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Garland M, Wilbur J, Schoeny M, Reed M, Semanik P, Halloway S, Waters T. Determinants of Physical Activity Among Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:172-184. [PMID: 38072009 DOI: 10.1016/j.jogn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN Longitudinal cohort. SETTING Medical center obstetric clinic. PARTICIPANTS Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.
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Leiferman JA, Lacy R, Walls J, Farewell CV, Dinger MK, Downs DS, Farrabi SS, Huberty JL, Paulson JF. My Baby, My Move+: feasibility of a community prenatal wellbeing intervention. Pilot Feasibility Stud 2023; 9:134. [PMID: 37507732 PMCID: PMC10375613 DOI: 10.1186/s40814-023-01368-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG. METHODS Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 and Spring of 2021. Eligible pregnant women were randomized to either the MBMM + intervention or the control group. Each group met over Zoom for 16 sessions (twice weekly for 60 min over 8 weeks) to learn either behavioral change and wellbeing knowledge and skills (MBMM +) or knowledge and skills related to parenting (control group). Multiple methods of evaluation to better understand the feasibility of the intervention were conducted. RESULTS A total of 49 women (25 MBMM + intervention, 24 control) completed both pre- and post-survey assessments and were included in the analyses. A subsample of 19 (39%) intervention participants completed a combination of semi-structured interviews/surveys to assess acceptability, demand, implementation, and practicality. Participants expressed positive feedback regarding acceptability (satisfaction and intent to continue use) and were extremely likely or likely to recommend the program to a friend (demand). Implementation metrics were assessed by observation and feedback forms completed by peer leaders and demonstrated high-quality control. Findings suggest that the intervention was practical due to remote sessions and cost-effectiveness. CONCLUSION The MBMM + intervention was deemed to be a feasible intervention with high acceptability, demand, implementation, and practicality. These findings can be used to inform the scalability of the intervention and implementation of a larger efficacy trial. TRIAL REGISTRATION 19-1366, initial date is on January 23, 2020.
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Affiliation(s)
- Jenn A Leiferman
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA.
| | - Rachael Lacy
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Jessica Walls
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Charlotte V Farewell
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Mary K Dinger
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Danielle Symons Downs
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, State College, PA, USA
- Department of Obstetrics and Gynecology, College of Medicine, The Pennsylvania State University, 266 Recreation Building University Park, State College, PA, 16802, USA
| | - Sarah S Farrabi
- Goldfarb School of Nursing at Barnes-Jewish College, 4483 Duncan Ave, St. Louis, MO, 63110, USA
- Center for Human Nutrition, Washington University School of Medicine, 660 S. Euclid, St. Louis, MO, 63110, USA
| | - Jennifer L Huberty
- College of Health Solutions, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | - James F Paulson
- Department of Psychology, Old Dominion University, 5115 Terminal Blvd, Norfolk, VA, 23529, USA
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3
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Jahan AM, Anaiba SM. Exploring Antenatal Exercise: Knowledge, Attitudes, Practices, and Influencing Factors among Pregnant Women in Libya. ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2023; 12:27536351231212132. [PMID: 38029061 PMCID: PMC10644730 DOI: 10.1177/27536351231212132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Background Antenatal exercise is crucial in promoting pregnant women's health and well-being. However, no research in Libya examined the knowledge, attitudes, and practices of antenatal exercise among pregnant women. Methods This cross-sectional study aimed to explore the knowledge, attitudes, and practices related to antenatal exercise among pregnant women in Libya. A convenience sample of pregnant women (n = 205) receiving prenatal care at Misrata Medical Center and having no contraindication for exercise participated in the study. A self-administered, previously elaborated questionnaire was used to assess participants' awareness, knowledge, attitudes, and practice of antenatal exercise. Descriptive statistics and binary logistic regression analysis were employed using SPSS version 28. Results The findings revealed that nearly half of the participants demonstrated good knowledge (56.1%) and a positive attitude (47.8%) regarding antenatal exercise. Less than one-third (30.2%) of participants engaged in some form of exercise during pregnancy. The logistic regression results showed that age, income, and practice of exercise before pregnancy significantly contributed to the knowledge score. The analysis indicated that the unemployment status (AOR = 2.42, 95% CI [0.78-6.38], P = .03) and practicing exercise before pregnancy (AOR = 1.97, 95% CI [0.92-4.24], P = .02) were significantly associated with a higher likelihood of engaging in antenatal exercise. The main subjective reasons for pregnant women not engaging in antenatal exercise were lack of time, poor knowledge, fatigue, and worries about harming the baby. Conclusion This study sheds light on the current state of antenatal exercise among pregnant women in Libya and highlights the factors shaping these behaviors. The findings underscore the importance of promoting accurate knowledge, addressing misconceptions, and providing support and resources to overcome barriers and encourage safe and effective antenatal exercise practices in Libya. Future studies should consider employing qualitative or mixed methods research designs to examine antenatal exercise from different perspectives.
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Affiliation(s)
- Alhadi M Jahan
- Physiotherapy Department, College of Medical Technology, Misrata, Libya
| | - Salima M Anaiba
- Physiotherapy Department, College of Medical Technology, Misrata, Libya
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Knudsen SDP, Roland CB, Alomairah SA, Jessen AD, Molsted S, Clausen TD, Løkkegaard E, Stallknecht B, Bønnelycke J, Bendix JM, Maindal HT. Physical activity in pregnancy: a mixed methods process evaluation of the FitMum randomised controlled trial interventions. BMC Public Health 2022; 22:2283. [PMID: 36474181 PMCID: PMC9724308 DOI: 10.1186/s12889-022-14717-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Physical activity (PA) at moderate intensity is recommended for healthy pregnant women. The three-arm FitMum randomised controlled trial showed that it was possible to increase PA level during pregnancy with structured supervised exercise training (EXE) compared to standard care. Motivational counselling on PA (MOT) did not increase PA. This process evaluation aims to understand the implementation and mechanisms of impact of EXE and MOT. METHODS A mixed methods process evaluation was conducted using the UK Medical Research Council's process evaluation framework by assessing implementation (reach, fidelity, and dose) and mechanisms of impact of the two interventions provided to pregnant women in FitMum. Data was collected both quantitatively (n = 220) and qualitatively (n = 20). RESULTS The FitMum trial reached educated pregnant women (80% having an educational level ≥ bachelor's degree) with high autonomy of everyday life. Most participants (58%) were recruited at their first-trimester ultrasonic scan. Reasons to participate were personal (91%) and altruistic (56%). The intervention dose was delivered as intended with high fidelity in the original physical intervention setup and in the altered online setup during the COVID-19 restrictions. A low dose received in EXE (1.3 [95% CI, 1.1; 1.5] sessions/week) was partly explained by the pre-scheduled EXE sessions favouring participants with a flexible everyday life and a supportive social network. Dose received in EXE increased during online intervention delivery. Participants in MOT received 5.2 [4.7; 5.7] of 7 sessions. Mechanisms of impact comprised a perception of intervention commitment among participants in EXE due to the scheduled EXE sessions, whereas participants in MOT considered themselves as PA self-determined. PA was considered as constrained activities in EXE and included in daily activities in MOT. CONCLUSION The FitMum interventions was delivered with high fidelity. During COVID-19, the dose received in EXE increased compared to the previous physical setup. Mechanisms of impact as commitment, perception of empowerment and perception of PA as well as the paradox between prioritising PA and family and the need of a flexible everyday life need to be considered when offering pregnant women PA interventions. Future interventions should consider a combination of physical and online exercise training for pregnant women.
