surveys of motivational determinants/self-regulation. Daily EI was estimated with a validated back-calculation method as a function of maternal weight, PA, and resting metabolic rate. Sixty-five percent of eligible women were randomized; study completion was 87%; 10% partially completed the study and drop-out was 3%. Compliance with using the mHealth tools for intensive data collection ranged from 77 to 97%; intervention women attended > 90% education/counseling sessions, and 68-93% dosage step-up sessions. The intervention group (6.9 kg) had 21% lower GWG than controls (8.8 kg) although this difference was not significant. Exploratory analyses also showed the intervention group had significantly lower EI kcals at post-intervention than controls. A theoretical, adaptive intervention with varied dosages to regulate GWG is feasible to deliver to pregnant women with overweight/obesity.
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Davenport MH, Ruchat SM, Poitras VJ, Jaramillo Garcia A, Gray CE, Barrowman N, Skow RJ, Meah VL, Riske L, Sobierajski F, James M, Kathol AJ, Nuspl M, Marchand AA, Nagpal TS, Slater LG, Weeks A, Adamo KB, Davies GA, Barakat R, Mottola MF. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med 2018; 52:1367-1375. [DOI: 10.1136/bjsports-2018-099355] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2018] [Indexed: 12/11/2022]
Abstract
ObjectiveGestational diabetes mellitus (GDM), gestational hypertension (GH) and pre-eclampsia (PE) are associated with short and long-term health issues for mother and child; prevention of these complications is critically important. This study aimed to perform a systematic review and meta-analysis of the relationships between prenatal exercise and GDM, GH and PE.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcomes (GDM, GH, PE).ResultsA total of 106 studies (n=273 182) were included. ‘Moderate’ to ‘high’-quality evidence from randomised controlled trials revealed that exercise-only interventions, but not exercise+cointerventions, reduced odds of GDM (n=6934; OR 0.62, 95% CI 0.52 to 0.75), GH (n=5316; OR 0.61, 95% CI 0.43 to 0.85) and PE (n=3322; OR 0.59, 95% CI 0.37 to 0.9) compared with no exercise. To achieve at least a 25% reduction in the odds of developing GDM, PE and GH, pregnant women need to accumulate at least 600 MET-min/week of moderate-intensity exercise (eg, 140 min of brisk walking, water aerobics, stationary cycling or resistance training).Summary/conclusionsIn conclusion, exercise-only interventions were effective at lowering the odds of developing GDM, GH and PE.
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Rauff EL, Downs DS. A Prospective Examination of Physical Activity Predictors in Pregnant Women with Normal Weight and Overweight/Obesity. Womens Health Issues 2018; 28:502-508. [PMID: 30337214 DOI: 10.1016/j.whi.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Scant research has examined the relationship between exercise behavior and weight status in pregnant women. METHODS A prospective study was conducted in which pregnant women (N = 332) completed self-report measures at each trimester. Repeated measures multivariate analysis of covariance (controlling for race, education, and parity) examined changes in the motivational determinants of exercise over time and by weight status. Regression analyses were conducted to understand how the motivational determinants predicted exercise behavior and to examine the impact of prepregnancy weight status. RESULTS A significant main effect for time was observed, with an increase in early pregnancy followed by a decrease in late pregnancy for the motivational determinants of exercise and exercise behavior. A significant main effect for weight status was observed such that normal weight pregnant women had significantly greater attitude and intention for exercise when compared with pregnant women with overweight/obesity. The primary predictors of intention were perceived behavioral control (first to second trimester) and attitude (second to third trimester). The primary predictor of exercise behavior was intention. Prepregnancy weight status provided no unique contributions. CONCLUSIONS Findings from this study suggest that interventions designed to promote exercise in pregnancy should consider targeting perceived behavioral control in early pregnancy and attitude in later pregnancy. Improving exercise attitude in women with overweight or obesity may further strengthen their motivation to be active in pregnancy. Customized interventions may need to be designed to address the unique needs of women because their motivational determinants change over the course of pregnancy.
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Affiliation(s)
- Erica L Rauff
- Kinesiology Department, Seattle University, Seattle, Washington
| | - Danielle Symons Downs
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania.
