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Green CR, Harding KD, Unsworth K, Kaminsky K, Roberts N, Nagpal TS, Cook JL. Reporting on Health Care and Social Service Provider Approaches to Promoting Alcohol Abstinence During Pregnancy. Soc Work Public Health 2024; 39:422-433. [PMID: 38713493 DOI: 10.1080/19371918.2024.2323136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Despite the known detrimental health effects of alcohol use during pregnancy, there are still health care (HCP) and social service providers (SSP) who do not promote complete abstinence. The purpose of this study was to explore the current practices of HCPs and SSPs when discussing alcohol use during pregnancy, and to understand their rationale for their specific recommendations. An online survey was completed by 1123 HCPs (n = 588) and SSPs (n = 535) that asked them to identify their approach to discussing alcohol and pregnancy. Participants had the option to further explain their current recommendations regarding alcohol use during pregnancy in an open-ended format. Open-ended responses were analyzed using a content analysis approach (n = 156). The majority of respondents recommend abstinence (83.9% of HCPs, n = 493; 78.4% of SSPs, n = 419), while 9.8% of HCPs (n = 57) and 2.2% of SSPs (n = 12) responded that low levels of consumption may be acceptable. HCPs may recommend low levels of consumption based on other international guidelines, limited evidence to suggest that one unit of alcohol is harmful, and as a harm reduction strategy. SSPs stated that they refer clients to HCPs for recommendations related to alcohol consumption, and that they prefer to provide information based on public health guidelines. This exploratory work may inform the development of resources to support HCPs and SSPs to recommend abstinence from alcohol throughout gestation.
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Affiliation(s)
- Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
| | - Kelly D Harding
- The Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC Canada
- Psychology Department, Laurentian University, Sudbury, ON, Canada
| | - Kathy Unsworth
- The Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC Canada
| | - Kyla Kaminsky
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
| | | | - Taniya S Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
- The Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC Canada
- The University of Ottawa, Ottawa, ON, Canada
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Nagpal TS, Pearce N, Adamo KB. Presentation of a weight bias internalization tool for use in pregnancy and a call for future research: A commentary. Obes Pillars 2024; 10:100107. [PMID: 38524875 PMCID: PMC10957497 DOI: 10.1016/j.obpill.2024.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
Background Emerging evidence has shown that weight stigma is a concern during pregnancy, with several studies documenting common sources including healthcare, the media and interpersonal networks. Experiencing weight stigma may lead to weight bias internalization (WBI), whereby individuals accept and self-direct negative weight-related stereotypes, and limited research has assessed this in the context of pregnancy. Pregnancy is unique in terms of weight changes as many individuals will experience gestational weight gain (GWG). Accordingly, a WBI tool that accounts for GWG may be a more population-specific resource to use. Methods This commentary presents a pregnancy-specific WBI tool that accounts for GWG. The validated Adult WBI scale was modified to include 'pregnancy weight gain'. This commentary also presents a brief summary of research that has assessed WBI in pregnancy and recommendations for future work. Results Recommended future work includes validation of the pregnancy-specific WBI tool and prospective examinations of weight stigma and WBI in pregnancy and implications on maternal and newborn outcomes. Conclusion Ultimately this research may inform development of interventions and resources to mitigate weight stigma and WBI in pregnancy and overall may contribute to improving prenatal outcomes and experiences.
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Affiliation(s)
- Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
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3
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Nutter S, Eggerichs LA, Nagpal TS, Ramos Salas X, Chin Chea C, Saiful S, Ralston J, Barata-Cavalcanti O, Batz C, Baur LA, Birney S, Bryant S, Buse K, Cardel MI, Chugh A, Cuevas A, Farmer M, Ibrahim A, Kataria I, Kotz C, Kyle T, le Brocq S, Mooney V, Mullen C, Nadglowski J, Neveux M, Papapietro K, Powis J, Puhl RM, Rea Ruanova B, Saunders JF, Stanford FC, Stephen O, Tham KW, Urudinachi A, Vejar-Renteria L, Walwyn D, Wilding J, Yusop S. Changing the global obesity narrative to recognize and reduce weight stigma: A position statement from the World Obesity Federation. Obes Rev 2024; 25:e13642. [PMID: 37846179 DOI: 10.1111/obr.13642] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/02/2023] [Accepted: 09/09/2023] [Indexed: 10/18/2023]
Abstract
Weight stigma, defined as pervasive misconceptions and stereotypes associated with higher body weight, is both a social determinant of health and a human rights issue. It is imperative to consider how weight stigma may be impeding health promotion efforts on a global scale. The World Obesity Federation (WOF) convened a global working group of practitioners, researchers, policymakers, youth advocates, and individuals with lived experience of obesity to consider the ways that global obesity narratives may contribute to weight stigma. Specifically, the working group focused on how overall obesity narratives, food and physical activity narratives, and scientific and public-facing language may contribute to weight stigma. The impact of weight stigma across the lifespan was also considered. Taking a global perspective, nine recommendations resulted from this work for global health research and health promotion efforts that can help to reduce harmful obesity narratives, both inside and outside health contexts.
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Affiliation(s)
- Sarah Nutter
- Educational Psychology and Leadership Studies, University of Victoria, Victoria, British Columbia, Canada
| | - Laura A Eggerichs
- Department of Public Health and Community Medicine, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Taniya S Nagpal
- Department of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Ximena Ramos Salas
- Replica Communications, Kristianstad, Sweden
- Obesity Canada, Edmonton, Canada
- European Association for the Study of Obesity, Teddington, UK
| | - Christine Chin Chea
- Internal and Obesity Medicine, University of the West Indies School of Clinical Medicine and Research, Nassau, Bahamas
| | | | | | | | - Claudia Batz
- George Institute for Global Health, Sydney, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Susie Birney
- Irish Coalition for People Living with Obesity, Dublin, Ireland
| | - Sheree Bryant
- European Association for the Study of Obesity, Teddington, UK
| | - Kent Buse
- George Institute for Global Health, Imperial College London, London, UK
| | - Michelle I Cardel
- WW International, Inc., Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Ada Cuevas
- Advanced Center for Metabolic Medicine and Nutrition (CAMMYN), Santiago, Chile
| | | | - Allison Ibrahim
- Educational Consultant and Patient Advocate, Kuwait City, Kuwait
| | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Catherine Kotz
- Department of Integrative Biology and Physiology, University of Minnesota, and the Minneapolis VA Health Care System, Geriatric Research, Education and Clinical Care, Minneapolis, Minnesota, USA
| | - Ted Kyle
- ConscienHealth, Pittsburgh, Pennsylvania, USA
| | - Sara le Brocq
- National Institute for Health and Care Excellence, London, UK
| | - Vicki Mooney
- European Coalition for People Living with Obesity, Dublin, Ireland
| | - Clare Mullen
- Health Consumers' Council WA, Mount Lawley, Australia
| | | | | | - Karin Papapietro
- Nutrition Unit, Hospital Clínico de La Universidad de Chile, Santiago, Chile
| | | | - Rebecca M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut, Storrs, Connecticut, USA
| | | | - Jessica F Saunders
- Psychology Convening Group, Ramapo College of New Jersey, Mahwah, New Jersey, USA
| | - Fatima Cody Stanford
- Neuroendocrine Unit, Pediatric Endocrinology, Nutrition Obesity Research Center at Harvard, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Ogweno Stephen
- Global Health Medicine And Health, Faculty of Biology, University Of Manchester, Manchester, UK
| | - Kwang Wei Tham
- Singapore Association for the Study of Obesity, Singapore
| | | | - Lesly Vejar-Renteria
- Nutrition and Health Research Center, National Institute of Public Health Mexico, Cuernavaca, Mexico
| | | | - John Wilding
- World Obesity Federation, London, UK
- University of Liverpool, Liverpool, UK
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Sánchez-Polán M, Nagpal TS, Zhang D, Silva-Jose C, Montejo R, Barakat R. The Influence of Physical Activity during Pregnancy on Maternal Pain and Discomfort: A Meta-Analysis. J Pers Med 2023; 14:44. [PMID: 38248744 PMCID: PMC10817295 DOI: 10.3390/jpm14010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Pregnant women may experience pain and discomfort during pregnancy, especially in areas such as the lower back and pelvic girdle. Pain in pregnancy is associated with poor quality of life, and because it is a common occurrence, pregnant women may be offered several resources to prevent discomforts throughout pregnancy, such as engaging in physical activity. This study was a meta-analysis of randomised controlled trials (prospectively registered in Prospero, registration number: CRD42023451320) aimed to assess the effects of physical activity during pregnancy on maternal pain and discomfort. We analysed 16 randomised clinical trials. The results of these analyses indicate that women who performed physical activity had significantly less intensity of pain (z = <2.69, p = <0.007; SMD = -0.66, 95% CI = -1.13, -0.18, I2 = <91%, Pheterogeneity = <0.001) and a reduction observed in the disability questionnaire (z = <2.37, p = <0.02; SMD = -0.80, 95% CI = -1.47, -0.14, I2 = <91%, Pheterogeneity = <0.001), and overall reduced general pain (z = <3.87, p = <0.001; SMD = -0.56, 95% CI = -0.84, -0.27, I2 = <86%, Pheterogeneity = <0.001) than women who did not practice physical activity during pregnancy. In conclusion, physical activity during pregnancy could effectively help to diminish pain intensity, reduce disability due to pain, and generally reduce pain.