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Affiliation(s)
- Signe de Place Knudsen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark. .,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Caroline Borup Roland
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Anne Dsane Jessen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tine D Clausen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Bønnelycke
- Department of Visual Culture and Performance Design, Roskilde University, Roskilde, Denmark
| | - Jane M Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.,Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center Copenhagen, Herlev, Denmark
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5
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Knudsen SDP, Alomairah SA, Roland CB, Jessen AD, Hergel IM, Clausen TD, Larsen JE, van Hall G, Jensen AK, Molsted S, Bendix JM, Løkkegaard E, Stallknecht B. Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women's Physical Activity Level: FitMum - Randomized Controlled Trial. J Med Internet Res 2022; 24:e37699. [PMID: 35857356 PMCID: PMC9350815 DOI: 10.2196/37699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/18/2022] [Accepted: 05/31/2022] [Indexed: 02/06/2023] Open
Abstract
Background Physical activity (PA) during pregnancy is an effective and safe way to improve maternal health in uncomplicated pregnancies. However, compliance with PA recommendations remains low among pregnant women. Objective The purpose of this study was to evaluate the effects of offering structured supervised exercise training (EXE) or motivational counseling on PA (MOT) during pregnancy on moderate-to-vigorous intensity physical activity (MVPA) level. Additionally, complementary measures of PA using the Pregnancy Physical Activity Questionnaire (PPAQ) and gold standard doubly labeled water (DLW) technique were investigated. The hypotheses were that both EXE and MOT would increase MVPA in pregnancy compared with standard care (CON) and that EXE would be more effective than MOT. In addition, the association between MVPA and the number of sessions attended was explored. Methods A randomized controlled trial included 220 healthy, inactive pregnant women with a median gestational age of 12.9 (IQR 9.4-13.9) weeks. A total of 219 women were randomized to CON (45/219), EXE (87/219), or MOT (87/219). The primary outcome was MVPA (minutes per week) from randomization to the 29th gestational week obtained by a wrist-worn commercial activity tracker (Vivosport, Garmin International). PA was measured by the activity tracker throughout pregnancy, PPAQ, and DLW. The primary outcome analysis was performed as an analysis of covariance model adjusting for baseline PA. Results The average MVPA (minutes per week) from randomization to the 29th gestational week was 33 (95% CI 18 to 47) in CON, 50 (95% CI 39 to 60) in EXE, and 40 (95% CI 30 to 51) in MOT. When adjusted for baseline MVPA, participants in EXE performed 20 (95% CI 4 to 36) minutes per week more MVPA than participants in CON (P=.02). MOT was not more effective than CON; EXE and MOT also did not differ. MVPA was positively associated with the number of exercise sessions attended in EXE from randomization to delivery (P=.04). Attendance was higher for online (due to COVID-19 restrictions) compared with physical exercise training (P=.03). Adverse events and serious adverse events did not differ between groups. Conclusions Offering EXE was more effective than CON to increase MVPA among pregnant women, whereas offering MOT was not. MVPA in the intervention groups did not reach the recommended level in pregnancy. Changing the intervention to online due to COVID-19 restrictions did not affect MVPA level but increased exercise participation. Trial Registration ClinicalTrials.gov NCT03679130; https://clinicaltrials.gov/ct2/show/NCT03679130 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-043671
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Affiliation(s)
- Signe de Place Knudsen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Caroline Borup Roland
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Dsane Jessen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida-Marie Hergel
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Tine D Clausen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Eg Larsen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Gerrit van Hall
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Biochemistry, Clinical Metabolomics Core Facility, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Kryger Jensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Stig Molsted
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Jane M Bendix
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Ellen Løkkegaard
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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6
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Hinkle SN, Li M, Grewal J, Yisahak SF, Grobman WA, Newman RB, Wing DA, Grantz KL, Zhang C. Changes in Diet and Exercise in Pregnant Women after Diagnosis with Gestational Diabetes: Findings from a Longitudinal Prospective Cohort Study. J Acad Nutr Diet 2021; 121:2419-2428.e4. [PMID: 34023277 PMCID: PMC8599498 DOI: 10.1016/j.jand.2021.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Lifestyle changes are recommended for women diagnosed with gestational diabetes mellitus (GDM), yet there are few data available documenting whether women change their diet and exercise after GDM diagnosis. OBJECTIVE The aim of this study was to assess whether, and to what extent, pregnant women receiving usual prenatal care change their diet and exercise after a GDM diagnosis. DESIGN This study was a post-hoc secondary analysis using data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons (2009-2013), a prospective pregnancy cohort study. PARTICIPANTS/SETTING Pregnant US women without major chronic medical conditions were enrolled from 12 participating hospital centers at 8 to 13 weeks' gestation. Diet analyses were based on 5,194 dietary recalls from 1,371 women. Exercise analyses were based on 6,440 physical activity assessments from 1,875 women. GDM was ascertained from medical records according to Carpenter and Coustan criteria. Women completed 24-hour dietary recalls and exercise assessments at weeks 16 to 22, 24 to 29, 30 to 33, 34 to 37, and 38 to 41 (exercise only). MAIN OUTCOME MEASURES The main outcome was the diet and exercise change from before to after GDM diagnosis or screening. STATISTICAL ANALYSES Diet and exercise changes with 95% CIs from before to after GDM diagnosis or screening for women with and without GDM were estimated using weighted multivariable linear mixed models. RESULTS Women with GDM (n = 72) significantly reduced their total energy intake (-184 kcal/d; 95% CI -358 to -10 kcal/d) and carbohydrate intake (-47.6 g/d; 95% CI -71.4 to -23.7 g/d) from before to after GDM diagnosis; these changes were unique to women with GDM and not observed among women without GDM (n = 1,299). Women with GDM decreased intakes of juice (-0.4 cups/d; 95% CI -0.7 to -0.2 cups/d) and added sugar (-3.2 teaspoons/d; 95% CI -5.5 to -0.5 teaspoons/d) and increased cheese (0.3 cups/d; 95% CI 0.1 to 0.6 cups/d) and artificially sweetened beverages (0.2 cups/d; 95% CI 0.0 to 0.3 cups/d). Women with GDM (n = 84) did not change their exercise duration after diagnosis; women without GDM (n = 1,791) significantly decreased moderate (-19.5 min/wk; 95% CI -24.7 to -14.3 min/wk) and vigorous exercise (-8.8 min/wk; 05% CI -10.6 to -6.9 min/wk) after GDM screening. CONCLUSIONS Women with GDM made modest dietary improvements and maintained their prediagnosis exercise routine, yet opportunities remain to further improve dietary intake and exercise after a diagnosis of GDM.
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Affiliation(s)
- Stefanie N Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
| | - Mengying Li
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Jagteshwar Grewal
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Samrawit F Yisahak
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - William A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Roger B Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - Deborah A Wing
- Korn Ferry, Los Angeles, CA; Department of Obstetrics-Gynecology, University of California, Irvine, School of Medicine, Orange, CA; Miller Children' s and Women's Hospital Long Beach/Long Beach Memorial Medical Center, Long Beach, CA
| | - Katherine L Grantz
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
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7
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Women's Usage Behavior and Perceived Usefulness with Using a Mobile Health Application for Gestational Diabetes Mellitus: Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126670. [PMID: 34205744 PMCID: PMC8296439 DOI: 10.3390/ijerph18126670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022]
Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing, and only a few mobile health (mHealth) applications are specifically designed to manage GDM. In this mixed-methods study, a follow-up study of a randomized controlled trial (RCT) analyzed a largely automated mHealth application-based lifestyle coaching program to (a) measure the application's usage behavior and (b) explore users' perceptions of its usefulness in GDM management. Quantitative data were collected from the 170 application users who had participated in the intervention arm of the RCT. Semi-structured interviews (n = 14) captured users' experiences when using the application. Data were collected from June 2019 to January 2020. Quantitative data were analyzed descriptively, and interviews were analyzed thematically. Only 57/170 users (34%) logged at least one meal, and only 35 meals on average were logged for eight weeks because of the incorrectly worded food items and limited food database. On the contrary, an average of 1.85 (SD = 1.60) weight values were logged per week since the weight tracking component was easy to use. Many users (6/14 (43%)) mentioned that the automatic coach messages created an immediate sense of self-awareness in food choices and motivated behavior. The findings suggest that for GDM management, a largely automated mHealth application has the potential to promote self-awareness of healthy lifestyle choices, reducing the need for intensive human resources. Additionally, several gaps in the application's design were identified which need to be addressed in future works.
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8
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Lü Y, Feng Y, Ma S, Jiang Y, Ma L. Changes in physical activity across pregnancy among Chinese women: a longitudinal cohort study. BMC WOMENS HEALTH 2021; 21:236. [PMID: 34092212 PMCID: PMC8183053 DOI: 10.1186/s12905-021-01377-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/27/2021] [Indexed: 11/11/2022]
Abstract
Background Sufficient physical activity (PA) during pregnancy is beneficial for a woman’s health; however, the PA levels of Chinese women at different pregnancy stages are not clear. The aim of our study was to investigate PA changes during pregnancy and the association of population characteristics with PA change among Chinese women. Methods Data were obtained from 2485 participants who were enrolled in the multicentre prospective Chinese Pregnant Women Cohort Study. PA level was assessed in early pregnancy (mean = 10, 5–13 weeks of gestation) and again in mid-to-late pregnancy (mean = 32, 24–30 weeks of gestation) using the International Physical Activity Questionnaire short form (IPAQ-SF). Sufficient PA (≥ 600 MET min/week) in early pregnancy and insufficient PA in mid-to-late pregnancy indicated decreasing PA. Insufficient PA in early pregnancy and sufficient PA in mid-to-late pregnancy indicated increasing PA. The associations between demographic, pregnancy and health characteristics and PA changes were examined by multivariable logistic regression. Results Total energy expenditure for PA increased significantly from early (median = 396 MET min/week) to mid-to-late pregnancy (median = 813 MET min/week) (P < 0.001), and 55.25% of the participants eventually had sufficient PA. Walking was the dominant form of PA. Women with sufficient PA levels in early pregnancy were more likely to have sufficient PA in mid-to-late pregnancy (OR 1.897, 95% CI 1.583–2.274). Women in West China and those in Central China were most and least likely, respectively, to have increasing PA (OR 1.387, 95% CI 1.078–1.783 vs. OR 0.721, 95% CI 0.562–0.925). Smoking was inversely associated with increasing PA (OR 0.480, 95% CI 0.242–0.955). Women with higher educational levels were less likely to have decreasing PA (OR 0.662, 95% CI 0.442–0.991). Conclusions PA increased as pregnancy progressed, and walking was the dominant form of PA among Chinese women. Further research is needed to better understand correlates of PA change. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01377-3.
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Affiliation(s)
- Yan Lü
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, 100730, Beijing, People's Republic of China
| | - Yahui Feng
- School of Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Shuai Ma
- School of Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, 100730, Beijing, People's Republic of China.
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9
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Dieberger AM, van Poppel MNM, Watson ED. Baby Steps: Using Intervention Mapping to Develop a Sustainable Perinatal Physical Activity Healthcare Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5869. [PMID: 34070723 PMCID: PMC8198094 DOI: 10.3390/ijerph18115869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022]
Abstract
While the benefits of physical activity (PA) during and after pregnancy have been established, many women do not reach the recommended PA levels during this time. A major barrier found in the literature is a lack of counselling by healthcare providers (HCPs), which is partly caused by the limited knowledge on the topic. The aim of this study was to develop an intervention to improve the promotion of PA by HCPs. We used Intervention Mapping (IM), a theory-based framework to develop an intervention, called "Baby steps", in a high-income (Austria) and a low-to-middle-income country (South Africa). We applied the following IM steps: (1) A needs assessment to determine the barriers and enablers of PA promotion by HCPs, including a scoping literature review and community needs assessments (qualitative interviews, questionnaires, and focus groups with midwives, obstetricians, and community health workers) to determine the desired outcomes of the intervention. (2) Performance and change objectives were formulated, describing the behaviors that need to change for the intervention to succeed. (3) Based on these objectives, theory-based behavior change techniques were selected, and practical applications were developed. (4) The applications were combined into two evidence-based interventions tailored to each country's needs. Step (5) and (6) consist of an implementation and evaluation plan, respectively. The intervention is aimed at HCPs, such as midwives and community health workers, consisting of a two-day training course, including practical resources. Combining didactic and interactive education, it addresses both PA knowledge and the skills needed to transfer knowledge and facilitate behavior change. In the future, the intervention's effect on women's activity levels during and after pregnancy needs to be studied.