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Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies. Sports Med 2018; 47:295-317. [PMID: 27282925 DOI: 10.1007/s40279-016-0565-2] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Evidence suggests that leisure-time physical activity (LTPA) during pregnancy is associated with a reduced risk of preeclampsia, gestational diabetes mellitus (GDM), and preterm birth. However, these results are inconsistent when comparing cohort studies and randomized controlled trials (RCTs). OBJECTIVE The purpose of our study was to compare the associations between LTPA in pregnancy and maternal (GDM, preeclampsia, and weight gain during pregnancy) and child health outcomes (preterm birth, birthweight, and fetal growth) between RCTs and cohort studies. METHODS We performed a systematic search in PubMed, Web of Science, and EBSCO up to 31 August 2015. Inclusion criteria for experimental studies required randomized trials with a control group and exposure to a physical activity structured program. The inclusion criteria for cohort studies required information on LTPA during pregnancy as an exposure and at least one maternal-child health outcome. We assessed the methodological quality of all studies and performed a meta-analysis to produce summary estimates of the effects using random models. RESULTS We included 30 RCTs and 51 cohort studies. The meta-analysis of RCTs indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower likelihood of delivering a large-for-gestational-age infant. Cohort studies indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower risk of preterm delivery. CONCLUSIONS Our findings support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.
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Thompson EL, Vamos CA, Daley EM. Physical activity during pregnancy and the role of theory in promoting positive behavior change: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:198-206. [PMID: 30356571 PMCID: PMC6189011 DOI: 10.1016/j.jshs.2015.08.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/16/2015] [Accepted: 07/10/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND Physical activity (PA) during pregnancy provides physical and psychological benefits for mother and child. U.S. guidelines recommend ≥30 min of moderate exercise for healthy pregnant women most days of the week; however, most women do not meet these recommendations. Theory assists in identifying salient determinants of health behavior to guide health promotion interventions; however, the application of theory to examine PA among pregnant women has not been examined cohesively among multiple levels of influence (e.g., intrapersonal, interpersonal, neighborhood/environmental, and organizational/political). Subsequently, this systematic review aims to identify and evaluate the use of health behavior theory in studies that examine PA during pregnancy. METHODS Articles published before July 2014 were obtained from PubMed and Web of Science. Inclusion criteria applied were: (1) empirically-based; (2) peer-reviewed; (3) measured factors related to PA; (4) comprised a pregnant sample; and (5) applied theory. Fourteen studies were included. Each study's application of theory and theoretical constructs were evaluated. RESULTS Various theories were utilized to explain and predict PA during pregnancy; yet, the majority of these studies only focused on intrapersonal level determinants. Five theoretical frameworks were applied across the studies-all but one at the intrapersonal level. Few determinants identified were from the interpersonal, neighborhood/environmental, or organizational/political levels. CONCLUSION This systematic review synthesized the literature on theoretical constructs related to PA during pregnancy. Interpersonal, community, and societal levels remain understudied. Future research should employ theory-driven multi-level determinants of PA to reflect the interacting factors influencing PA during this critical period in the life course.
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Malek L, Umberger WJ, Makrides M, ShaoJia Z. Predicting healthy eating intention and adherence to dietary recommendations during pregnancy in Australia using the Theory of Planned Behaviour. Appetite 2017; 116:431-441. [PMID: 28536056 DOI: 10.1016/j.appet.2017.05.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/16/2017] [Accepted: 05/16/2017] [Indexed: 11/29/2022]
Abstract
This study aims to aid in the development of more effective healthy eating intervention strategies for pregnant women by understanding the relationship between healthy eating intention and actual eating behaviour. Specifically, the study explored whether Theory of Planned Behaviour (TPB) constructs [attitude, subjective-norm, perceived-behavioural-control (PBC)] and additional psychosocial variables (perceived stress, health value and self-identity as a healthy eater) are useful in explaining variance in women's 1) intentions to consume a healthy diet during pregnancy and 2) food consumption behaviour (e.g. adherence to food group recommendations) during pregnancy. A cross-sectional sample of 455 Australian pregnant women completed a TPB questionnaire as part of a larger comprehensive web-based nutrition questionnaire. Women's perceived stress, health value and self-identity as a healthy eater were also measured. Dietary intake was assessed using six-items based on the 2013 Australian Dietary Guidelines. Hierarchical multiple linear regression models were estimated (significance level <0.05), which explained 70% of the variance in healthy eating intention scores and 12% of the variance in adherence to food group recommendations. TPB constructs explained 66% of the total variance in healthy eating intention. Significant predictors of stronger healthy eating intention were greater PBC and subjective norm, followed by positive attitude and stronger self-identity as a healthy eater. Conversely, TPB constructs collectively explained only 3.4% of total variance in adherence to food group recommendations. These findings reveal that the TPB framework explains considerable variance in healthy eating intention during pregnancy, but explains little variance in actual food consumption behaviour. Further research is required to understand this weak relationship between healthy eating intention and behaviour during pregnancy. Alternative behavioural frameworks, particularly those that account for the automatic nature of most dietary choices, should also be considered.