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Affiliation(s)
- Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
| | - Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
| | - Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
| | - Rocío Montejo
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 413 46 Gothenburg, Sweden
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
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Abraham Roshan J, Nagpal TS, Pearce N, Dhaliwal KK, El-Hussein M, Forhan M, Hadjiyanakis S, Hawa R, Kushner RF, Lee-Baggley D, McMillan M, Nutter S, Piccinini-Vallis H, Vallis M, Wharton S, Wiljer D, Sockalingam S. Transforming the landscape of obesity education - The Canadian obesity education competencies. Obes Pillars 2023; 8:100091. [PMID: 38125661 PMCID: PMC10728696 DOI: 10.1016/j.obpill.2023.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023]
Abstract
Background With ongoing gaps in obesity education delivery for health professions in Canada and around the world, a transformative shift is needed to address and mitigate weight bias and stigma, and foster evidence-based approaches to obesity assessment and care in the clinical setting. Obesity Canada has created evidence-based obesity competencies for medical education that can guide curriculum development, assessment and evaluation and be applied to health professionals' education programs in Canada and across the world. Methods The Obesity Canada Education Action Team has seventeen members in health professions education and research along with students and patient experts. Through an iterative group consensus process using four guiding principles, key and enabling obesity competencies were created using the 2015 CanMEDS competency framework as its foundation. These principles included the representation of all CanMEDS Roles throughout the competencies, minimizing duplication with the original CanMEDS competencies, ensuring obesity focused content was informed by the 2020 Adult Obesity Clinical Practice Guidelines and the 2019 US Obesity Medication Education Collaborative Competencies, and emphasizing patient-focused language throughout. Results A total of thirteen key competencies and thirty-seven enabling competencies make up the Canadian Obesity Education Competencies (COECs). Conclusion The COECs embed evidence-based approaches to obesity care into one of the most widely used competency-based frameworks in the world, CanMEDS. Crucially, these competencies outline how to address and mitigate the damaging effects of weight bias and stigma in educational and clinical settings. Next steps include the creation of milestones and nested Entrustable Professional Activities, a national report card on obesity education for undergraduate medical education in Canada, and Free Open Access Medication Education content, including podcasts and infographics, for easier adoption into curriculum around the world and across the health professions spectrum.
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Affiliation(s)
| | - Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Mohamed El-Hussein
- Faculty of Health, Community & Education, School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada
| | - Mary Forhan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stasia Hadjiyanakis
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Raed Hawa
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Robert F. Kushner
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dayna Lee-Baggley
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Sarah Nutter
- Educational Psychology and Leadership Studies, University of Victoria, Victoria, British Columbia, Canada
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sean Wharton
- University of Toronto, Wharton Medical Clinic, Toronto, Ontario, Canada
| | - David Wiljer
- University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Angrish K, Khan-Poulin Y, Mangat J, Mack DE, Nagpal TS. Culturally Tailored Strategies for Prenatal Physical Activity for South Asian Women: A Scoping Review. J Immigr Minor Health 2023; 25:1463-1481. [PMID: 37193874 DOI: 10.1007/s10903-023-01486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/18/2023]
Abstract
Low levels of physical activity (PA) are reported in South Asian pregnant women. This scoping review summarizes culturally tailored strategies in prenatal PA studies for South Asian women and identifies barriers and facilitators. A search strategy was developed with the keywords "Physical Activity" AND Pregnant AND "South Asian" and was carried out on Medline, SportDiscus, EMBASE, Web of Science and Proquest Theses and Dissertations. Primary research studies were included. Forty-six studies were included of which 40 were from South Asian countries. No interventions were identified outside of South Asian countries. Offering material in different languages was the most common tailoring strategy. Reported barriers were possible social norms favouring inactivity, lack of awareness on safe exercises, and physical symptoms (e.g., fatigue). Facilitators included social support and relief from physical symptoms. Future PA interventions for South Asian pregnant women should account for population-specific barriers and facilitators to increase PA initiation and maintenance.
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Affiliation(s)
- Kirina Angrish
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | | | - Jasman Mangat
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | - Diane E Mack
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 2R3, Canada.
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Nagpal TS, Pearce N, Dhaliwal K, Abraham JR. Implementing evidence-based obesity management guidelines requires development of medical competencies: A commentary outlining future directions in obesity education in Canada. Obes Pillars 2023; 8:100086. [PMID: 38125664 PMCID: PMC10728703 DOI: 10.1016/j.obpill.2023.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 12/23/2023]
Abstract
Background This commentary provides an overview of forthcoming activities by Obesity Canada (OC) to inform obesity competencies in medical education. Competencies in medical education refer to abilities of medical professionals to appropriately provide patients the care they need. A recognized Canadian framework for informing medical competencies is CanMEDs. Additionally, the Obesity Medicine Education Collaborative (OMEC) provides 32 obesity specific medical competencies to be integrated across medical education curriculum. OC released the first globally recognized Adult Obesity Clinical Practice Guideline (CPGs) in 2020 inclusive of 80 recommendations. Referring to the CanMEDs and OMEC competencies, OC is developing medical education competencies for caring for patients who have obesity in line with the recent CPGs that can be applied to health professions education programs around the world. Methods Activities being completed by OC's Education Action Team include a scoping review to summarize Canadian obesity medical education interventions or programs. Next, with expert consensus a competency set is being developed by utilizing the CanMEDs Framework, OMEC and the CPGs. Following this, OC will initially survey undergraduate medical programs across the country and determine to what degree they are meeting the competencies in content delivery. These findings will lead to a national report card outlining the current state of obesity medical education in Canada within undergraduate medical education. Results To date, OC has completed the scoping review and the competency set. The Education Action Team is in the process of developing the survey tools to assess the current delivery of obesity medical education in Canada. Conclusion The evidenced-based report card will support advocacy to refine and enhance future educational initiatives with the overall goal of improving patient care for individuals living with obesity. The process being applied in Canada may also be applicable and modified for other regions to assess and better obesity medical education.
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Affiliation(s)
- Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | | | - Khushmol Dhaliwal
- Department of Family Medicine Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph Roshan Abraham
- Department of Family Medicine Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
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Perera M, Hawk GS, Nagpal TS, Tinius RA. Social support for exercise from pregnancy to postpartum and the potential impact of a mobile application: A randomized control pilot trial in Southern United States. Prev Med Rep 2023; 36:102485. [PMID: 37954963 PMCID: PMC10637991 DOI: 10.1016/j.pmedr.2023.102485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023] Open
Abstract
This study compared perceived social support among women of all body mass index (BMI) categories with an attempt to assess the efficacy of the BumptUp® mobile application to improve social support for exercise during pregnancy and postpartum. Thirty-five pregnant women living in Southern United States were included in the sample. The intervention group received access to the BumptUp® mobile application that was designed to promote physical activity during pregnancy and postpartum. The control group received an evidence-based educational brochure. Perceived social support for exercise was assessed at four-time points using the social support and exercise survey. Outcomes were evaluated at 23-25, 35-37 gestational weeks, and 6 and 12 weeks postpartum. Based on their pre-pregnancy weight and height, BMI was computed to categorize participants into lean, overweight, and obese groups. Social support across BMI categories and between control and intervention groups were compared using linear mixed-effect models. Women grouped in the overweight and obese BMI categories reported receiving significantly lower levels of social support for exercise than women in the lean category throughout pregnancy and postpartum during mid-pregnancy, late pregnancy, and at 12 weeks postpartum (p < 0.05). Although the intervention group received higher social support than the control group throughout all four assessment points, the difference was not statistically significant (p > 0.05). Women with a pre-pregnancy BMI of overweight and obese received lower social support for exercise during pregnancy and postpartum. The efficacy of BumptUp® to improve perceived social support for exercise in pregnancy and postpartum was not evident in the results.
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Affiliation(s)
- Madhawa Perera
- Exercise Science, Western Kentucky University, Bowling Green, KY 42101, USA
| | - Gregory S. Hawk
- Department of Statistics, University of Kentucky, Lexington, KY 40506, USA
| | - Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Rachel A. Tinius
- Exercise Science, Western Kentucky University, Bowling Green, KY 42101, USA
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Nagpal TS, Pearce N, Sockalingam S, Hawa R, Dhaliwal KK, Lee-Baggley D, El-Hussein M, Nutter S, Piccinini-Vallis H, Vallis M, Dennett L, Forhan M, Hadjiyanakkis S, Kushner RF, McMillan M, Wharton S, Wiljer D, Abraham JR. A scoping review of obesity education interventions for current and prospective medical professionals in Canada. Obes Pillars 2023; 8:100085. [PMID: 38125662 PMCID: PMC10728706 DOI: 10.1016/j.obpill.2023.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 12/23/2023]
Abstract
Background Obesity is a prevalent chronic disease in Canada. Individuals living with obesity frequently interact with medical professionals who must be prepared to provide evidence-based and person-centred care options. The purpose of this scoping review was to summarize existing educational interventions on obesity in Canada for current and prospective medical professionals and to identify key future directions for practice and research. Methods A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The search strategy was conducted using Medline (via PubMed), Embase, Eric, CBCA, Proquest Education, and Proquest Theses. The inclusion criteria included delivery of an educational intervention on obesity for current medical professionals, medical undergraduate trainees, or residents administered in Canada. Data were extracted from the included studies to thematically summarize the intervention content, and main outcomes assessed. Future directions for research and practice were identified. Results Eight studies met the inclusion criteria. The interventions ranged in terms of the mode of delivery, including interactive in-person workshops and seminars, online learning modules, webinars, and videos. The main outcomes assessed were attitudes towards patients living with obesity, self-efficacy for having sensitive obesity-related discussions, skills to assess obesity and provision of management options. All studies reported improvements in the outcomes. Future directions identified were the need to develop standardized obesity competencies for inclusion across medical education programs, further research on effective pedagogical approaches to integrating content into existing curricula and the need for broader awareness and assessment of the quality of obesity education resources. Conclusion Although there have been few obesity-specific educational interventions for current and prospective medical professionals in Canada, existing evidence shows positive learning outcomes. These findings advocate for continued investment in the development of obesity medical training and educational interventions.