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Affiliation(s)
- Anna M. Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Mireille N. M. van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Mozartgasse 14, 8010 Graz, Austria;
| | - Estelle D. Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 27 St. Andrews Road, Parktown, Johannesburg 2193, South Africa;
- Department of Exercise Sciences, Faculty of Science, The University of Auckland, Building 907, Suiter Street, Newmarket, Auckland 1142, New Zealand
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10
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Roland CB, Knudsen SDP, Alomairah SA, Andersen AD, Bendix J, Clausen TD, Molsted S, Jensen AK, Teilmann G, Jespersen AP, Larsen JE, Hall GV, Andersen E, Barrès R, Mortensen OH, Maindal HT, Tarnow L, Løkkegaard ECL, Stallknecht B. Structured supervised exercise training or motivational counselling during pregnancy on physical activity level and health of mother and offspring: FitMum study protocol. BMJ Open 2021; 11:e043671. [PMID: 33741668 PMCID: PMC7986889 DOI: 10.1136/bmjopen-2020-043671] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/30/2020] [Accepted: 02/25/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION A physically active lifestyle during pregnancy improves maternal and offspring health but can be difficult to follow. In Denmark, less than 40% of pregnant women meet physical activity (PA) recommendations. The FitMum study aims to explore strategies to increase PA during pregnancy among women with low PA and assess the health effects of PA. This paper presents the FitMum protocol, which evaluates the effects of structured supervised exercise training or motivational counselling supported by health technology during pregnancy on PA level and health of mother and offspring. METHODS AND ANALYSIS A single-site three-arm randomised controlled trial that aims to recruit 220 healthy, pregnant women with gestational age (GA) no later than week 15 and whose PA level does not exceed one hour/week. Participants are randomised to one of three groups: structured supervised exercise training consisting of three weekly exercise sessions, motivational counselling supported by health technology or a control group receiving standard care. The interventions take place from randomisation until delivery. The primary outcome is min/week of moderate-to-vigorous intensity PA (MVPA) as determined by a commercial activity tracker, collected from randomisation until GA of 28 weeks and 0-6 days, and the secondary outcome is gestational weight gain (GWG). Additional outcomes are complementary measures of PA; clinical and psychological health parameters in participant, partner and offspring; analyses of blood, placenta and breastmilk samples; process evaluation of interventions; and personal understandings of PA. ETHICS AND DISSEMINATION The study is approved by the Danish National Committee on Health Research Ethics (# H-18011067) and the Danish Data Protection Agency (# P-2019-512). Findings will be disseminated via peer-reviewed publications, at conferences, and to health professionals via science theatre performances. TRIAL REGISTRATION NUMBER NCT03679130. PROTOCOL VERSION This paper was written per the study protocol version 8 dated 28 August 2019.
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Affiliation(s)
- Caroline Borup Roland
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark
| | - Signe de Place Knudsen
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Anne Dsane Andersen
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark
| | - Jane Bendix
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark
| | - Tine D Clausen
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjaellands Hospital, Hillerod, Denmark
| | - Andreas Kryger Jensen
- Department of Clinical Research, Nordsjaellands Hospital, Hillerod, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Grete Teilmann
- Department of Paediatrics, Nordsjaellands Hospital, Hillerod, Denmark
| | - Astrid Pernille Jespersen
- The Saxo Institute, University of Copenhagen, Centre for Health Research in the Humanities, Copenhagen, Denmark
| | - Jakob Eg Larsen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | - Gerrit van Hall
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Clinical Metabolomics Core Facility, Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Emil Andersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Romain Barrès
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Ole Hartvig Mortensen
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus Universitet, Aarhus, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Lise Tarnow
- Steno Diabetes Center Copenhagen, Holbaek, Denmark
| | - Ellen Christine Leth Løkkegaard
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
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11
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Physical Activity Based on the BASNEF Model Constructs in Women with a Child Less Than Two Years of Age. Asian J Sports Med 2021. [DOI: 10.5812/asjsm.107700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Lack of physical activity plays an important role in increasing blood pressure, diabetes, elevated lipids, and obesity. Postpartum women are at risk for low physical activity. Objectives: The aim of this study was to determine the status of physical activity based on beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model constructs at the postpartum period in women attending the centers of comprehensive health services. Methods: This cross-sectional study was performed on 217 randomly selected mothers who had a child less than 2 years of age in Sanandaj, Kurdistan Province, northwest of Iran. A researcher-made questionnaire including demographic information and BASNEF model components was used to collect the data. Data were analyzed in SPSS software version 22 and using Pearson’s correlation coefficient, multiple linear regression, and logistic regression. Results: Results showed that 89% of mothers had low or no physical activity. According to the findings, despite the fact that all three components of knowledge, attitude, and subjective norms somewhat predicted the intention to engage in physical activity, the predictive ability of the subjective norms with a correlation coefficient of 0.34 was statistically significant (P < 0.001) in predicting the mother’s physical activity. Conclusions: The results of this study showed that the level of physical activity of studied women after childbirth was undesirable. Designing and implementing interventions by health managers and providers to change women’s behavior and encouraging them to do physical activity is necessary.
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12
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Yew TW, Chi C, Chan SY, van Dam RM, Whitton C, Lim CS, Foong PS, Fransisca W, Teoh CL, Chen J, Ho-Lim ST, Lim SL, Ong KW, Ong PH, Tai BC, Tai ES. A Randomized Controlled Trial to Evaluate the Effects of a Smartphone Application-Based Lifestyle Coaching Program on Gestational Weight Gain, Glycemic Control, and Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus: The SMART-GDM Study. Diabetes Care 2021; 44:456-463. [PMID: 33184151 PMCID: PMC7818327 DOI: 10.2337/dc20-1216] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/04/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE SMART-GDM examined whether Habits-GDM, a smartphone application (app) coaching program, can prevent excessive gestational weight gain (EGWG) and improve glycemic control and maternal and neonatal outcomes in gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS In this randomized controlled trial, women diagnosed with GDM between 12 and 30 weeks were randomly assigned to usual care (control) or to additional support from Habits-GDM that integrated dietary, physical activity, weight, and glucose monitoring (intervention). The primary outcome was the proportion of participants with EGWG. Secondary outcomes included absolute gestational weight gain (GWG), glycemic control, and maternal, delivery, and neonatal outcomes. RESULTS In total, 340 women were randomized (170 intervention, 170 control; mean ± SD age 32.0 ± 4.2 years; mean BMI 25.6 ± 5.6 kg/m2). There were no statistically significant differences in the proportions of women with EGWG, absolute GWG, or maternal and delivery outcomes between experimental groups. Average glucose readings were lower in the intervention group (mean difference -0.15 mmol/L [95% CI -0.26; -0.03], P = 0.011) as were the proportions of glucose above targets (premeal: 17.9% vs. 23.3%, odds ratio 0.68 [95% CI 0.53; 0.87], P = 0.003; 2-h postmeal: 19.9% vs. 50%, 0.54 [0.42; 0.70], P < 0.001). When regarded as a composite (although not prespecified), the overall neonatal complications (including birth trauma, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress, neonatal intensive care unit admission, and perinatal death) were significantly lower in the intervention group (38.1% vs. 53.7%, 0.53 [0.34; 0.84], P = 0.006). CONCLUSIONS When added to usual care, Habits-GDM resulted in better maternal glycemic control and composite neonatal outcomes (nonprespecified) but did not reduce EGWG among women with GDM.
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Affiliation(s)
- Tong Wei Yew
- Department of Medicine, National University Hospital, Singapore .,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Claudia Chi
- Department of Obstetrics and Gynecology, National University Hospital, Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynecology, National University Hospital, Singapore.,Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Clare Whitton
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chang Siang Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Pin Sym Foong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Winni Fransisca
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chieu Leng Teoh
- Department of Nursing, National University Hospital, Singapore
| | - Jeannie Chen
- Department of Nursing, National University Hospital, Singapore
| | - Su Tin Ho-Lim
- Department of Nursing, National University Hospital, Singapore
| | - Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore
| | - Kai Wen Ong
- Department of Dietetics, National University Hospital, Singapore
| | | | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - E Shyong Tai
- Department of Medicine, National University Hospital, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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13
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Kawajiri M, Nakamura Y, Yoshida M, Takeishi Y, Masaki A, Iwasaki Y, Sato S, Kodera Y, Chiba K, Yoshizawa T. Acceptability and Feasibility of a Sedentary Behavior Reduction Program during Pregnancy: A Semi-Experimental Study. Healthcare (Basel) 2020; 8:healthcare8040439. [PMID: 33137900 PMCID: PMC7712505 DOI: 10.3390/healthcare8040439] [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: 10/04/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/03/2022] Open
Abstract
Physical activity (PA) during pregnancy is associated with maternal benefits. Therefore, innovative strategies that promote PA are needed. This study investigated the acceptability and feasibility of a sedentary behavior (SB) reduction program during pregnancy. The study employed a semi-experimental research design using historical control subjects. The intervention group program consisted of individual face-to-face guidance, automatic alerts during SB from wearable devices, and self-monitoring of SB patterns, from 20 gestation weeks to delivery. PA and SB, assessed using a wearable device, were compared with those of the control group at 24–27 (T1) and 32–35 (T2) weeks of gestation. In 56 women, the mean wearing time was 90.2 days in the intervention phase. The response rate to automatic SB alerts was 55.5% at T1 and 63.0% at T2. Self-monitoring more than twice or thrice a week was 77.8% at T1 and 59.3% at T2. There was no significant difference in the cumulative SB time at T2 between the two groups (F = 2.31, p = 0.132). This program appears to be acceptable and feasible for pregnant women; however, SB reduction effect of the intervention remains unclear. Improvements to increase the response rate to automatic SB alerts and the frequency of self-monitoring are needed.
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Affiliation(s)
- Maiko Kawajiri
- Department of Women’s Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 9808575, Japan; (Y.N.); (M.Y.); (Y.T.); (T.Y.)