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Affiliation(s)
- Lenka Malek
- Centre for Global Food and Resources, Faculty of the Professions, The University of Adelaide, Level 6 NEXUS 10 Tower, 10 Pulteney Street, SA 5005, Australia.
| | - Wendy J Umberger
- Centre for Global Food and Resources, Faculty of the Professions, The University of Adelaide, Level 6 NEXUS 10 Tower, 10 Pulteney Street, SA 5005, Australia.
| | - Maria Makrides
- The Discipline of Paediatrics, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia; Healthy Mothers, Babies and Children, South Australian Health Medical Research Institute, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia.
| | - Zhou ShaoJia
- The Discipline of Paediatrics, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia; School of Agriculture, Food and Wine, The University of Adelaide, Waite Campus, PMB 1, Glen Osmond, SA 5064, Australia.
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Downs DS, Dinallo JM, Birch LL, Paul IM, Ulbrecht JS. Randomized Face-to-Face vs. Home Exercise Interventions in Pregnant Women with Gestational Diabetes. PSYCHOLOGY OF SPORT AND EXERCISE 2017; 30:73-81. [PMID: 28428728 PMCID: PMC5393351 DOI: 10.1016/j.psychsport.2017.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVES Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). DESIGN Randomized control trial with two intervention arms and control (standard care). METHOD Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery. Assessments of exercise and motivational determinants were obtained at baseline (20-weeks gestation) and follow-up (32-weeks gestation). Blood glucose levels (fasting/postprandial mg/dL) and insulin use were extrapolated from medical records. RESULTS At the 32-week follow-up, the F2F group had significantly higher exercise min, pedometer steps/day, and motivational determinants (attitude, subjective norm, perceived control, intention) than controls (p's < .05) and significantly higher exercise min and subjective norm than the Home group (p's < .05); these effect sizes were medium-large (η2 = .11-.23). There was a medium effect (η2 = .13) on postprandial blood glucose at 36-weeks gestation with the F2F group having lower values than controls. Although not significant, the F2F group started insulin later (33 weeks gestation) than the Home (27 weeks) and Control (31 weeks) groups. CONCLUSION A theoretically-based, F2F exercise intervention has multiple health benefits and may be the necessary approach for promoting exercise motivation and behavior among GDM women.
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Affiliation(s)
- Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University
- Department of Obstetrics and Gynecology, The Pennsylvania State University
| | | | - Leann L Birch
- College of Family and Consumer Sciences, University of Georgia
| | - Ian M Paul
- Department of Pediatrics and Public Health Sciences, The Pennsylvania State University
| | - Jan S Ulbrecht
- Mount Nittany Physician Group, State College, Pennsylvania
- Departments of Biobehavioral Health and Medicine, The Pennsylvania State University
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Devlin CA, Huberty J, Downs DS. Influences of prior miscarriage and weight status on perinatal psychological well-being, exercise motivation and behavior. Midwifery 2016; 43:29-36. [PMID: 27838526 PMCID: PMC5314732 DOI: 10.1016/j.midw.2016.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/28/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES women who have experienced miscarriage may be at increased risk for elevated depressive and anxiety symptoms in subsequent pregnancies. Exercise may be a useful strategy for coping with these symptoms. Little is known about how miscarriage influences prenatal exercise behavior. The study purpose was to examine the influences of miscarriage history and prepregnancy weight status on pregnant women's psychological health, exercise motivation, and behavior using the Theory of Planned Behavior. PARTICIPANTS/SETTING Pregnant women (N=203; 41 with prior miscarriage; 72 overweight/obese; BMI > 25.0) in the northeast United States. DESIGN Women prospectively reported their depressive/anxiety symptoms and exercise motivation/behavior in the 1st, 2nd, and 3rd trimesters via mailed surveys. Group differences in depressive/anxiety symptoms, exercise behavior, and its motivational determinants were examined using Chi Square analyses and Univariate and Multivariate Analyses of Covariance. MEASUREMENTS AND FINDINGS Women with a history of miscarriage had higher 1st and 2nd trimester depressive/anxiety symptoms and lower 1st trimester attitudes about exercise and 1st and 2nd trimester perceived behavior control than women without a history of miscarriage. Overweight/obese women had higher 1st and 2nd trimester pregnancy depressive/anxiety symptoms, engaged in less prepregnancy exercise, and had lower levels of exercise intention, attitude, and perceived behavior control throughout pregnancy than normal weight women. KEY CONCLUSIONS Women with a history of miscarriage and overweight/obese women have poorer psychological health and lower motivation to exercise during pregnancy than women without a history of miscarriage and normal weight women. IMPLICATIONS FOR PRACTITIONERS Interventions and healthcare provider communications aimed at promoting perinatal exercise behavior and psychological health should take into account pre-pregnancy weight status and pregnancy history to identify strategies to help women, particularly overweight/obese women with a history of miscarriage, to overcome exercise barriers.