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Affiliation(s)
- Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | | | - Sanjeev Sockalingam
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Raed Hawa
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Khushmol K. Dhaliwal
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dayna Lee-Baggley
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mohamed El-Hussein
- Faculty of Health, Community & Education, School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada
| | - Sarah Nutter
- Educational Psychology and Leadership Studies, University of Victoria, Victoria, British Columbia, Canada
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Liz Dennett
- Scott Health Sciences Library, University of Alberta, Edmonton Alberta Canada
| | - Mary Forhan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stasia Hadjiyanakkis
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert F. Kushner
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Sean Wharton
- University of Toronto, Wharton Medical Clinic, Toronto, Ontario, Canada
| | - David Wiljer
- University Health Network; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Puranda JL, da Silva DF, Edwards CM, Nagpal TS, Souza SCS, Semeniuk K, McLean L, Adamo KB. Characteristics Associated with Pelvic Floor Disorders among Female Canadian Armed Forces Members. J Obstet Gynaecol Can 2023; 45:646-654. [PMID: 37268158 DOI: 10.1016/j.jogc.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent pelvic floor disorders (PFDs) among the female population. In the military environment, being a non-commissioned member (NCM), and physically demanding occupations are factors associated with higher PFD risk. This study seeks to characterize the profile of female Canadian Armed Forces (CAF) members reporting symptoms of UI and/or POP. METHODS Present CAF members (18-65 years) responded to an online survey. Only current members were included in the analysis. Symptoms of UI and POP were collected. Multivariate logistic regressions analyzed the relationships between PFD symptoms and associated characteristics. RESULTS 765 active members responded to female-specific questions. The prevalence of self-reported POP and UI symptoms were 14.5% and 57.0%, respectively, with 10.6% of respondents reporting both. Advanced age (adjusted odds ratio [aOR]: 1.062, CI 1.038-1.087), a body mass index (BMI) categorized as obese (aOR: 1.909, [1.183-3.081]), parity ≥1 (e.g., aOR for 1: 2.420, [1.352-4.334]) and NCMs (aOR: 1.662, [1.144-2.414]) were factors associated with urine leakage. Parity of ≥2 (aOR: 2.351, [1.370-4.037]) compared to nulliparous and having a perception of a physically demanding job (aOR: 1.933, [1.186-3.148]) were associated with experiencing POP symptoms. Parity of ≥2 increased the odds of reporting both PFD symptoms (aOR: 5.709, [2.650-12.297]). CONCLUSION Parity was associated with greater odds of experiencing symptoms of UI and POP. Higher age, higher BMI, and being an NCM were associated with more symptoms of UI, and the perception of having a physically demanding role increased the likelihood of reporting POP symptoms.
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Affiliation(s)
- Jessica L Puranda
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, QC
| | - Chris M Edwards
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB
| | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Kevin Semeniuk
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Linda McLean
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON.
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11
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Cox JM, Sánchez-Polán M, Mota P, Barakat R, Nagpal TS. A scoping review exploring stigma associated with postpartum urinary incontinence. Int Urogynecol J 2023; 34:1997-2005. [PMID: 37060372 DOI: 10.1007/s00192-023-05526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/19/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Postpartum urinary incontinence (UI) is prevalent, yet health-seeking behaviours for prevention and treatment are markedly low. Health-related stigma refers to conditions that may be socially devalued and considered deviating from "expected norms" and is a barrier to equitable health care. It may be plausible that stigma is associated with postpartum UI and leads to avoiding health-seeking behaviours, which this scoping review sought to examine and summarize. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews was followed. The following keywords were used to develop a search strategy: Postpartum, Urinary Incontinence and Stigma. The search was carried out on PubMed, PsycInfo, Scopus, CINAHL, Web of Science and ProQuest Dissertation and Theses Global. All study designs (clinical trials, observational studies, qualitative studies) were eligible for inclusion. Data were extracted and mapped to identify causal factors of postpartum UI stigma and implications for outcomes and behaviours. RESULTS Twelve studies were included. Most studies utilized questionnaires assessing constructs related to quality of life that also captured potential stigma, or interviews. Sources of postpartum UI stigma included community values surrounding UI and self-stigma, whereby participants directed stereotypes associated with urinary leakage towards themselves. Implications of postpartum UI stigma included negative mental emotions such as shame and embarrassment, which led to avoiding situations where they needed to disclose symptoms, including in health care environments. CONCLUSIONS Future research requires a purposeful assessment of postpartum UI stigma to learn from lived experience how to mitigate stigma and improve quality of care.
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Affiliation(s)
- Jordyn M Cox
- Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Patrícia Mota
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisboa, Portugal
- Univ Lisboa, Fac. Motricidade Humana, CIPER, LBMF, 1499-002, Lisboa, Portugal
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Taniya S Nagpal
- Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada.
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12
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Zhang D, Nagpal TS, Silva-José C, Sánchez-Polán M, Gil-Ares J, Barakat R. Influence of Physical Activity during Pregnancy on Birth Weight: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2023; 12:5421. [PMID: 37629463 PMCID: PMC10455907 DOI: 10.3390/jcm12165421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Birth weight is a marker that is often referred to determine newborn health, potential growth trajectories and risk of future disease. Accordingly, interventions to promote appropriate and healthy birth weight have been extensively studied and implemented in pregnancy. In particular, physical activity in pregnancy is recommended to promote appropriate fetal development and newborn birth weight. This systematic review and meta-analyses aimed to summarize the effect of physical activity during pregnancy specifically from randomized controlled trials on the following outcomes: birth weight, macrosomia, low birth weight, being large for the gestational age, and being small for the gestational age (Registration No.: CRD42022370729). 63 studies (16,524 pregnant women) were included. There was a significant negative relationship between physical activity during pregnancy and macrosomia (z = 2.16; p = 0.03; RR = 0.79, 95% CI = 0.63, 0.98, I2 = 29%, Pheterogeneity = 0.09). No other significant relationships were found. Promoting physical activity during pregnancy may be an opportune time to reduce the risk of future chronic disease, such as obesity, through the prevention of macrosomia and the promotion of appropriate birth weights.
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Affiliation(s)
- Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Taniya S. Nagpal
- Faculty of Kinesiology Sport and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Cristina Silva-José
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
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13
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Schwartz BD, Pellerine LP, Bray NW, Fowles JR, Furlano JA, Morava A, Nagpal TS, O'Brien MW. Binge drinking and smoking are associated with worse academic performance in Canadian undergraduate students. J Am Coll Health 2023:1-7. [PMID: 37463523 DOI: 10.1080/07448481.2023.2232871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Test the hypothesis that smoking, fast-food consumption, and binge drinking were negatively associated with academic performance in Canadian undergraduate students. PARTICIPANTS Undergraduate students across Canada [n = 411 (335♀) aged: 22 ± 4 years] completed a questionnaire regarding their lifestyle behaviors and academic grades. METHODS Relationships between lifestyle behaviors and academic performance were assessed via covariate-adjusted multiple regressions. Mediation models were used to test whether significant relationships between smoking/fast-food and grades were explained by binge drinking. RESULTS Smoking (β= -4.00, p < .001) and binge drinking (β= -1.98, p = .002) were independent predictors of grades (average: 84 ± 8%). Binge drinking partially mediated the relationships between smoking (indirect effect β= -1.19, 95%CI [-2.49, -0.08] and fast-food consumption (indirect effect: β= -.75, 95%CI [-1.20, -0.29]), with grades. CONCLUSIONS These findings highlight the negative influence of binge drinking, smoking, and fast-food consumption on academic success, with binge drinking as a partial mediator of these relationships.