- Correspondence: ; Tel.: +81-22-717-7933
| | - Yasuka Nakamura
- Department of Women’s Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 9808575, Japan; (Y.N.); (M.Y.); (Y.T.); (T.Y.)
| | - Mikako Yoshida
- Department of Women’s Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 9808575, Japan; (Y.N.); (M.Y.); (Y.T.); (T.Y.)
| | - Yoko Takeishi
- Department of Women’s Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 9808575, Japan; (Y.N.); (M.Y.); (Y.T.); (T.Y.)
| | - Ai Masaki
- Department of Nursing, Tohoku University Hospital, Sendai, Miyagi 9808575, Japan; (A.M.); (Y.I.); (S.S.); (Y.K.); (K.C.)
| | - Yuki Iwasaki
- Department of Nursing, Tohoku University Hospital, Sendai, Miyagi 9808575, Japan; (A.M.); (Y.I.); (S.S.); (Y.K.); (K.C.)
| | - Satomi Sato
- Department of Nursing, Tohoku University Hospital, Sendai, Miyagi 9808575, Japan; (A.M.); (Y.I.); (S.S.); (Y.K.); (K.C.)
| | - Yuri Kodera
- Department of Nursing, Tohoku University Hospital, Sendai, Miyagi 9808575, Japan; (A.M.); (Y.I.); (S.S.); (Y.K.); (K.C.)
| | - Kazumi Chiba
- Department of Nursing, Tohoku University Hospital, Sendai, Miyagi 9808575, Japan; (A.M.); (Y.I.); (S.S.); (Y.K.); (K.C.)
| | - Toyoko Yoshizawa
- Department of Women’s Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 9808575, Japan; (Y.N.); (M.Y.); (Y.T.); (T.Y.)
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14
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Al-Youbi GM, Elsaid T. Knowledge, attitude, and practices on exercise among pregnant females attending Al-Wazarat Health Center, Riyadh, Saudi Arabia. J Family Med Prim Care 2020; 9:3905-3915. [PMID: 33110786 PMCID: PMC7586593 DOI: 10.4103/jfmpc.jfmpc_276_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/19/2020] [Accepted: 03/26/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The consequences of physical inactivity during pregnancy are one of the major problems among pregnant women in Saudi. To explore the pattern of exercise and to know the beliefs and reasons for not doing physical activity (PA) emphasized the need for conducting this study. This study aimed to improve the level of knowledge and practice of PA among women during pregnancy. METHODS A cross-sectional study was performed using quota sampling. RESULTS 41.62% of pregnant women had high level of physical activity (PA) awareness and practice and 58.37% had a low level of awareness and practice. Statistical difference was found between the two groups in terms of parity, education level, work status, and family income. Pregnant women preferred walking as exercise. They are aware about PA benefits during pregnancy, but perceived that tiredness was the greatest barrier for physical activity. CONCLUSION This study recommends conducting well-designed intervention sessions to promote PA awareness and practice among pregnant women, especially those with low education, low income, and low number of children.
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Affiliation(s)
- Ghadi M. Al-Youbi
- Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh, KSA
| | - Tarek Elsaid
- Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh, KSA
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15
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James P, Morgant R, Merviel P, Saraux A, Giroux-Metges MA, Guillodo Y, Dupré PF, Muller M. How to promote physical activity during pregnancy : A systematic review. J Gynecol Obstet Hum Reprod 2020; 49:101864. [PMID: 32663651 DOI: 10.1016/j.jogoh.2020.101864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/02/2020] [Accepted: 07/04/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Sedentary lifestyles and physical inactivity have been shown to increase during pregnancy and are a cause of obstetric comorbidity. The objective of this study was to conduct a systematic review of interventions aiming to promote physical activity during pregnancy. MATERIAL AND METHODS Databases were searched from January 2008 to September 2019. Selection criteria included randomized controlled trials evaluating the efficacy of interventions promoting physical activity during pregnancy. RESULTS In total, 256 articles were extracted from databases. 202 articles were excluded. Finally, 15 articles were included in the study. 5633 patients were included from various populations. Six studies rated physical activity (PA) as the primary outcome. Five studies suggested promoting physical activity through individual interviews which in two studies showed an increase in PA. Three studies evaluated an intervention based on group interviews and one of these reported a significant increase in PA. Two studies evaluated the use of a Smartphone application to promote physical activity but they did not conclude that they were effective because they were designed with low statistical power. CONCLUSION The practice of regular PA during pregnancy reduces obstetrical comorbidity. However, interventions seem to have a low impact on the promotion of PA during pregnancy. New intervention strategies need to assessed, such as the use of mobile health interventions.
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Affiliation(s)
- P James
- JAMES Pandora, Resident, Centre Hospitalier Universitaire Brest, France.
| | - R Morgant
- Dr MORGANT Romain, Cabinet de traumatologie du TER, Clinique du TER, 56270, Ploemeur, France
| | - P Merviel
- Pr MERVIEL Philippe, Service de Gynécologie-Obstétrique et Médecine de la reproduction, CHRU Brest - Hôpital Morvan, France
| | - A Saraux
- Pr SARAUX Alain, Service de Rhumatologie, Hôpital de la Cavale Blanche, CHRU Brest, France
| | - M A Giroux-Metges
- Pr GIROUX-METGES Marie-Agnès, Service des EFR, Hôpital de la Cavale Blanche, CHRU Brest, France
| | - Y Guillodo
- Dr GUILLODO Yannick, Service de Rhumatologie, CHRU Brest, France
| | - P F Dupré
- Dr DUPRE Pierre-François, Chirurgie Oncologique Gynécologique et mammaire, CHRU Brest, France
| | - M Muller
- Dr MULLER Matthieu, Service Gynécologie-Obstétrique, Centre Hospitalier des Pays de Morlaix, France
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16
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Lee CF, Huang YC, Wen FH, Lin CJ, Chi LK, Chang CW. Effectiveness of individual face-to-face exercise counselling in changing exercise behaviours to relieve symptom distress in pregnant women. Int J Nurs Pract 2020; 26:e12837. [PMID: 32314501 DOI: 10.1111/ijn.12837] [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: 09/27/2019] [Revised: 01/14/2020] [Accepted: 03/13/2020] [Indexed: 12/30/2022]
Abstract
AIM The present study aimed to evaluate the effectiveness of individualized exercise counselling in changing exercise behaviour and relieving pregnancy-related distress symptoms in pregnant women. METHODS A quasi-experimental design and convenience sampling technique were used. Participants were recruited from the prenatal outpatient departments of medical centre hospitals in Taipei, Taiwan. The experimental group (n = 52) received face-to-face exercise counselling followed by 8 weeks of exercise sessions in their homes. The control group (n = 49) received no exercise counselling. Pregnancy-related distress symptoms were assessed before and after 8 weeks in both groups. RESULTS The after-counselling scores of total (t = 2.46, P < 0.05) and physical (t = 3.18, P < 0.01) distress symptoms were significantly lower than the before-counselling scores in the experimental group. The total, physical and psychological distress scores significantly differed between groups and before and after counselling. The adjusted R2 values for total, physical and psychological distress symptoms ranged from 0.59 to 0.70. Participants' exercise habits increased from prepregnancy (19.2%) to after counselling (71.2%). CONCLUSION Exercise counselling may effectively increase exercise habits and reduce pregnancy-related distress symptoms among pregnant women. Women with higher pretest symptom distress scores also had higher posttest symptom distress scores. Based on our outcomes, health care providers should routinely provide exercise counselling to pregnant women.
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Affiliation(s)
- Ching-Fang Lee
- Department of Nursing, Mackay Medical College, New Taipei, Taiwan
| | - Yao-Chung Huang
- Physical Education Office, National Taipei University of Technology, Taipei, Taiwan
| | - Fur-Hsing Wen
- Department of International Business, Soochow University, Taipei, Taiwan
| | - Chen-Ju Lin
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei, Taiwan
| | - Li-Kang Chi
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chun-Wei Chang
- Department of Psychiatry, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
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17
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Connolly CP, Conger SA, Montoye AH, Marshall MR, Schlaff RA, Badon SE, Pivarnik JM. Walking for health during pregnancy: A literature review and considerations for future research. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:401-411. [PMID: 31534815 PMCID: PMC6742678 DOI: 10.1016/j.jshs.2018.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/12/2018] [Accepted: 08/31/2018] [Indexed: 05/04/2023]
Abstract
Walking is the most commonly chosen type of physical activity (PA) during pregnancy and provides several health benefits to both mother and child. National initiatives have promoted the importance of walking in general, but little emphasis is directed toward pregnant women, the majority of whom are insufficiently active. Pregnant women face a variety of dynamic barriers to a physically active lifestyle, some of which are more commonly experienced during specific times throughout the pregnancy experience. Walking is unique in that it appears resistant to a number of these barriers that limit other types of PA participation, and it can be meaningfully integrated into some transportation and occupational activities when leisure-time options are unavailable. Preliminary intervention work suggests that walking programs can be effectively adopted into a typical pregnancy lifestyle. However, a great deal of work remains to administer successful pregnancy walking interventions, including developing and using validated methods of PA and walking assessment. This narrative review discusses the unique advantages of walking during pregnancy, provides recommendations for future intervention work, and outlines the need for pregnancy-focused community walking initiatives. Standard search procedures were followed to determine sources from the literature specific to walking during pregnancy for use in each section of this review.