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Affiliation(s)
- Courtenay A Devlin
- Exercise Psychology Laboratory, Department of Kinesiology, Penn State University, University Park, PA, USA.
| | - Jennifer Huberty
- Department of Exercise Science & Health, School of Nutrition Health and Promotion, Arizona State University, Phoenix, AZ, USA
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, Penn State University, University Park, PA, USA; Department of OBGYN, Hershey Medical Center, Hershey, PA, USA
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De Vivo M, Hulbert S, Mills H, Uphill M. Examining exercise intention and behaviour during pregnancy using the Theory of Planned Behaviour: a meta-analysis. J Reprod Infant Psychol 2016. [DOI: 10.1080/02646838.2015.1118022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Padmapriya N, Shen L, Soh SE, Shen Z, Kwek K, Godfrey KM, Gluckman PD, Chong YS, Saw SM, Müller-Riemenschneider F. Physical Activity and Sedentary Behavior Patterns Before and During Pregnancy in a Multi-ethnic Sample of Asian Women in Singapore. Matern Child Health J 2015; 19:2523-35. [DOI: 10.1007/s10995-015-1773-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aldrich RS, Harrington NG, Cerel J. The Willingness to Intervene Against Suicide Questionnaire. DEATH STUDIES 2014; 38:100-108. [PMID: 24517708 DOI: 10.1080/07481187.2012.738763] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Three studies resulted in the Willingness to Intervene Against Suicide Questionnaire. College students (ns = 172, 253, and 367) completed an online questionnaire based on theory of planned behavior constructs regarding suicide intervention. Exploratory factor analysis produced 10 factors: intervening will affect the suicidal person and the participant; important others recommend seeking help, suggesting the suicidal person see a counselor, and talking to the suicidal person; interpersonal and intervention self-efficacy; and intention to seek outside help, encourage to seek outside help, and recognize a need for action. The Willingness to Intervene Against Suicide Questionnaire assesses college students' willingness to intervene when someone is suicidal.
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Affiliation(s)
- Rosalie S Aldrich
- a School of Humanities and Social Sciences, Indiana University East , Richmond , Indiana , USA
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Yan CF, Hung YC, Gau ML, Lin KC. Effects of a stability ball exercise programme on low back pain and daily life interference during pregnancy. Midwifery 2013; 30:412-9. [PMID: 23759131 DOI: 10.1016/j.midw.2013.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 04/26/2013] [Accepted: 04/30/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND most pregnant women experience back pain during pregnancy, a serious issue that negatively impacts life quality during pregnancy. Research into an exercise intervention programme targeting low back pain and daily life interference is lacking. OBJECTIVE this study evaluates how a stability ball exercise programme influences low back pain and daily life interference across the second and third pregnancy trimester. METHODS the study was non-randomised and controlled, examining a target population of low-risk pregnancy women between 20 and 22 weeks of gestation located in a regional hospital in northern Taiwan. All participants had at least minimal low back pain, no prior history of chronic low back pain before pregnancy, and no indications of preterm labour. In total, 89 individuals participated: 45 in the control group and 44 in the experimental group (who attended an antenatal stability ball exercise programme). This programme lasted 12 weeks, composed of at least three sessions per week. Fitness workouts lasted from 25 to 30 minutes. The women completed their basic personal information, the Brief Pain Inventory-Short Form, and the Family Exercise Support Attitude Questionnaire. RESULTS after adjusting for demographic data and antenatal exercise status by propensity scores, experimental-group women who participated in the antenatal stability ball exercise programme reported significantly less low back pain and daily life interferences than the control group at 36 weeks of gestation. DISCUSSION the inclusion of stability ball exercises during pregnancy may reduce pregnancy low back pain and boost daily life functions. This stability ball exercise programme provides health-care professionals with an evidence-based intervention.