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Affiliation(s)
- Beverly D Schwartz
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Liam P Pellerine
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Nick W Bray
- Cumming School of Medicine, Department of Physiology & Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Jonathon R Fowles
- Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, Nova Scotia, Canada
| | - Joyla A Furlano
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Anisa Morava
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Myles W O'Brien
- School of Physiotherapy (Faculty of Health) & Department of Medicine (Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada
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14
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Hill IF, Angrish K, Nutter S, Ramos-Salas X, Minhas H, Nagpal TS. Exploring body dissatisfaction in pregnancy and the association with gestational weight gain, obesity, and weight stigma. Midwifery 2023; 119:103627. [PMID: 36804829 DOI: 10.1016/j.midw.2023.103627] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 12/30/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Body dissatisfaction in pregnancy has been associated with negative psychological maternal outcomes, including increased risk of postpartum depression. This study aimed to explore weight-related factors that influence body dissatisfaction in pregnancy, including gestational weight gain (GWG), weight stigma, obesity, and weight loss attempts before pregnancy. DESIGN Secondary analysis of a larger cross-sectional study. SETTING Online survey administered via Qualtrics. PARTICIPANTS ≥12 weeks pregnant, ≥18 years of age, having a singleton pregnancy and residing in Canada. MEASUREMENTS AND FINDINGS A battery of questionnaires were completed, including the Body Image in Pregnancy Scale (BIPS) sub-scale. The BIPS scores were compared based on experiences of weight stigma in pregnancy, perception towards their GWG, weight loss attempts before pregnancy, obesity, and GWG category classified as excessive or not referring to Institute of Medicine (2009) guidelines. Significant differences were entered into a linear regression model with BIPS scores as the dependent variable. Significance was accepted as p<0.05. A total of 182 participants completed the survey. There were no differences in BIPS scores based on GWG category (p = 0.160), or obesity (p = 0.230). Poorer BIPS scores were reported by those who felt they had gained 'too much' pregnancy weight than 'appropriate' (p<0.001), and among those who were trying to lose weight before pregnancy compared to those who were not (p = 0.002). Poorer BIPS scores were also reported by individuals who indicated they had experienced weight stigma during pregnancy compared to those who had not (p<0.001). Regression results showed that significant variables were perceptions towards GWG (p = 0.003) and experiencing weight stigma in pregnancy (p = 0.011). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Perceptions towards GWG and experiencing weight stigma can influence body dissatisfaction in pregnancy. Given the detrimental physical and psychological consequences of body dissatisfaction, effective strategies to reduce prenatal weight stigma are needed, such as training maternal healthcare providers to offer sensitive preconception and prenatal weight counselling.
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Affiliation(s)
- Isabelle F Hill
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada
| | - Kirina Angrish
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada
| | - Sarah Nutter
- Department of Educational Psychology and Leadership Studies, University of Victoria, BC, Canada
| | | | - Harneet Minhas
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada
| | - Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada; Faculty of Kinesiology, Sport and Recreation, University of Alberta, AB, Canada.
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15
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Nagpal TS, Nippert KE, Velletri M, Tomiyama AJ, Incollingo Rodriguez AC. Close Relationships as Sources of Pregnancy-Related Weight Stigma for Expecting and New Mothers. Int J Behav Med 2023; 30:297-303. [PMID: 35486351 DOI: 10.1007/s12529-022-10083-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Experiencing weight stigma during pregnancy is detrimental to psychosocial health outcomes, including increasing maternal stress and undermining engagement in health behaviors. Guided by a recent socioecological framework, close interpersonal relationships are integral in pregnancy to facilitate healthy behaviors and protect maternal mental health, but they may also be sources that project weight stigma. The purpose of this study was to characterize weight stigma experienced during pregnancy and postpartum from close relationships including partners, immediate family, extended family, and friends. METHOD Women who were pregnant or up to 1 year postpartum completed a survey that assessed sources of weight stigma since becoming pregnant. A thematic analysis was performed to code open-ended responses to understand the lived experiences of pregnancy-related weight stigma experienced from close relations. RESULTS Of the 501 women who completed the online survey, 157 indicated experiencing weight stigma from close relations. Average frequency of weight stigma from close relations was 1.83 ("less than once a month" to "a few times a month"). Weight-stigmatizing examples from close relations during pregnancy included negative assumptions about maternal or fetal health and maternal lifestyle behaviors based on weight gain; comparing women to pregnant body ideals; and making comments that resulted in women judging themselves poorly as a pregnant individual or mother. CONCLUSIONS Close relationships can be sources of pregnancy-related weight stigma. This may not only increase risk for adverse stigma-related consequences, but also could cut off the important benefits of maternal social support resulting in poor mental health outcomes and health behaviors.
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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Kathryn E Nippert
- Psychological & Cognitive Sciences, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Mia Velletri
- Psychological & Cognitive Sciences, Worcester Polytechnic Institute, Worcester, MA, USA
| | | | - Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Worcester Polytechnic Institute, Worcester, MA, USA.
- Salisbury Labs 317B, 100 Institute Road, Worcester, MA, 01609, USA.
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16
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Puranda JL, Silva DFD, Edwards CM, Nagpal TS, Souza SS, Semeniuk K, Adamo KB. Association Between Reproductive Health Factors and Musculoskeletal Injuries in Female Canadian Armed Forces Members. J Womens Health (Larchmt) 2023; 32:199-207. [PMID: 36094835 DOI: 10.1089/jwh.2021.0647] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Musculoskeletal injuries (MSKi) play a role in member retention in the military. In general, female military members have higher rates of MSKi than males and female reproductive health characteristics may be contributing to these disparities. This study seeks to characterize reproductive health factors in female Canadian Armed Forces (CAF) members and their relationship with MSKi. Materials and Methods: An electronic survey (SurveyMonkey®) was made available to present and former CAF members 18-65 years of age. Responses were collected between September 2020 and February 2021. Seven female reproductive characteristics were assessed: age of menarche, menstrual cycle regularity, birth control use, having given birth while serving, endometriosis, early menopause, and secondary oligomenorrhea/amenorrhea. Binary logistic regressions were used to analyze associations between reproductive characteristics with repetitive strain (RSI) and acute injuries. Results: A total of 2,001 participants consented to the survey with 855 respondents being female. Females reporting menstrual cycles as never regular, irregular for a few months, who never had a period, and whose periods stopped while serving presented a greater likelihood of reporting RSI compared to their peers who reported regular menstrual cycles (adjusted odds ratio [aOR]: 1.898, confidence interval [CI]: 1.138-3.166). Participants who have experienced endometriosis presented a higher likelihood of reporting acute injuries than those who did not (aOR: 2.426, CI: 1.030-5.709). Conclusion: This examination of females within the CAF suggests that irregular menstrual cycles or absent periods increase the likelihood of experiencing MSKi, namely those categorized as RSI injuries and reporting endometriosis were associated with greater rates of acute injuries.
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Affiliation(s)
- Jessica L Puranda
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Danilo F da Silva
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Chris M Edwards
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Sara S Souza
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Kevin Semeniuk
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
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17
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Deck S, Nagpal TS, Morava A, Farhat J, Cisneros Sanchez F, Prapavessis H. Tobacco use among varsity athletes - why do they do it and how do we make it stop: a brief report. J Am Coll Health 2023; 71:333-337. [PMID: 33760706 DOI: 10.1080/07448481.2021.1897014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/05/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
The current study explores the motivations underlying tobacco use among varsity athletes. A cross-sectional exploratory mixed method approach was used. Both tobacco users (TU) and non-tobacco users (NTU) completed an online survey of closed and open-ended questions. These questions focused on tobacco use, motivations for tobacco use, teammate and coaches' perceptions of athlete tobacco use, and self-perceived effects of tobacco use on health and athletic performance. Thirty-eight completed surveys were included of which 12 were TU and 26 were NTU. The majority of TU indicated that they used products during the off-season. Motivations for using tobacco products included social influences, stress-relief, and increasing energy. TU mostly indicated that there are negative effects on their health but not on their athletic performance, whereas NTU reported potential detrimental effects on their teammate's performance. Overall, varsity athletes who use tobacco products are aware of the health effects and negative opinions of their teammates.
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Affiliation(s)
- Sarah Deck
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Taniya S Nagpal
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Anisa Morava
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada
| | - Jade Farhat
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada
| | - Federico Cisneros Sanchez
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada
| | - Harry Prapavessis
- School of Kinesiology, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada
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18
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Bray NW, O'Brien MW, Wong MY, Sui W, Voss ML, Turnbull N, Nagpal TS, Fowles JR. The importance of collaboration between medical and exercise professionals in addressing patient physical inactivity. Appl Physiol Nutr Metab 2023; 48:88-90. [PMID: 36288605 DOI: 10.1139/apnm-2022-0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Physical activity has declined further during the coronavirus disease 2019 (COVID-19) pandemic. Physicians are at the front lines of proactively educating and promoting physical activity to patients; however, physicians do not feel confident and face numerous barriers in prescribing exercise to patients. Exercise referral schemes, comprising collaborations with qualified exercise professionals, represent a fruitful option for supporting physicians hoping to promote physical activity to more patients. Herein, we provide practical suggestions for establishing and creating a successful referral scheme. Ultimately, exercise referral schemes offer an alternative to help physician burnout and mitigate patient physical inactivity during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Nick W Bray
- Department of Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Myles W O'Brien
- Division of Kinesiology, Dalhousie University, Halifax, NS, Canada
| | - Michelle Ys Wong
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Wuyou Sui
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - M Lauren Voss
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Nolan Turnbull
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation. University of Alberta, Edmonton, AB, Canada
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19
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Sánchez-Polán M, Nagpal TS, Barakat R. Knowledge into action: proposing an evidence-based group prenatal exercise prescription. Perspect Public Health 2023; 143:29-33. [PMID: 34137308 DOI: 10.1177/17579139211018724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIMS In accordance with the American College of Obstetricians and Gynaecologists recommendations for exercise during pregnancy, this article provides an evidence-based prescription for a group-based prenatal exercise programme. METHODS This prescription has been tested in 21 randomized controlled trials. This short report outlines in detail the seven components included in each session (warm-up, aerobic training, resistance training, coordination and balance, pelvic floor training, cool-down, and final discussion). RESULTS Using the 26-item behaviour change taxonomy proposed by Abraham and Michie, we identified common techniques that are employed in each session to provide a rationale for the high-programme adherence. CONCLUSIONS This session model can be replicated to design prenatal exercise programmes with high adherence and that can be offered by trained exercise professionals.