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Affiliation(s)
- Christopher P. Connolly
- Kinesiology Program, Washington State University, Pullman, WA 99164-1410, USA
- Corresponding Author.
| | - Scott A. Conger
- Department of Kinesiology, Boise State University, Boise, ID 83725, USA
| | - Alexander H.K. Montoye
- Department of Integrative Physiology and Health Science, Alma College, Alma, MI 48801, USA
| | | | - Rebecca A. Schlaff
- Department of Kinesiology, Saginaw Valley State University, University Center, MI 48710, USA
| | - Sylvia E. Badon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - James M. Pivarnik
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824-1034, USA
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18
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Garland M, Wilbur J, Semanik P, Fogg L. Correlates of Physical Activity During Pregnancy: A Systematic Review with Implications for Evidence‐based Practice. Worldviews Evid Based Nurs 2019; 16:310-318. [DOI: 10.1111/wvn.12391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Louis Fogg
- Rush University College of Nursing Chicago IL USA
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19
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Parent-Vachon M, Beaudry F, Carrier D, Di Cristo G, Vachon P. The Effects of Exercise on Pain and Reproductive Performance in Female Pregnant Mice With Neuropathic Pain. Biol Res Nurs 2019; 21:500-509. [PMID: 31288563 DOI: 10.1177/1099800419857812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Pain can have negative, physiological and psychological impacts on pregnancy. Pregnant women are fearful of using pain medication because of teratogenic effects. In this study, we evaluated whether exercise could lower pain sensitivity in pregnant mice with neuropathic pain and reduce the negative effects of maternal pain on newborns. We randomly assigned 32 female mice to one of four groups (eight mice/group): Sham surgery with standard environment (SE) or enriched environment (EE) or spare nerve injury (SNI) with SE or EE. Mice in EE groups had access to an exercise wheel. Mothers were evaluated for mechanical sensitivity with Von Frey filaments and for exercise performance with computerized running wheels. Mice were impregnated 2 weeks after the initiation of EE. Pups were weighed and measured for length at birth and evaluated for negative geotaxis, righting, forelimb grasping, rooting, and crawling at 3 days postpartum and for crawling at 6 days postpartum. Following euthanasia, mothers' frontal cortexes were analyzed for selected neuropeptides. After exercise exposure, only SNI-SE females remained neuropathic. Exercise levels were similar between EE groups. Some brain neuropeptides (endorphins, enkephalins, and oxytocin) from SNI females showed significant differences with exercise. Number of pups was significantly smaller in the SNI-SE group. Significantly more pups died at birth in the SNI-SE group, but pup behavior tests (except righting) were similar across groups. Exercise can reduce neuropathic pain in pregnant mice. Neuropathic pain does not impact motor neurodevelopment of mice pups but does appear to affect litter size and neonatal mortality.
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Affiliation(s)
- Madeleine Parent-Vachon
- 1 Department of Veterinary Biomedicine, Faculty of Veterinary Medicine, Saint-Hyacinthe, Quebec, Canada
| | - Francis Beaudry
- 1 Department of Veterinary Biomedicine, Faculty of Veterinary Medicine, Saint-Hyacinthe, Quebec, Canada
| | - Denise Carrier
- 2 Ste-Justine Children's Hospital Research Center, University of Montreal, Montreal, Quebec, Canada
| | - Graziella Di Cristo
- 2 Ste-Justine Children's Hospital Research Center, University of Montreal, Montreal, Quebec, Canada
| | - Pascal Vachon
- 1 Department of Veterinary Biomedicine, Faculty of Veterinary Medicine, Saint-Hyacinthe, Quebec, Canada
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20
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Flannery C, Dahly D, Byrne M, Khashan A, McHugh S, Kenny LC, McAuliffe F, Kearney PM. Social, biological, behavioural and psychological factors related to physical activity during early pregnancy in the Screening for Pregnancy Endpoints (Cork, Ireland) cohort study. BMJ Open 2019; 9:e025003. [PMID: 31227527 PMCID: PMC6596951 DOI: 10.1136/bmjopen-2018-025003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the social, biological, behavioural and psychological factors related to physical activity (PA) in early pregnancy. DESIGN This is a secondary analysis of data from a prospective cohort study. SETTING The study was conducted in Cork, Ireland. PARTICIPANTS Nulliparous women with singleton pregnancies were recruited and then interviewed at 15±1 weeks' gestation. PRIMARY AND SECONDARY OUTCOMES The biopsychosocial model identified factors including social (age), biological (body mass index), behavioural (diet) and psychological (anxiety) at 15±1 weeks' gestation. PA subgroups were identified based on a latent class analysis of their responses to a set of questions about the amount and intensity of activity they were engaging in during the pregnancy. Associations were estimated with multivariable multinomial logistic regression models. RESULTS From a total of 2579, 1774 (69%) women were recruited; ages ranged from 17 to 45 years. Based on a combination of model fit, theoretical interpretability and classification quality, the latent class analyses identified three PA subgroups: low PA (n=393), moderate PA (n=960) and high PA (n=413). The fully adjusted model suggests non-smokers, and consumers of fruit and vegetables were more likely to be in the high PA subgroup (vs low). Women with more than 12 years of schooling and a higher socioeconomic status were more likely to be in the moderate PA subgroup (vs low). CONCLUSION The findings highlight potential links between PA, a low education level and a low socioeconomic background. These factors should be considered for future interventions to improve low PA levels during pregnancy. TRIAL REGISTRATION NUMBER ACTRN 12607000551493.
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Affiliation(s)
- Caragh Flannery
- School of Psychology, Health Behaviour Change Research Group, National University of Ireland Galway, Galway, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
- Health Research Board, Clinical Research Facility Cork, University College Cork, Cork, Ireland
| | - Molly Byrne
- School of Psychology, Health Behaviour Change Research Group, National University of Ireland Galway, Galway, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork, Cork, Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Louise C Kenny
- Department of Women’s and Children’s Health, University of Liverpool School of Life Sciences, Liverpool, UK
| | - Fionnuala McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, Dublin, Ireland
- National Maternity Hospital, University College Dublin, Dublin, Ireland
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21
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Hill B, Kothe EJ, Currie S, Danby M, Lang AY, Bailey C, Moran LJ, Teede H, North M, Bruce LJ, Skouteris H. A systematic mapping review of the associations between pregnancy intentions and health-related lifestyle behaviours or psychological wellbeing. Prev Med Rep 2019; 14:100869. [PMID: 31011520 PMCID: PMC6465583 DOI: 10.1016/j.pmedr.2019.100869] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/11/2019] [Accepted: 04/03/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to conduct a systematic mapping review of the literature that explored associations of pregnancy intentions with health-related lifestyle behaviours and psychological wellbeing before and during pregnancy. Six databases were searched (May 2017) for papers relating to pregnancy intentions, health-related lifestyle behaviours, and psychological wellbeing. The literature was mapped according to the preconception or pregnancy period; prospective or retrospective variable assessment; and reported lifestyle behaviours and psychological wellbeing outcomes. Of 19,430 retrieved records, 303 studies were eligible. Pregnancy intentions were considered during the preconception period in 103 studies (only 23 assessed prospectively), and during the pregnancy period in 208 studies (141 prospectively). Associations between pregnancy intention and preconception behaviours/psychological wellbeing were primarily reported for supplement use (n = 58) and were lacking for diet/exercise, and psychological factors. For behaviours/psychological wellbeing during pregnancy, associations with pregnancy intention were focused on prenatal care (n = 79), depression (n = 61), and smoking (n = 56) and were lacking for diet/exercise. Only 7 studies assessed pregnancy intentions with a validated tool. Despite a large body of literature, there were several methodological limitations identified, namely assessment of pregnancy intentions with non-validated measures and the reliance on retrospective assessment. Future primary studies are needed to fill gaps in our understanding regarding energy-balance-related behaviours. Future studies (including reviews/meta-analyses) should take care to address the noted limitations to provide a comprehensive and accurate understanding of the relationships between pregnancy intentions and health-related lifestyle behaviours and psychological wellbeing before and during pregnancy. Reliance on the assessment of pregnancy intentions with non-validated measures Reliance on retrospective assessment Studies on preconception pregnancy intentions and diet/exercise lacking
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Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia.,School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Emily J Kothe
- School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Sinéad Currie
- Psychology, Faculty of Natural Sciences, University of Stirling, FK9 4LA, United Kingdom
| | - Meaghan Danby
- School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Adina Y Lang
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Madelon North
- School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Lauren J Bruce
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
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22
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Grym K, Niela-Vilén H, Ekholm E, Hamari L, Azimi I, Rahmani A, Liljeberg P, Löyttyniemi E, Axelin A. Feasibility of smart wristbands for continuous monitoring during pregnancy and one month after birth. BMC Pregnancy Childbirth 2019; 19:34. [PMID: 30654747 PMCID: PMC6337833 DOI: 10.1186/s12884-019-2187-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/10/2019] [Indexed: 12/31/2022] Open
Abstract
Background Smart wristbands enable the continuous monitoring of health parameters, for example, in maternity care. Understanding the feasibility and acceptability of these devices in an authentic context is essential. The aim of this study was to evaluate the feasibility of using a smart wristband to collect continuous activity, sleep and heart rate data from the beginning of the second trimester until one month postpartum. Methods The feasibility of a smart wristband was tested prospectively through pregnancy in nulliparous women (n = 20). The outcomes measured were the wear time of the device and the participants’ experiences with the smart wristband. The data were collected from the wristbands, phone interviews, questionnaires, and electronic patient records. The quantitative data were analyzed with hierarchical linear mixed models for repeated measures, and qualitative data were analyzed using content analysis. Results Participants (n = 20) were recruited at a median of 12.9 weeks of gestation. They used the smart wristbands for an average of 182 days during the seven-month study period. The daily use of the devices was similar during the second (17.9 h, 95% CI 15.2 to 20.7) and third trimesters (16.7 h, 95% CI 13.8 to 19.5) but decreased during the postpartum period (14.4 h, 95% CI 11.4 to 17.4, p = 0.0079). Participants who could not wear smart wristbands at work used the device 300 min less per day than did those with no use limitations. Eight of the participants did not wear the devices or wore them only occasionally after giving birth. Nineteen participants reported that the smart wristband did not have any permanent effects on their behavior. Problems with charging and synchronizing the devices, perceiving the devices as uncomfortable, or viewing the data as unreliable, and the fear of scratching their babies with the devices were the main reasons for not using the smart wristbands. Conclusions A smart wristband is a feasible tool for continuous monitoring during pregnancy. However, the daily use decreased after birth. The results of this study may support the planning of future studies and help with overcoming barriers related to the use of smart wristbands on pregnant women. Electronic supplementary material The online version of this article (10.1186/s12884-019-2187-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kirsi Grym
- Department of Nursing Science, University of Turku, FI-20014 University of Turku, Turku, Finland.