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Affiliation(s)
- Chiu-Fang Yan
- Department of Nursing, Chang-Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ya-Chi Hung
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Meei-Ling Gau
- Graduate Institute of Nurse-Midwifery, National Taipei University of Nursing and Health Sciences, No. 365, Ming-Te Road 112, Taipei, Taiwan.
| | - Kuan-Chia Lin
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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Downs DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2012; 83:485-502. [PMID: 23367811 PMCID: PMC3563105 DOI: 10.1080/02701367.2012.10599138] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE In this review, we provide researchers and practitioners with an overview of the physical activity and pregnancy literature to promote prenatal physical activity, improve measurement, further elucidate the role of activity in reducing maternal health complications, and inform future research. METHOD We examined past and present physical activity and pregnancy studies and highlight key papers with a focus on maternal health outcomes to best inform physical activity promotion efforts. RESULTS We discuss: (a) historical overview of prenatal physical activity relative to the physical activity guidelines, how they have changed over time, and how evidence of the effect of prenatal activity on maternal/fetal health outcomes has affected clinical recommendations; (b) existing tools and challenges associated with measuring prenatal physical activity; (c) empirical evidence on multilevel determinants of prenatal activity to guide future intervention work; (d) empirical evidence of prenatal activity on adverse maternal outcomes (gestational diabetes mellitus, preeclampsia, excessive gestational weight gain) from observational and intervention studies; and (e) summary/recommendations for future research and practice. CONCLUSIONS The physical activity and pregnancy literature has evolved over the past 50 years, and there is sufficient empirical evidence to support the promotion of moderate-to-vigorous prenatal physical activity for maternal health benefits. Future studies and interventions should be carefully designed, theoretically driven, and include validated and reliable activity measures. Researchers and practitioners should also consider the multifaceted determinants and outcomes of prenatal physical activity and intervene to promote physical activity before, during, and after pregnancy.
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Affiliation(s)
- Danielle Symons Downs
- Department of Kinesiology at The Pennsylvania State University, University Park 16802, USA.
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Hausenblas H, Giacobbi P, Cook B, Rhodes R, Cruz A. Prospective examination of pregnant and nonpregnant women’s physical activity beliefs and behaviours. J Reprod Infant Psychol 2011. [DOI: 10.1080/02646838.2011.629993] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Gaston A, Cramp A. Exercise during pregnancy: A review of patterns and determinants. J Sci Med Sport 2011; 14:299-305. [DOI: 10.1016/j.jsams.2011.02.006] [Citation(s) in RCA: 185] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 11/02/2010] [Accepted: 02/19/2011] [Indexed: 01/11/2023]
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Cramp AG, Bray SR. A prospective examination of exercise and barrier self-efficacy to engage in leisure-time physical activity during pregnancy. Ann Behav Med 2009; 37:325-34. [PMID: 19499279 DOI: 10.1007/s12160-009-9102-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Pregnant women without medical contraindications should accumulate 30 min of moderate exercise on most days of the week, yet many pregnant women do not exercise at recommended levels. PURPOSE The purpose the study was to examine barriers to leisure-time physical activity (LTPA) and investigate barrier and exercise self-efficacy as predictors of self-reported LTPA during pregnancy. METHODS Pregnant women (n = 160) completed questionnaires eliciting barriers to LTPA, measures of exercise and barrier self-efficacy, and 6-week LTPA recall at gestational weeks 18, 24, 30, and 36. RESULTS A total of 1,168 barriers were content-analyzed, yielding nine major themes including fatigue, time constraints, and physical limitations. Exercise self-efficacy predicted LTPA from gestational weeks 18 to 24 (beta = 0.32, R(2) = 0.26) and weeks 30 to 36 (beta = 0.41, R(2) = 0.37), while barrier self-efficacy predicted LTPA from weeks 24 to 30 (beta = 0.40, R(2) = 0.32). CONCLUSIONS Pregnant women face numerous barriers to LTPA during pregnancy, the nature of which may change substantially over the course of pregnancy. Higher levels of self-efficacy to exercise and to overcome exercise barriers are associated with greater LTPA during pregnancy. Research and interventions to understand and promote LTPA during pregnancy should explore the dynamic nature of exercise barriers and foster women's confidence to overcome physical activity barriers.