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Affiliation(s)
- M Sánchez-Polán
- Faculty of Physical Activity and Sports Sciences, INEF, Universidad Politécnica de Madrid, Calle Martín Fierro, 7, Madrid 28040, Spain
| | - T S Nagpal
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - R Barakat
- Universidad Politécnica de Madrid, Madrid, Spain
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20
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Momen R, Weinreich M, Nagpal TS, Mottola MF. How Did Participating in a Prenatal Nutrition and Exercise Program Influence Postpartum Behaviour During COVID-19? Int J Exerc Sci 2023; 16:1-11. [PMID: 37113658 PMCID: PMC10124726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Lifestyle interventions focusing on prenatal physical activity (PA) and healthy nutritional habits can carry forward into the postpartum period. As many health resources, like PA facilities and postpartum support groups, were inaccessible due to the Coronavirus-19 (COVID-19) pandemic restrictions, it may be plausible that individuals who participated in a prenatal lifestyle intervention continued engaging in positive health behaviours on their own. This study explored experiences of postpartum individuals during the pandemic who had engaged in a prenatal PA and nutrition program prior to COVID-19. Semi-structured interviews were completed with postpartum individuals following a qualitative description approach. The study objectives were to identify and summarize the impact of the COVID-19 pandemic on PA and nutritional behaviours postpartum, and the role of previous participation in a prenatal lifestyle intervention, pre-pandemic, on PA and nutritional habits during postpartum quarantine restrictions. Thirteen participants completed interviews and reported that overall, PA levels stayed the same however, there was a change in PA type, as walking became the prominent choice of PA. Diet became more limited and involved a great deal of meal planning. Participation in a prenatal lifestyle intervention prior to the pandemic positively impacted PA and nutritional habits postpartum during COVID-19 restrictions. Specifically, it enabled individuals to implement walking as a daily PA habit and encouraged important concepts such as mindful eating and meal planning. Prenatal lifestyle interventions can be beneficial in establishing healthy postpartum habits, even during pandemic restrictions.
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Affiliation(s)
- Rozhan Momen
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, University of Western Ontario, London, ON, CANADA
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, CANADA
| | - Maya Weinreich
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, University of Western Ontario, London, ON, CANADA
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, CANADA
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, CANADA
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, University of Western Ontario, London, ON, CANADA
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, CANADA
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Everest C, da Silva DF, Puranda J, Souza SCS, Goudreau AD, Nagpal TS, Edwards CM, Gupta R, Adamo KB. Physical Activity and Weight Gain Throughout Pregnancy Are Associated With Umbilical Cord Markers. J Obstet Gynaecol Can 2022; 44:1262-1270. [PMID: 36216221 DOI: 10.1016/j.jogc.2022.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Maternal serum and umbilical cord (UC) lipid and glucose levels are influenced by a variety of maternal factors over the course of pregnancy, including maternal physical activity (PA) levels and gestational weight gain (GWG). However, previous research has not assessed the interaction of these 2 variables. This study investigated mid-gestation (24-28 weeks) and late gestation (34-38 weeks) maternal and UC serum lipid and glucose profiles in relation to maternal PA status and GWG, independently and in combination. METHODS This study had a longitudinal design. Pregnant participants (n = 40) were categorized as active or inactive based on the 2019 Canadian Guideline for Physical Activity throughout Pregnancy, and GWG was categorized as insufficient, appropriate, or excessive based on 2009 Institute of Medicine recommendations. Fasting maternal serum was taken in mid- and late gestation, and venous UC serum was taken at birth. RESULTS No relationship was found between maternal serum values and PA and/or GWG. Infants born to individuals who were physically active across pregnancy, or who were active in mid-pregnancy and had their activity status drop in late gestation, had lower UC total cholesterol levels than those who were inactive throughout pregnancy (P < 0.0001). Participants who had gained weight appropriately at mid-gestation had significantly lower UC glucose levels than those who gained weight insufficiently (P = 0.040) or excessively (P = 0.021). CONCLUSION In our study, PA, and GWG (independently and in combination) may not have affected maternal serum; however, meeting PA recommendations at mid-gestation may provide prophylactic effects on UC serum, potentially providing long-term health benefits to the newborn.
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Affiliation(s)
- Catherine Everest
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Danilo F da Silva
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Jessica Puranda
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Alexandra D Goudreau
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Taniya S Nagpal
- Department of Kinesiology, Brock University, St. Catharine's, ON
| | - Chris M Edwards
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Rhea Gupta
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON.
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22
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Heslehurst N, Evans EH, Incollingo Rodriguez AC, Nagpal TS, Visram S. Newspaper media framing of obesity during pregnancy in the UK: A review and framework synthesis. Obes Rev 2022; 23:e13511. [PMID: 36268693 PMCID: PMC9788256 DOI: 10.1111/obr.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 12/30/2022]
Abstract
Two thirds of women report experiencing weight stigma during pregnancy. Newspaper media is powerful in framing health issues. This review synthesized UK newspaper media portrayal of maternal obesity. NexisUni was searched to identify newspaper articles, published January 2010 to May 2021, reporting content on obesity during pregnancy. Framework synthesis integrated quantitative and qualitative analysis of the content of articles. There were 442 articles included (59% tabloids and 41% broadsheets). Three overarching themes with interacting sub-themes were as follows: (1) Women were blamed for their weight, risks, and NHS impact. (2) Women were solely responsible for solving obesity, gendered from school age. (3) Women with obesity were a burden on individuals (e.g., themselves, their children, and health professionals), to society, and the NHS. Catastrophizing language framed the "problem," "scale," and "public health concern" of maternal obesity, emphasizing risk, and danger and was alarmist, aggressive, and violent as to elicit fear or devalue women. Articles platformed 'expert' voices rather than women's lived experiences. This review identified that UK newspaper media negatively frames and oversimplifies the topic of maternal obesity. Exposure to blaming and alarmist messaging could increase women's guilt, stigma, and internalized weight bias. The newspaper media should be harnessed to de-stigmatize maternal obesity and promote maternal well-being.
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Affiliation(s)
- Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Canada
| | - Shelina Visram
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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23
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Heslehurst N, Evans EH, Rodriguez ACI, Nagpal TS, Visram S. Newspaper media framing of maternal obesity in the UK: a review and framework synthesis. Lancet 2022; 400 Suppl 1:S48. [PMID: 36929993 DOI: 10.1016/s0140-6736(22)02258-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND News media is powerful at framing health, shaping public perceptions and demand for policy. The effects of news media include perpetuating obesity discrimination, which threatens public health. Two-thirds of pregnant women report experiencing bodyweight-related stigma. The aim of this review was to explore the portrayal of maternal obesity in UK newspaper outlets. METHODS NexisUni was searched for newspaper articles published between Jan 1, 2010, and May 31, 2021, reporting content on obesity during pregnancy. Articles were screened against inclusion criteria. Integrated quantitative and qualitative analytics supported a novel framework synthesis to characterise the content of the articles. FINDINGS 442 articles were included: 261 (59%) published in tabloids and 181 (41%) in broadsheets. We identified three overarching themes: blame; responsibility; and burden of women with obesity. Subthemes were health outcomes (primarily of the infants); impact on the UK National Health Service (NHS); causes of and solutions for obesity; and calls for action. Women were blamed for their bodyweight, pregnancy risks, and NHS care requirements. Solutions were framed as the woman's responsibility to reduce her own and future generations' bodyweight, prevent adverse pregnancy outcomes, and alleviate the burden on the NHS. The burden of maternal obesity was consistently placed on women, as a burden on individuals (ie, themselves, their children, and health professionals), society, and the NHS. Patterns in language framed the so-called problem and scale of maternal obesity, emphasised risk and danger, and were alarmist, aggressive, and violent. Articles platformed purported experts' voices, such as professional organisations representatives, rather than women's lived experiences. The article narratives were underpinned by oversimplifications of obesity development, weight management, and causal pathways to health outcomes. INTERPRETATION UK newspapers negatively frame and oversimplify maternal obesity. Exposure to blaming and alarmist messaging could increase women's guilt and internalised weight bias, which can harm maternal and child physical and mental health during this life phase. The newspaper media should instead be harnessed to destigmatise maternal obesity, promote maternal wellbeing, and improve public health. The interdisciplinary, multinational research team and novel, rigorous methods are strengths of this review. A limitation is the focus on article texts but not on accompanying images. FUNDING None.