| | - Hannakaisa Niela-Vilén
- Department of Nursing Science, University of Turku, FI-20014 University of Turku, Turku, Finland
| | - Eeva Ekholm
- Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital, FI-20014 University of Turku, Turku, Finland
| | - Lotta Hamari
- Department of Nursing Science, University of Turku, FI-20014 University of Turku, Turku, Finland.,Faculty of Communication Sciences, University of Tampere, Tampere, Finland
| | - Iman Azimi
- Department of Future Technology, University of Turku, FI-20014 University of Turku, Turku, Finland
| | - Amir Rahmani
- Department of Computer Science, University of California, Irvine, USA.,Department of Computer Science, Institute of Computer Technology TU Wien, Vienna, Austria
| | - Pasi Liljeberg
- Department of Future Technology, University of Turku, FI-20014 University of Turku, Turku, Finland
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku, FI-20014 University of Turku, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, FI-20014 University of Turku, Turku, Finland
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23
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Ekelin M, Langeland Iversen M, Grønbæk Backhausen M, Hegaard HK. Not now but later - a qualitative study of non-exercising pregnant women's views and experiences of exercise. BMC Pregnancy Childbirth 2018; 18:399. [PMID: 30305060 PMCID: PMC6180661 DOI: 10.1186/s12884-018-2035-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that there are several physical and mental advantages of exercise during pregnancy. Despite this, the recommendations for exercise during pregnancy are poorly fulfilled. The aim of this study was to illuminate non-exercising pregnant women's views and experiences concerning exercise before and during pregnancy. METHOD The study had a qualitative design with an inductive approach and was analysed by content analysis. A total of 16 individual and face-to-face interviews were conducted with healthy pregnant women, mainly in the third trimester and living in Sweden. The participating women had not been exercising 3 months before pregnancy or during pregnancy. RESULTS The main category "Insurmountable now, but possible in the future" was based on the four categories: "Lost and lack of routines", "Feelings of inadequacy", "Having a different focus" and "Need for support". The women experienced that their lack of routines was a major barrier that prevented them from exercising. Other factors that contributed were, for example, pregnancy-related problems, long working days and prioritizing family life. The women described it as difficult to combine exercise with their focus on the pregnancy and they missed continuous support from the antenatal care provider. The women expressed a need for suggestions concerning exercise during pregnancy and follow-up on previous counselling, especially when pregnancy-related issues arose. Information about easily accessible alternatives or simple home exercises was requested. They felt immobile and were not satisfied with their inactivity and tried to partly compensate with everyday activities. The women identified the postpartum period as an important possibility for becoming more active, for their own sake, but also because they wanted to become role models for their children. CONCLUSION Continuous support during pregnancy is needed concerning exercise. Pregnancy is mostly a barrier that prevents exercise for this group of women but, at the same time, may be a motivator and a possibility for better health. As the result showed that these women were highly motivated to a life-style change post-pregnancy, it may be crucial to support previously non-exercising women postpartum.
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Affiliation(s)
- Maria Ekelin
- Department of Health Sciences, Lund University, PO Box 157, S-22100, Lund, Sweden.
| | - Mette Langeland Iversen
- The Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Mette Grønbæk Backhausen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,The Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Gynecology and Obstetrics, Zealand University Hospital, Sygehusvej 10, 4000, Roskilde, Denmark
| | - Hanne Kristine Hegaard
- Department of Health Sciences, Lund University, PO Box 157, S-22100, Lund, Sweden.,Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,The Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
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24
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Choi J, Fukuoka Y. Spousal influence on physical activity in physically inactive pregnant women: A cross-sectional study. Health Care Women Int 2017; 39:263-274. [PMID: 29116912 DOI: 10.1080/07399332.2017.1402333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Regular physical activity (PA) is recommended during pregnancy, but the prevalence of pregnant women who met the recommended level for PA is very low. In this descriptive study, we examined the association between spousal characteristics (belief, knowledge, social support, and PA level) and pregnant women's PA level in 18 couples living in the San Francisco Bay Area. Among other spousal characteristics, only spousal PA level was a significant predictor of pregnant women's PA level regardless of whether it was unadjusted or adjusted by spouses' age and body index mass (p = .01). Our finding shows a need to develop strategies to incorporate spousal support for PA.
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Affiliation(s)
- JiWon Choi
- a Institute for Health & Aging, Department of Social and Behavioral Sciences , School of Nursing, University of California , San Francisco , CA , USA
| | - Yoshimi Fukuoka
- b Institute for Health & Aging, Department of Physiological Nursing , School of Nursing, University of California , San Francisco , CA , USA
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25
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Santo EC, Forbes PW, Oken E, Belfort MB. Determinants of physical activity frequency and provider advice during pregnancy. BMC Pregnancy Childbirth 2017; 17:286. [PMID: 28870169 PMCID: PMC5583983 DOI: 10.1186/s12884-017-1460-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 08/21/2017] [Indexed: 02/03/2023] Open
Abstract
Background Our aims were to (1) describe the frequency of physical activity and prenatal healthcare provider advice about physical activity during pregnancy and (2) examine determinants and correlates of 3rd trimester physical activity and receipt of physical activity advice. Methods We analyzed data from the 2008 Pregnancy Risk Assessment Monitoring System. We studied 2669 women from North Carolina and Colorado with data on physical activity frequency in the 3 months prior to pregnancy and during the 3rd trimester and 1584 women from Oklahoma with data on provider advice regarding physical activity during pregnancy. Respondents reported physical activity, defined as 30 min or more of exercise/physical activity (excluding vocationally related activity), in in these categories: <1 day/week, 1-4 days/week, and ≥5 days/week. We defined adherence to American College of Obstetrics & Gynecology (ACOG) criteria as physical activity ≥5 days/week in the 3rd trimester. We performed logistic regression analyses weighted for sampling and adjusted for socio-demographic factors. Results Forty-two percent of women in North Carolina and Colorado reported 3rd trimester physical activity <1 day/week, 42% 1-4 days/week, 9% ≥5 days/week; 7% reported being told not to exercise. Seventy-two percent of women in Oklahoma reported receiving physical activity advice from a prenatal care provider. Low activity frequency (<1 day/week) prior to pregnancy was strongly associated with low likelihood of ACOG guideline adherence in the 3rd trimester (aOR 0.10, 95% CU 0.04, 0.30 vs. 1–4 days/week). Underweight women were more likely to adhere to ACOG guidelines than normal weight women (aOR 2.27, 95% CI 1.36, 3.79). Overweight women were more likely to receive physical activity advice (aOR 2.9, 95% CI 1.3, 6.3 vs. normal weight), but obese women were not (aOR 0.65, 95% CI 0.4, 1.2). Conclusions Few women meet ACOG guideline criteria for physical activity during pregnancy. Improving physical activity and weight status prior to pregnancy may improve activity levels during pregnancy. Nearly one third did not receive advice about physical activity during prenatal care. Obese women were no more likely to receive advice than their normal weight counterparts, indicating the need for targeted physical activity counseling in this population.
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Affiliation(s)
- Eilann C Santo
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA. .,Clinical Research Program, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
| | - Peter W Forbes
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Landmark Center 401 Park Drive Suite 401 East, Boston, MA, 02215, USA
| | - Emily Oken
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Mandy B Belfort
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
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26
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Rodríguez-Díaz L, Ruiz-Frutos C, Vázquez-Lara JM, Ramírez-Rodrigo J, Villaverde-Gutiérrez C, Torres-Luque G. Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour. ENFERMERIA CLINICA 2017; 27:271-277. [PMID: 28689647 DOI: 10.1016/j.enfcli.2017.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. METHOD A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. RESULTS Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. CONCLUSION A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery.
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Affiliation(s)
| | - Carlos Ruiz-Frutos
- Departamento de Sociología, Trabajo Social y Salud Pública, Universidad de Huelva, Huelva, España
| | | | | | | | - Gema Torres-Luque
- Facultad Ciencias de la Salud, Universidad de Granada, Granada, España
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27
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Lindqvist M, Lindkvist M, Eurenius E, Persson M, Mogren I. Change of lifestyle habits - Motivation and ability reported by pregnant women in northern Sweden. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:83-90. [PMID: 28844363 DOI: 10.1016/j.srhc.2017.07.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/08/2017] [Accepted: 07/04/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnant women are generally more motivated to change their lifestyle habits compared with non-pregnant women. However, the ability to change these habits depends on the motivation to change. This study describes pregnant women's self-reported motivation and ability to change lifestyle habits and their relation to body mass index (BMI), self-rated health, educational level and country of origin. METHODS This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant residents in Västerbotten County (northern Sweden) between 2011 and 2012. Chi-square test, two independent samples t-test and univariate and multivariate logistic regression were performed. RESULTS Most of the pregnant women (61.3%) were satisfied with their self-reported lifestyle habits irrespective of BMI, self-rated health, educational level, and country of origin. Many reported that they wanted to increase their physical activity, improve their dietary habits, and reduce their weight. In general, they estimated their ability to change their lifestyle habits as equal to their motivation of change. Women who reported a large or very large motivation to change their lifestyle habits were characterized by higher BMI and higher educational level. CONCLUSIONS Most of the participating pregnant women were satisfied with their lifestyle habits, although they reported being further motivated to change some of them. Health care professionals encountering fertile and pregnant women may have a unique opportunity to support and promote lifestyle changes, taking into account women's motivation for change. Future research should focus on factors that motivate pregnant women to change their lifestyle, explore barriers for change of lifestyle and how support best may be provided to pregnant women. In addition, studies on lifestyle and motivation for lifestyle change from non-Nordic countries are called for.
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Affiliation(s)
- Maria Lindqvist
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Sweden.
| | - Marie Lindkvist
- Department of Statistics, Umeå University, Sweden; Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden.
| | - Eva Eurenius
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden.
| | | | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Sweden.
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28
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Huberty JL, Buman MP, Leiferman JA, Bushar J, Hekler EB, Adams MA. Dose and timing of text messages for increasing physical activity among pregnant women: a randomized controlled trial. Transl Behav Med 2017; 7:212-223. [PMID: 27800565 PMCID: PMC5526801 DOI: 10.1007/s13142-016-0445-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Text4baby (T4b), a free nation-wide mobile health information service, delivers health-related text messages (SMS) to pregnant women. The objective of this study was to determine the effectiveness of physical activity (PA) specific SMS to improve PA in pregnant women (vs standard T4b) and the most effective dose/timing of PA-specific SMS to improve PA. Pregnant women (N = 80) were randomized to one of four groups that differed in frequency and time of SMS. The Fitbit™ Flex measured PA. Data were analyzed using mixed model analyses. There were no increases in PA regardless of frequency or time. Those that received six PA SMS/week had greater decreases in activity and greater increases in sedentary time. SMS may not be a "potent" enough strategy to improve PA. Future studies should explore a modified focus on behavior change (e.g., decrease sedentary activity, increase light activity) and incorporate SMS as part of a multi-level approach with other evidence-based strategies.