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Wallace DA, Dodd MM, McNeil DA, Churchill AJ, Oelke ND, Arnold SL, Oberle K. A pregnancy wellness guide to enhance care through self-assessment, personal reflection, and self-referral. J Obstet Gynecol Neonatal Nurs 2009; 38:134-47. [PMID: 19323710 DOI: 10.1111/j.1552-6909.2009.01008.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To develop a tool and evaluate its content validity and utility. The tool was designed to be used by women to assess lifestyle and psychosocial factors that could impact their pregnancies and unborn babies. It also provided resources for self-help. DESIGN Methodological study in 4 phases. SETTING Alberta Health Services, Calgary area and community. PARTICIPANTS Thirty-five experts and 375 pregnant women. METHODS Pregnant women and new mothers participated in focus groups to establish content validity; prenatal class attendees completed the self-assessment and a questionnaire, and women from the community completed a questionnaire on the instrument's utility. RESULTS Responses from experts and participants in all 4 phases led to changes in the content, wording, and format of the tool. Survey responses indicated that it contained useful information that prompted a number of women to make positive changes during their pregnancies. CONCLUSION The Pregnancy Wellness Guide is a simple tool that can help pregnant women assess their knowledge and health behaviors and self-refer to helpful resources. It will be widely distributed throughout the health region in the urban and rural Calgary area, and its use is anticipated to result in better health outcomes in pregnancy.
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Affiliation(s)
- Donna A Wallace
- Prenatal Community Programs, Alberta Health Services Calgary, AB, Canada.
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Hausenblas H, Downs DS, Giacobbi P, Tuccitto D, Cook B. A multilevel examination of exercise intention and behavior during pregnancy. Soc Sci Med 2008; 66:2555-61. [PMID: 18372085 DOI: 10.1016/j.socscimed.2008.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Indexed: 10/22/2022]
Abstract
Research examining exercising in pregnancy is limited by non-theoretical and cross-sectional assessments that fail to capture the specific physical and psychological demands of the pregnancy trimesters. Drawing on a population in Gainesville, Florida, USA we prospectively examined, within a multilevel design, 61 pregnant women's first and second trimester exercise intention and behavior, and the potential moderating effect of past exercise behavior using the framework of the Theory of Planned Behavior (TPB). Significant cross-sectional associations were found with exercise intention, although the only significant longitudinal effect was the relation between first trimester intention and second trimester changes in exercise behavior. Implications of our findings for study design and exercise intervention development during pregnancy are discussed.
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Affiliation(s)
- Heather Hausenblas
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL 32611, USA.
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DiNallo JM, Le Masurier GC, Williams NI, Downs DS. Walking for health in pregnancy: assessment by indirect calorimetry and accelerometry. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2008; 79:28-35. [PMID: 18431948 DOI: 10.1080/02701367.2008.10599457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this study was to examine RT3 accelerometer activity counts and activity energy expenditure of 36 pregnant women at 20 and 32 weeks' gestation during treadmill walking and free-living conditions. During treadmill walking, oxygen consumption was collected, and activity energy expenditure was estimated for a 30-min walk at a self-selected walking pace. The number of min it would take a pregnant woman to meet exercise recommendations (i.e., kcal/week) were calculated. Preliminary activity count cut points at a self-selected walking pace were then estimated and applied in interpreting free-living data. For the treadmill walking condition, the self-selected walking pace significantly decreased from 20 to 32 weeks' gestation. Additionally, few women (< 12% each day) met physical activity guidelines in the free-living condition. Encouraging pregnant women to walk for 30-40 min per day at a self-selected walking pace may be an appropriate public health recommendation.
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Affiliation(s)
- Jennifer M DiNallo
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802-5701, USA
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