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Affiliation(s)
- Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | | | | | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Shelina Visram
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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24
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Nagpal TS, Sánchez-Polán M, da Silva DF, Souza SCS, Pelaez M, Perales M, Cordero Y, Vargas-Terrones M, Adamo KB, Barakat R. Population characteristics associated with adherence to prenatal group-based exercise programs. J Sports Sci 2022; 40:2275-2281. [PMID: 36526440 DOI: 10.1080/02640414.2022.2158011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34-36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, The University of Alberta, Edmonton, Alberta, Canada
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, Quebec, Canada
| | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Mireia Pelaez
- Faculty of Health Sciences, Universidad Europea del Atlántico, Spain
| | - María Perales
- Faculty of Sport Science, Camilo José Cela University, Villanueva de la Cañada, Spain.,Research Institute of Hospital 12 Octubre ('i+12'), Madrid, Spain
| | - Yaiza Cordero
- Faculty of Education, Complutense University of Madrid (UCM), Spain
| | - Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
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25
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Pellerine LP, Bray NW, Fowles JR, Furlano JA, Morava A, Nagpal TS, O’Brien MW. The Influence of Motivators and Barriers to Exercise on Attaining Physical Activity and Sedentary Time Guidelines among Canadian Undergraduate Students. Int J Environ Res Public Health 2022; 19:ijerph191912225. [PMID: 36231525 PMCID: PMC9566408 DOI: 10.3390/ijerph191912225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 05/18/2023]
Abstract
Canadian 24 h movement guidelines recommend engaging in >150 min/week of moderate-vigorous-intensity physical activity and ≤8 h/day of sedentary time. Half of Canadian post-secondary students do not meet physical activity or sedentary time guidelines. This pan-Canadian study aimed to (1) identify commonly cited motivators/barriers to exercise, and (2) determine which motivators/barriers were most influential for attaining physical and sedentary activity guidelines. A total of 341 respondents (279 females, 23 ± 4 years old, 53% met activity guidelines, 49% met sedentary guidelines) completed an online survey regarding undergraduate student lifestyle behaviours. Improved physical health (74% of respondents), mental health (67%), physical appearance (60%), and athletic performance (28%) were the most common motivators to exercise. The most common barriers were school obligations (68%), time commitments (58%), job obligations (32%), and lack of available fitness classes (26%). Students citing improved athletic performance (odds ratio (OR) = 1.94, p = 0.02) were more likely to adhere to activity guidelines, while those who selected physical health (OR = 0.56, p = 0.03) and physical appearance (OR = 0.46, p = 0.001) as motivators were less likely to meet activity guidelines. Students who cited school obligations as a barrier were less likely (OR = 0.59, p = 0.03) to meet sedentary guidelines. The motivators and barriers identified provide a foundation for university-led initiatives aimed at promoting physical activity and reducing sedentary time among undergraduate students. Strategies that positively re-frame students' physical health and appearance-based motivations for exercise may be particularly useful in helping more students achieve national activity recommendations.
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Affiliation(s)
- Liam P. Pellerine
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Nick W. Bray
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jonathon R. Fowles
- Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, NS B4P 2R6, Canada
| | - Joyla A. Furlano
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Anisa Morava
- School of Kinesiology, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Taniya S. Nagpal
- Faculty of Kinesiology Sport and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Myles W. O’Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Correspondence:
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26
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Smith ST, Raleigh J, Katz G, Prapavessis H, Fowles JR, Nagpal TS. Medical Students’ Perspectives Of Physical Activity In Medical Practice. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000881736.72722.da] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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27
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Edwards CM, da Silva DF, Souza SC, Puranda JL, Nagpal TS, Semeniuk K, Adamo KB. Body Regions Susceptible To Musculoskeletal Injuries In Canadian Armed Forces Pilots. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000876780.96756.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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28
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Angrish K, Barakat R, Adamo KB, Sánchez-Polán M, da Silva DF, Souza SC, Pelaez M, Perales M, Cordero Y, Vargas-Terrones M, Nagpal TS. Pregnant Together Work Out Together? Evaluating Population Characteristics Associated With Adherence To Group Prenatal Exercise. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000882320.56346.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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29
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Nagpal TS, Salas XR, Vallis M, Piccinini-Vallis H, Alberga AS, Bell RC, da Silva DF, Davenport MH, Gaudet L, Rodriguez ACI, Liu RH, Myre M, Nerenberg K, Nutter S, Russell-Mayhew S, Souza SCS, Vilhan C, Adamo KB. Exploring weight bias internalization in pregnancy. BMC Pregnancy Childbirth 2022; 22:605. [PMID: 35906530 PMCID: PMC9338529 DOI: 10.1186/s12884-022-04940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Recent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG. Methods Pregnant individuals in Canada and USA completed a modified version of the Adult Weight Bias Internalization Scale. Self-reported pre-pregnancy height and weight were collected to calculate and classify pre-pregnancy BMI. Current weight was also reported to calculate GWG, which was then classified as excessive or not based on Institute of Medicine (2009) guidelines. Participants indicated if they were diagnosed with obesity by a healthcare provider. Inferential analyses were performed comparing WBI scores according to pre-pregnancy BMI, excessive GWG, and obesity diagnosis. Significance was accepted as p < 0.05 and effect sizes accompanied all analyses. Result 336 pregnant individuals completed the survey, with an average WBI score of 3.9 ± 1.2. WBI was higher among those who had a pre-pregnancy BMI of obese than normal weight (p = 0.04, η2 = 0.03), diagnosed with obesity than not diagnosed (p < 0.001, Cohen’s d = 1.3), and gained excessively versus not (p < 0.001, Cohen’s d = 1.2). Conclusions Pregnant individuals who have a higher BMI, obesity and gain excessively may experience WBI. Given that weight stigma frequently occurs in pregnancy, effective person-oriented strategies are needed to mitigate stigma and prevent and care for WBI.
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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada. .,Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Angela S Alberga
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada
| | - Danilo F da Silva
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada
| | - Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Social Science and Policy Studies, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Rebecca H Liu
- Women's College Hospital Institute for Health System Solutions and Virtual Care (WIHV), Toronto, ON, Canada
| | - Maxine Myre
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Kara Nerenberg
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Nutter
- Department of Educational Psychology and Leadership Studies, University of Victoria, Victoria, BC, Canada
| | | | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Candace Vilhan
- Obesity Canada, Patient Advocate Volunteer, Edmonton, AB, Canada
| | - Kristi B Adamo
- Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada
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30
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Capozzi LC, Lun V, Shellington EM, Nagpal TS, Tomasone JR, Gaul C, Roberts A, Fowles JR. Physical activity RX: development and implementation of physical activity counselling and prescription learning objectives for Canadian medical school curriculum. Can Med Educ J 2022; 13:52-59. [PMID: 35875444 PMCID: PMC9297235 DOI: 10.36834/cmej.73767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Physical activity is an important component of health and well-being, and is effective in the prevention, management, and treatment of numerous non-communicable chronic diseases. Despite the known health benefits of physical activity in all populations, most Canadians do not meet physical activity recommendations. Physicians play a key role in assessing, counselling, and prescribing physical activity. Unfortunately, many barriers, including the lack of adequate education and training, prevent physicians from promoting this essential health behaviour. To support Canadian medical schools in physical activity curriculum development, a team of researchers, physicians, and exercise physiologists collaborated to develop a key set of learning objectives deemed essential to physician education in physical activity counselling and prescription. This commentary will review the newly developed Canadian Physical Activity Counselling Learning Objectives and give case examples of three Canadian medical schools that have implemented these learning objectives.
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Affiliation(s)
- Lauren C Capozzi
- Faculty of Kinesiology, University of Calgary, Alberta, Canada
- Section of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Victor Lun
- Faculty of Kinesiology, University of Calgary, Alberta, Canada
| | - Erin M Shellington
- Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Taniya S Nagpal
- Faculty of Applied Health Sciences, Kinesiology, Brock University, Ontario, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Ontario, Canada
| | - Catherine Gaul
- School of Exercise Science, Physical & Health Education, University of Victoria, British Columbia, Canada
| | - Arielle Roberts
- Family Practice Residency Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Jonathon R Fowles
- Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Ontario, Canada
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31
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Nagpal TS, Furlano JA, Reilly KC, Karmali S, Prapavessis H, Mottola MF, Burke SM, Vanderloo LM. Describing the views of Canadian post-secondary students in health-related disciplines on the recognition of obesity as a chronic disease. J Am Coll Health 2022:1-4. [PMID: 35549826 DOI: 10.1080/07448481.2022.2074279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/21/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This cross-sectional study examined students' perspectives on the ramifications of obesity being recognized as a chronic disease in Canada. PARTICIPANTS Undergraduate and graduate students (n = 150) in health-related programs at a major Canadian university. METHODS An online survey featured open-ended questions to capture student perspectives on recognizing obesity as a disease. Data were evaluated using content analysis methods. RESULTS Positive themes identified included: (a) treatment accessibility; (b) improved healthcare provider attitudes; (c) de-stigmatization of obesity; (d) promotion of health behaviors; and (e) greater research/funding. Negative themes included potential: (a) healthcare system burdens; (b) perpetuation of obesity stigma; (c) medicalization of obesity; and (d) de-emphasis on modifiable risk factors as contributing to obesity. CONCLUSIONS There is a need to increase students' understanding of the multifaceted nature of obesity and the prevention of obesity-related stigma within healthcare. Findings may inform post-secondary health curricula and obesity initiatives.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Joyla A Furlano
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kristen C Reilly
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Shazya Karmali
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Harry Prapavessis
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | | | - Shauna M Burke
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Leigh M Vanderloo
- Faculty of Health Sciences, Western University, London, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
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32
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Silva-Jose C, Nagpal TS, Coterón J, Barakat R, Mottola MF. The 'new normal' includes online prenatal exercise: exploring pregnant women's experiences during the pandemic and the role of virtual group fitness on maternal mental health. BMC Pregnancy Childbirth 2022; 22:251. [PMID: 35337280 PMCID: PMC8953965 DOI: 10.1186/s12884-022-04587-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/11/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic In addition, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity levels and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs. METHODS Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women's experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory and these data supplemented qualitative findings. RESULTS Twenty-four women were interviewed, and the anxiety scores were on average 32.23 ± 9.31, ranging from low to moderate levels. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional. CONCLUSION Pregnant women are receptive to online group exercise classes and expressed that they are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health.