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Affiliation(s)
- Jennifer L Huberty
- Exercise Science and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA.
| | - Matthew P Buman
- Exercise Science and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | - Jenn A Leiferman
- Department of Community and Behavioral Health Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | | | - Eric B Hekler
- Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA
| | - Marc A Adams
- Exercise Science and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA
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Borgen I, Garnweidner-Holme LM, Jacobsen AF, Bjerkan K, Fayyad S, Joranger P, Lilleengen AM, Mosdøl A, Noll J, Småstuen MC, Terragni L, Torheim LE, Lukasse M. Smartphone application for women with gestational diabetes mellitus: a study protocol for a multicentre randomised controlled trial. BMJ Open 2017; 7:e013117. [PMID: 28348183 PMCID: PMC5372027 DOI: 10.1136/bmjopen-2016-013117] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 11/30/2016] [Accepted: 01/17/2017] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The promotion of a healthy diet, physical activity and measurement of blood glucose levels are essential components in the care for women with gestational diabetes mellitus (GDM). Smartphones offer a new way to promote health behaviour. The main aim is to investigate if the use of the Pregnant+ app, in addition to standard care, results in better blood glucose levels compared with current standard care only, for women with GDM. METHODS AND ANALYSIS This randomised controlled trial will include 230 pregnant women with GDM followed up at 5 outpatient departments (OPD) in the greater Oslo Region. Women with a 2-hour oral glucose tolerance test (OGTT) ≥9 mmol/L, who own a smartphone, understand Norwegian, Urdu or Somali and are <33 weeks pregnant, are invited. The intervention group receives the Pregnant+ app and standard care. The control group receives standard care only. Block randomisation is performed electronically. Data are collected using self-reported questionnaires and hospital records. Data will be analysed according to the intention-to-treat principle. Groups will be compared using linear regression for the main outcome and χ2 test for categorical data and Student's t-test or Mann-Whitney-Wilcoxon test for skewed distribution. The main outcome is the glucose level measured at the 2-hour OGTT 3 months postpartum. Secondary outcomes are a change in health behaviour and knowledge about GDM, quality of life, birth weight, mode of delivery and complications for mother and child. ETHICS AND DISSEMINATION The study is exempt from regional ethics review due to its nature of quality improvement in patient care. Our study has been approved by the Norwegian Social Science Data Services and the patient privacy protections boards governing over the recruitment sites. Findings will be presented in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER NCT02588729, Post-results.
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Affiliation(s)
- Iren Borgen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | | | | | - Kirsti Bjerkan
- Division of Medicine, Section of Dietetics, Oslo University Hospital, Oslo, Norway
| | | | - Pål Joranger
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Anne Marie Lilleengen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Annhild Mosdøl
- The Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | - Josef Noll
- University Graduate Centre, Kjeller, Norway
| | | | - Laura Terragni
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Liv Elin Torheim
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Mirjam Lukasse
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Hayman M, Reaburn P, Browne M, Vandelanotte C, Alley S, Short CE. Feasibility, acceptability and efficacy of a web-based computer-tailored physical activity intervention for pregnant women - the Fit4Two randomised controlled trial. BMC Pregnancy Childbirth 2017; 17:96. [PMID: 28335767 PMCID: PMC5364580 DOI: 10.1186/s12884-017-1277-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/14/2017] [Indexed: 11/12/2022] Open
Abstract
Background Physical activity (PA) during pregnancy is associated with a variety of health benefits including a reduced risk of pregnancy related conditions such as pre-eclampsia and pregnancy-induced hypertension and leads to greater control over gestational weight gain. Despite these associated health benefits, very few pregnant women are sufficiently active. In an attempt to increase health outcomes, it is important to explore innovative ways to increase PA among pregnant women. Therefore, the aim of this study was to assess the feasibility, acceptability and efficacy of a four week web-based computer-tailored PA intervention among pregnant women. Methods Seventy-seven participants were randomised into either: (1) an intervention group that received tailored PA advice and access to a resource library of articles relating to PA during pregnancy; or (2) a standard information group that only received access to the resources library. Objective moderate-to-vigorous physical activity (MVPA) was assessed at baseline and immediately post-intervention. Recruitment, attrition, intervention adherence, and website engagement were assessed. Questions on usability and satisfaction were administered post-intervention. Results Feasibility was demonstrated through acceptable recruitment (8.5 participants recruited and randomised/month), and attrition (25%). Acceptability among intervention group participants was positive with high intervention adherence (96% of 4 modules completed). High website engagement (participants logged in 1.6 times/week although only required to log in once per week), usability (75/100), and satisfaction outcomes were reported in both groups. However, participants in the intervention group viewed significantly more pages on the website (p < 0.05), reported that the website felt more personally relevant (p < 0.05), and significantly increased their MVPA from baseline to post-intervention (mean difference = 35.87 min), compared to the control group (mean difference = 9.83 min) (p < 0.05), suggesting efficacy. Conclusions The delivery of a computer-tailored web-based intervention designed to increase PA in pregnant women is feasible, well accepted and associated with increases in short-term MVPA. Findings suggest the use of computer-tailored information leads to greater website engagement, satisfaction and greater PA levels among pregnant women compared to a generic information only website. Trial registration The trial was ‘retrospectively registered’ with the Australian New Zealand Clinical Trials Registry (ACTRN12614001105639) on 17th October, 2014.
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Affiliation(s)
- Melanie Hayman
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - Peter Reaburn
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - Matthew Browne
- School of Human, Health and Social Sciences, Central Queensland University, Bundaberg, QLD, 4670, Australia
| | - Corneel Vandelanotte
- School of Human, Health and Social Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia.
| | - Stephanie Alley
- School of Human, Health and Social Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - Camille E Short
- NHMRC ECR Fellow. Freemasons Foundation Centre for Men's Health. Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5000, Australia
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Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J 2017; 20:1091-101. [PMID: 26649879 DOI: 10.1007/s10995-015-1895-7] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Physical inactivity is prevalent in pregnant women, and innovative strategies to promote physical activity are strongly needed. The purpose of the study was to test a 12-week mobile health (mHealth) physical activity intervention for feasibility and potential efficacy. METHODS Participants were recruited between December 2012 and February 2014 using diverse recruitment methods. Thirty pregnant women between 10 and 20 weeks of gestation were randomized to an intervention (mobile phone app plus Fitbit) or a control (Fitbit) group. Both conditions targeted gradual increases in physical activity. The mHealth intervention included daily messages and a mobile phone activity diary with automated feedback and self-monitoring systems. RESULTS On monthly average, 4 women were screened for initial eligibility by telephone and 2.5 were randomized. Intervention participants had a 1096 ± 1898 step increase in daily steps compared to an increase of 259 ± 1604 steps in control participants at 12 weeks. The change between groups in weekly mean steps per day during the 12-week study period was not statistically significant (p = 0.38). The intervention group reported lower perceived barrier to being active, lack of energy, than the control group at 12-week visit (p = 0.02). The rates of responding to daily messages and using the daily diary through the mobile app declined during the 12 week study period. DISCUSSION It was difficult to recruit and randomize inactive women who wanted to increase physical activity during pregnancy. Pregnant women who were motivated to increase physical activity might find using mobile technologies in assessing and promoting PA acceptable. Possible reasons for the non-significant treatment effect of the mHealth intervention on physical activity are discussed. Public awareness of safety and benefits of physical activity during pregnancy should be promoted. Clinicaltrials.Gov Identifier NCT01461707.
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Affiliation(s)
- JiWon Choi
- Institute for Health and Aging/Department of Social and Behavioral Sciences, University of California, San Francisco, 3333 California St., Suite 340, San Francisco, CA, 94118, USA.
| | - Ji Hyeon Lee
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Yoshimi Fukuoka
- Department of Physiological Nursing/Institute for Health & Aging, University of California, San Francisco, San Francisco, CA, USA
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Garland M. Physical Activity During Pregnancy: A Prescription for Improved Perinatal Outcomes. J Nurse Pract 2017. [DOI: 10.1016/j.nurpra.2016.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Craike M, Hill B, Gaskin CJ, Skouteris H. Interventions to improve physical activity during pregnancy: a systematic review on issues of internal and external validity using the RE-AIM framework. BJOG 2016; 124:573-583. [PMID: 27571933 DOI: 10.1111/1471-0528.14276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Physical activity (PA) during pregnancy has significant health benefits for the mother and her child; however, many women reduce their activity levels during pregnancy and most are not sufficiently active. Given the important health benefits of PA during pregnancy, evidence that supports research translation is vital. OBJECTIVES To determine the extent to which physical activity interventions for pregnant women report on internal and external validity factors using the RE-AIM framework (reach, efficacy/effectiveness, adoption, implementation, and maintenance). SEARCH STRATEGY Ten databases were searched up to 1 June 2015. Eligible published papers and unpublished/grey literature were identified using relevant search terms. SELECTION CRITERIA Studies had to report on physical activity interventions during pregnancy, including measures of physical activity during pregnancy at baseline and at least one point post-intervention. Randomised controlled trials and quasi-experimental studies that had a comparator group were included. DATA COLLECTION AND ANALYSIS Reporting of RE-AIM dimensions were summarised and synthesised across studies. MAIN RESULTS The reach (72.1%) and efficacy/effectiveness (71.8%) dimensions were commonly reported; however, the implementation (28.9%) and adoption (23.2%) dimensions were less commonly reported and no studies reported on maintenance. CONCLUSIONS This review highlights the under-reporting of issues of contextual factors in studies of physical activity during pregnancy. The translation of physical activity interventions during pregnancy could be improved through reporting of representativeness of participants, clearer reporting of outcomes, more detail on the setting and staff who deliver interventions, costing of interventions and the inclusion of process evaluations and qualitative data. TWEETABLE ABSTRACT The systematic review highlights the under-reporting of contextual factors in studies of physical activity during pregnancy.