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Affiliation(s)
| | - Taniya S Nagpal
- Kinesiology, Faculty of Applied Health Sciences, Brock University St. Catharines, St. Catharines, Canada
| | - Javier Coterón
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain.
| | - Ruben Barakat
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Michelle F Mottola
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Canada.,Children's Health Research Institute, University of Western Ontario, London, Canada.,Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
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33
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Souza SCS, da Silva DF, Piccinini-Vallis H, Nagpal TS, Paludo AC, Mattes VV, Salas XR, Adamo KB. Thinking ahead: Brazilian healthcare providers also need culturally relevant tools to communicate gestational weight gain recommendations. Am J Clin Nutr 2022; 115:588-589. [PMID: 35139167 DOI: 10.1093/ajcn/nqab376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sara C S Souza
- From the Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Danilo F da Silva
- From the Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Helena Piccinini-Vallis
- Departments of Family Medicine and Obstetrics and Gynecology, Dalhousie University, Halifax, Canada
| | - Taniya S Nagpal
- Department of Kinesiology, Brock University, St. Catharines, Canada
| | - Ana C Paludo
- Incubator of Kinanthropology Research, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Verônica V Mattes
- Department of Physical Education, Midwestern Parana State University, Guarapuava, Brazil
| | | | - Kristi B Adamo
- From the Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Hayman MJ, Alfrey KL, Waters K, Cannon S, Mielke GI, Keating SE, Mena GP, Mottola MF, Evenson KR, Davenport MH, Barlow SA, Budzynski-Seymour E, Comardelle N, Dickey M, Harrison CL, Kebbe M, Moholdt T, Moran LJ, Nagpal TS, Schoeppe S, Alley S, Brown WJ, Williams S, Vincze L. Evaluating Evidence-Based Content, Features of Exercise Instruction, and Expert Involvement in Physical Activity Apps for Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e31607. [PMID: 35044318 PMCID: PMC8811692 DOI: 10.2196/31607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/01/2021] [Accepted: 11/17/2021] [Indexed: 01/07/2023] Open
Abstract
Background Guidelines for physical activity and exercise during pregnancy recommend that all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity and exercise during this life stage and are increasingly using mobile apps to access health-related information. However, the extent to which apps that provide physical activity and exercise advice align with current evidence-based pregnancy recommendations is unclear. Objective This study aims to conduct a systematic search and content analysis of apps that promote physical activity and exercise in pregnancy to examine the alignment of the content with current evidence-based recommendations; delivery, format, and features of physical activity and exercise instruction; and credentials of the app developers. Methods Systematic searches were conducted in the Australian App Store and Google Play Store in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and exercise or physical activity and screened for inclusion (with a primary focus on physical activity and exercise during pregnancy, free to download or did not require immediate paid subscription, and an average user rating of ≥4 out of 5). Apps were then independently reviewed using an author-designed extraction tool. Results Overall, 27 apps were included in this review (Google Play Store: 16/27, 59%, and App Store: 11/27, 41%). Two-thirds of the apps provided some information relating to the frequency, intensity, time, and type principles of exercise; only 11% (3/27) provided this information in line with current evidence-based guidelines. Approximately one-third of the apps provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. None of the apps actively engaged in screening for potential contraindications. Only 15% (4/27) of the apps collected information about the user’s current exercise behaviors, 11% (3/27) allowed users to personalize features relating to their exercise preferences, and a little more than one-third provided information about developer credentials. Conclusions Few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. None of the apps screened users for contraindications to physical activity and exercise during pregnancy, and most lacked appropriate personalization features to account for an individual’s characteristics. Few involved qualified experts during the development of the app. There is a need to improve the quality of apps that promote exercise in pregnancy to ensure that women are appropriately supported to engage in exercise and the potential risk of injury, complications, and adverse pregnancy outcomes for both mother and child is minimized. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalization and tailoring to individual users, or by developing a recognized system for regulating apps.
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Affiliation(s)
- Melanie J Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kristie-Lee Alfrey
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kim Waters
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Summer Cannon
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Gregore I Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Gabriela P Mena
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle F Mottola
- R Samuel McLaughlin Foundation Exercise and Pregnancy Laboratory, School of Kinesiology, University of Western Ontario, London, ON, Canada
- Department of Anatomy & Cell Biology, University of Western Ontario, London, ON, Canada
- Children's Health Research Institute, University of Western Ontario, London, ON, Canada
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - S Ariel Barlow
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Emily Budzynski-Seymour
- Faculty of Sport, Health and Social Sciences, Solent University, Southampton, United Kingdom
| | - Natalie Comardelle
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Madison Dickey
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maryam Kebbe
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Taniya S Nagpal
- Faculty of Applied Health Sciences, School of Kinesiology, Brock University, Niagara Region, ON, Canada
| | - Stephanie Schoeppe
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Stephanie Alley
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Susan Williams
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
- Menzies Health Institute Queensland, Griffith Health Centre, Gold Coast, Australia
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35
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Sánchez-Polán M, Nagpal TS, Barakat R. Call to Action for Promoting Exercise Is Medicine in Pregnancy—Collaboration Is Key. Transl J ACSM 2022. [DOI: 10.1249/tjx.0000000000000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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36
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Nagpal TS, Souza SCS, Moffat M, Hayes L, Nuyts T, Liu RH, Bogaerts A, Dervis S, Piccinini-Vallis H, Adamo KB, Heslehurst N. Does prepregnancy weight change have an effect on subsequent pregnancy health outcomes? A systematic review and meta-analysis. Obes Rev 2022; 23:e13324. [PMID: 34694053 DOI: 10.1111/obr.13324] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022]
Abstract
International guidelines recommend women with an overweight or obese body mass index (BMI) aim to reduce their body weight prior to conception to minimize the risk of adverse perinatal outcomes. Recent systematic reviews have demonstrated that interpregnancy weight gain increases women's risk of developing adverse pregnancy outcomes in their subsequent pregnancy. Interpregnancy weight change studies exclude nulliparous women. This systematic review and meta-analysis was conducted following MOOSE guidelines and summarizes the evidence of the impact of preconception and interpregnancy weight change on perinatal outcomes for women regardless of parity. Sixty one studies met the inclusion criteria for this review and reported 34 different outcomes. We identified a significantly increased risk of gestational diabetes (OR 1.88, 95% CI 1.66, 2.14, I2 = 87.8%), hypertensive disorders (OR 1.46 95% CI 1.12, 1.91, I2 = 94.9%), preeclampsia (OR 1.92 95% CI 1.55, 2.37, I2 = 93.6%), and large-for-gestational-age (OR 1.36, 95% CI 1.25, 1.49, I2 = 92.2%) with preconception and interpregnancy weight gain. Interpregnancy weight loss only was significantly associated with increased risk for small-for-gestational-age (OR 1.29 95% CI 1.11, 1.50, I2 = 89.9%) and preterm birth (OR 1.06 95% CI 1.00, 1.13, I2 = 22.4%). Our findings illustrate the need for effective preconception and interpregnancy weight management support to improve pregnancy outcomes in subsequent pregnancies.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Sara C S Souza
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Malcolm Moffat
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Louise Hayes
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Tinne Nuyts
- Department of Development and Regeneration, Research Unit Woman and Child, KU Leuven, Leuven, Belgium
| | - Rebecca H Liu
- Institute for Health System Solutions & Virtual Care, Women's College Hospital, Toronto, Canada
| | - Annick Bogaerts
- Department of Development and Regeneration, Research Unit Woman and Child, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Faculty of Health, University of Plymouth, Plymouth, UK
| | - Sheila Dervis
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Helena Piccinini-Vallis
- Faculty of Medicine, Departments of Family Medicine and Obstetrics and Gynecology, Dalhousie University, Halifax, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Nicola Heslehurst
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
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37
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Nagpal TS, Tomiyama AJ, Incollingo Rodriguez AC. Beyond BMI: Pregnancy-related weight stigma increases risk of gestational diabetes. Prim Care Diabetes 2021; 15:1107-1109. [PMID: 34275770 DOI: 10.1016/j.pcd.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/11/2022]
Abstract
The objective of this research brief was to assess if prenatal weight stigma is a predictive factor for perinatal complications compared to pre-pregnancy body mass index (BMI). Data were assessed from 358 women. Results indicated weight stigma concerns increased the odds of gestational diabetes, with a stronger association than BMI.