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Affiliation(s)
- M Craike
- Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Vic., Australia.,Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - B Hill
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - C J Gaskin
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - H Skouteris
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
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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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Garnweidner-Holme LM, Borgen I, Garitano I, Noll J, Lukasse M. Designing and Developing a Mobile Smartphone Application for Women with Gestational Diabetes Mellitus Followed-Up at Diabetes Outpatient Clinics in Norway. Healthcare (Basel) 2015; 3:310-23. [PMID: 27417764 PMCID: PMC4939538 DOI: 10.3390/healthcare3020310] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/08/2015] [Accepted: 05/14/2015] [Indexed: 11/30/2022] Open
Abstract
The prevalence of Gestational Diabetes Mellitus (GDM) is increasing worldwide. Controlling blood sugar levels is fundamental to the management of GDM. Current practice in Norway includes patients registering blood sugar levels in a booklet and receiving verbal and/or written health information. A smartphone application may provide patients individually targeted and easily available advice to control blood sugar levels. The aim of this paper is to document the process of designing and developing a smartphone application (the Pregnant+ app) that automatically transfers blood sugar levels from the glucometer and has information about healthy eating and physical activity. This formative research included expert-group discussions among health professionals, researchers and experts in data privacy and security. User-involvement studies were conducted to discuss prototypes of the app. Results indicated that the content of the application should be easy to understand given the varying degree of patients’ literacy and in line with the information they receive at clinics. The final version of the app incorporated behavior change techniques such as self-monitoring and cues to action. Results from the first round of interactions show the importance of involving expert groups and patients when developing a mobile health-care device.
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Affiliation(s)
- Lisa Maria Garnweidner-Holme
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PB 4 St. Olavs plass, Oslo N-0130, Norway.
| | - Iren Borgen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PB 4 St. Olavs plass, Oslo N-0130, Norway.
| | - Iñaki Garitano
- University Graduate Centre, P.O. Box 70, Kjeller N-2027, Norway.
| | - Josef Noll
- University Graduate Centre, P.O. Box 70, Kjeller N-2027, Norway.
| | - Mirjam Lukasse
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PB 4 St. Olavs plass, Oslo N-0130, Norway.
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Seneviratne SN, McCowan LME, Cutfield WS, Derraik JGB, Hofman PL. Exercise in pregnancies complicated by obesity: achieving benefits and overcoming barriers. Am J Obstet Gynecol 2015; 212:442-9. [PMID: 24909342 DOI: 10.1016/j.ajog.2014.06.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/08/2014] [Accepted: 06/03/2014] [Indexed: 01/21/2023]
Abstract
An increasing number of women are entering pregnancy in an overweight or obese state. Obese women and their offspring are at increased risk of adverse perinatal outcomes, which may be improved by regular moderate-intensity antenatal exercise. Current guidelines recommend that all pregnant women without contraindications engage in ≥30 minutes of moderate-intensity exercise on a daily basis. However, obese women are usually less physically active and tend to further reduce activity levels during pregnancy. This commentary summarizes the potential short- and long-term benefits of antenatal exercise in obese pregnant women, highlights the challenges they face, and discusses means of improving their exercise levels. In addition, we make recommendations on exercise prescription for pregnancies complicated by obesity.
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Affiliation(s)
- Sumudu N Seneviratne
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand
| | - Lesley M E McCowan
- Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand; Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand.
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Huberty J, Leiferman JA, Gold KJ, Rowedder L, Cacciatore J, McClain DB. Physical activity and depressive symptoms after stillbirth: informing future interventions. BMC Pregnancy Childbirth 2014; 14:391. [PMID: 25432802 PMCID: PMC4254184 DOI: 10.1186/s12884-014-0391-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/06/2014] [Indexed: 12/17/2022] Open
Abstract
Background In the United States, approximately one in 110 pregnancies end in stillbirth affecting more than 26,000 women annually. Women experiencing stillbirth have a threefold greater risk of developing depressive symptoms compared to women experiencing live birth. Depression contributes negatively to health outcomes for both mothers and babies subsequent to stillbirth. Physical activity may improve depression in these women, however, little is known about acceptable physical activity interventions for women after stillbirth. This is the purpose of this descriptive exploratory study. Methods Eligible women were between ages 19 and 45, and experienced stillbirth within one year of the study. An online survey was used to ask questions related to 1) pregnancy and family information (i.e., time since stillbirth, weight gain during pregnancy, number of other children) 2) physical activity participation, 3) depressive symptomatology, and 4) demographics. Results One hundred seventy-five women participated in the study (M age = 31.26 ± 5.52). Women reported participating in regular physical activity (at least 150 minutes of moderate activity weekly) before (60%) and during (47%) their pregnancy, as well as after their stillbirth (61%). Only 37% were currently meeting physical activity recommendations. Approximately 88% reported depression (i.e., score of >10 on depression scale). When asked how women cope with depression, anxiety, or grief, 38% said physical activity. Of those that reported using physical activity to cope after stillbirth, they did so to help with depression (58%), weight loss (55%), and better overall physical health (52%). To cope with stillbirth, women used walking (67%), followed by jogging (35%), and yoga (23%). Women who participated in physical activity after stillbirth reported significantly lower depressive symptoms (M = 15.10, SD = 5.32) compared to women who did not participate in physical activity (M = 18.06, SD = 5.57; t = -3.45, p = .001). Conclusions Physical activity may serve as a unique opportunity to help women cope with the multiple mental sequelae after stillbirth. This study provides data to inform healthcare providers about the potential role of physical activity in bereavement and recovery for women who have experienced stillbirth. Additional research is necessary in this vulnerable population.
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Affiliation(s)
- Jennifer Huberty
- Exercise and Wellness, Arizona State University, Phoenix, AZ, USA.
| | - Jenn A Leiferman
- Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA.
| | - Katherine J Gold
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. .,Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.
| | - Lacey Rowedder
- Exercise and Wellness, Arizona State University, Phoenix, AZ, USA.
| | | | - Darya Bonds McClain
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
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Zhang Y, Dong S, Zuo J, Hu X, Zhang H, Zhao Y. Physical activity level of urban pregnant women in Tianjin, China: a cross-sectional study. PLoS One 2014; 9:e109624. [PMID: 25286237 PMCID: PMC4186867 DOI: 10.1371/journal.pone.0109624] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022] Open
Abstract
Objective To determine the physical activity level and factors influencing physical activity among pregnant urban Chinese women. Methods This prospective cross-sectional study enrolled 1056 pregnant women (18–44 years of age) in Tianjin, China. Their socio-demographic characteristics were recorded, and the Pregnancy Physical Activity Questionnaire was used to assess their physical activity during pregnancy. The data were analyzed by multinomial logistic regression with adjustment for potential confounders. Results Median total energy expenditure of pregnant women in each of the three trimesters ranged from 18.50 to 21.90 metabolic equivalents of task (METs) h/day. They expended 1.76–1.85 MET h/day on moderate and vigorous activities and 0.11 MET h/day on exercise. Only 117 of the women (11.1%) met the international guideline for physical activity in pregnancy (≥150 min moderate intensity exercise per week). The most frequent reason given for not being more physically active was the fear of miscarriage. Higher education level (OR: 4.11, 95% CI: 1.59–10.62), habitual exercise before pregnancy (OR: 2.14, 95% CI: 1.39–3.28), and husbands who exercised regularly (OR: 2.21, 95% CI: 1.33–3.67) significantly increased the odds of meeting the guideline (p<0.001). A low pre gravid body mass index (OR: 0.42, 95% CI: 0.20–0.87) significantly decreased the odds (p<0.001). Conclusions Few urban Chinese pregnant women met the recommended physical activity guideline. They also expended little energy exercising. Future interventions should be based on the clinic environment and targeting family members as well as the subjects. All pregnant women should be targeted, not just those in high-risk groups.
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Affiliation(s)
- Yan Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Shengwen Dong
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jianhua Zuo
- Obstetrics and Gynecology Department, Wangdingdi Hospital, Tianjin, China
| | - Xiangqin Hu
- Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Hua Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
- * E-mail:
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Hawkins M, Chasan-Taber L, Marcus B, Stanek E, Braun B, Ciccolo J, Markenson G. Impact of an exercise intervention on physical activity during pregnancy: the behaviors affecting baby and you study. Am J Public Health 2014; 104:e74-81. [PMID: 25122031 PMCID: PMC4167076 DOI: 10.2105/ajph.2014.302072] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We examined the impact of a prenatal exercise intervention on physical activity in 260 women at risk for gestational diabetes mellitus. METHODS We randomized participants in the Behaviors Affecting Baby and You (BABY) Study, which took place from 2007 to 2012, to either a 12-week individually tailored, motivationally matched exercise intervention (n=132) or to a comparison health and wellness intervention (n=128). We assessed physical activity with the Pregnancy Physical Activity Questionnaire. We used linear mixed models to evaluate the impact of the interventions on change in physical activity according to intensity and type, total walking, and sedentary behavior. RESULTS Compared with the health and wellness arm, the exercise arm had significantly greater increases in sports or exercise activity (0.3 vs 5.3 metabolic equivalent of task [MET] hours/week; P<.001), and smaller declines in total activity (-42.7 vs -2.1 MET hours/week; P=.02) and activities of moderate to vigorous intensity (-30.6 vs -10.6 MET hours/week; P=.05), and was more likely to achieve recommended guidelines for physical activity (odds ratio=2.12; 95% confidence interval=1.45, 3.10). CONCLUSIONS These findings extend the previous literature by demonstrating the benefits of a clinically feasible exercise intervention in an ethnically and socio-economically diverse population. Given the increased risk of adverse maternal health outcomes in ethnic minority groups, these findings may have important implications for reducing health disparities.
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Affiliation(s)
- Marquis Hawkins
- Marquis Hawkins, Lisa Chasan-Taber, and Edward Stanek are with the Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst. Bess Marcus is with the Department Family and Preventive Medicine, University of California San Diego School of Medicine. Barry Braun is with the Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts. Joe Ciccolo is with Teachers College, Columbia University, New York, NY. Glenn Markenson is with the Baystate Medical Center, Springfield, MA
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