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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
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38
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Incollingo Rodriguez AC, Nagpal TS. The WOMBS Framework: A review and new theoretical model for investigating pregnancy-related weight stigma and its intergenerational implications. Obes Rev 2021; 22:e13322. [PMID: 34288364 DOI: 10.1111/obr.13322] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
As the growing weight stigma literature has developed, one critically relevant and vulnerable population has received little consideration-pregnant and postpartum women. Because weight fluctuations are inherent to this life phase, and rates of prepregnancy overweight and obesity are already high, this gap is problematic. More recently, however, there has been a rising interest in pregnancy-related weight stigma and its consequences. This paper therefore sought to (a) review the emerging research on pregnancy-related weight stigma phenomenology and (b) integrate this existing evidence to present a novel theoretical framework for studying pregnancy-related weight stigma. The Weight gain, Obesity, Maternal-child Biobehavioral pathways, and Stigma (WOMBS) Framework proposes psychophysiological mechanisms linking pregnancy-related weight stigmatization to increased risk of weight gain and, in turn, downstream childhood obesity risk. This WOMBS Framework highlights pregnant and postpartum women as a theoretically unique at-risk population for whom this social stigma engages maternal physiology and transfers obesity risk to the child via social and physiological mechanisms. The WOMBS Framework provides a novel and useful tool to guide the emerging pregnancy-related weight stigma research and, ultimately, support stigma-reduction efforts in this critical context.
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Affiliation(s)
- Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Department of Social Science & Policy Studies, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
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39
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Nagpal TS, Liu RH, Myre M, Gaudet L, Cook J, da Silva DF, Adamo KB. Weight stigma and prenatal physical activity: Exploring the perspectives of pregnant women living with obesity. Midwifery 2021; 104:103186. [PMID: 34788725 DOI: 10.1016/j.midw.2021.103186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To identify sources of weight stigma in physical activity (PA)-related milieus reported by pregnant women living with obesity. We also report person-informed strategies to improve the delivery of PA promotions and prescriptions to prevent weight stigma and improve maternal PA. DESIGN This is a qualitative descriptive study and semi-structured interviews were conducted. SETTING AND PARTICIPANTS Purposive sampling including pregnant women living with obesity, with a body mass index ≥35.0 kg/m2, ≥18 years of age, and receiving specialized prenatal care were recruited from an obstetrics clinic in Kingston, Canada. MEASUREMENT AND FINDINGS Data were assessed by a content analysis, whereby coded themes represented sources of weight stigma related to prenatal PA. Demographic characteristics (pre-pregnancy body mass index, age, gestational age) were summarized and presented as means and standard deviations. In-depth interview data were collected from eight women. Average pre-pregnancy BMI, age, and gestational age were 44.6±4.8 kg/m2, 32.0±4.1 years, 31.1±5.8 weeks, respectively. Two sources of weight stigma related to prenatal PA were identified: 1. Lack of visual representation - online images and images found in exercise promotional material do not include women who have obesity; 2. Lack of individualized recommendations - currently available prenatal PA guidelines and/or recommendations from healthcare providers do not always consider individual physical barriers or health goals women may have. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE By increasing body positive representation of pregnant women exercising and offering person-centered prenatal PA recommendations, maternal PA may improve including women living with obesity. Findings from this work can inform future PA interventions, health promotion programming, and prescriptions from prenatal care providers to implement person-oriented strategies to prevent weight stigma and improve the delivery of care for pregnant women living with obesity.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada; Society of Obstetricians and Gynaecologists of Canada, Ottawa K1B 1A7, Canada.
| | - Rebecca H Liu
- Women's College Hospital, Institute for Health System Solutions & Virtual Care, Toronto, Ontario, M5G 1N8, Canada.
| | - Maxine Myre
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada.
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston K7L 3N6, Canada.
| | - Jocelynn Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa K1B 1A7, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa K1N 6N5, Canada.
| | - Danilo F da Silva
- Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada.
| | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada.
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40
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Crozier M, Wasenius NS, Denize KM, da Silva DF, Nagpal TS, Adamo KB. Evaluation of Afterschool Activity Programs' (ASAP) Effect on Children's Physical Activity, Physical Health, and Fundamental Movement Skills. Health Educ Behav 2021; 49:87-96. [PMID: 34605699 PMCID: PMC8892040 DOI: 10.1177/10901981211033234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Physical literacy-focused afterschool activity programs (ASAPs) can be an effective strategy to improve children’s health-related parameters. We sought to compare physical activity, body composition, aerobic capacity, and fundamental movement skills between physical literacy-focused ASAP and a standard recreational ASAP. Method A pre–post (6 months) comparison study was conducted in 5- to 12-year-old children in a physical literacy-focused ASAP (physical literacy group, n = 14) and children attending a standard recreational ASAP (comparison group, n = 15). Physical activity guideline adherence was assessed using accelerometry, body composition was analyzed using bioelectrical impedance, aerobic capacity was estimated using the Progressive Aerobic Cardiovascular Endurance Run test, and fundamental movement skills were evaluated using the Test of Gross Motor Development–2. Results There were no significant differences between groups at baseline. After 6 months, the physical literacy group exhibited a significant improvement in their total raw score for the Test of Gross Motor Development–2 (p = .016), which was likely due to improvements in object control skills (p = .024). The comparison group significantly increased body mass index (p = .001) and body fat (p = .009) over time. No significant between-group differences were found; however, there was a trend for improved aerobic capacity in the physical literacy group (d = 0.58). Conclusions Engagement in the physical literacy-focused ASAP contributed to an attenuated increase in adiposity and an improvement in object control skills.
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Affiliation(s)
| | - Niko S Wasenius
- University of Ottawa, Ottawa, Ontario, Canada.,Folkhälsan Research Center, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
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41
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Nagpal TS, Maples JM, Duchette C, Altizer EA, Tinius R. Physical Activity during Pregnancy may Mitigate Adverse Outcomes Resulting from COVID-19 and Distancing Regulations: Perspectives of Prenatal Healthcare Providers in the Southern Region of the United States. Int J Exerc Sci 2021; 14:1138-1150. [PMID: 35096236 PMCID: PMC8758165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Prenatal physical activity (PA) may mitigate adverse outcomes that have increased as a result of the coronavirus pandemic, including poor maternal mental health. This study explored the perspectives of prenatal healthcare providers (PHCP) on maternal PA during the pandemic and identified resources providers would like to have to inform clinical discussions and prescription of PA. Semi-structured interviews were completed with PHCPs following a qualitative description approach. A content analysis coded data to inform three study objectives: 1. Changes to maternal health, 2. The role prenatal PA can have during a pandemic, 3. Resources PHCPs would find helpful to discuss and prescribe PA. Nine PHCPs completed interviews. Changes to maternal health include an increase in stress, fear surrounding labor and delivery, and risk of pre-existing problematic behaviors (e.g., substance abuse). PA was identified as helpful for improving mental health and preventing excessive gestational weight gain (EGWG). Providers expressed interest in having low cost referral options for prenatal PA that are accessible from home. PHCPs suggest PA during the pandemic can improve maternal mental health and prevent EGWG. To support clinical discussions and prescriptions of prenatal PA, knowledge translation initiatives should include informing PHCPs of referral resources for low cost at-home fitness options.
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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ONTARIO, CANADA
| | - Jill M Maples
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Cathryn Duchette
- Exercise Science Program, School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KENTUCKY, USA
| | - Elizabeth A Altizer
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Rachel Tinius
- Exercise Science Program, School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KENTUCKY, USA
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42
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S Nagpal T, F Mottola M. Physical activity throughout pregnancy is key to preventing chronic disease. Reproduction 2021; 160:R111-R118. [PMID: 32805707 DOI: 10.1530/rep-20-0337] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/17/2020] [Indexed: 11/08/2022]
Abstract
According to The Developmental Origins of Health and Disease theory, the intrauterine environment of the developing fetus may impact later life physiology, including susceptibility to chronic disease conditions. Maternal exposures during pregnancy can affect the intrauterine environment and result in fetal programming for chronic diseases through changes in the structure or function of specific organs. Negative maternal exposures, such as poor nutrition intake, have been shown to increase the risk for later life chronic diseases. On the contrary, healthful behaviors, such as physical activity, may have a positive and protective effect against chronic disease risk. This narrative review summarizes literature to discuss the potential preventative role prenatal physical activity may have on prevalent chronic diseases: obesity, type 2 diabetes, and cardiovascular disease. We describe the natural physiological response to pregnancy that may increase the risk for complications and consequently later life disease for both mother and baby. We then present evidence highlighting the role prenatal exercise may have in preventing pregnancy complications and downstream chronic disease development, as well as proposing potential mechanisms that may explain the protective maternal and fetal physiological response to exercise. As the prevalence of these non-communicable diseases increase globally, intervening during pregnancy with an effective exercise intervention may be the key to preventing chronic disease risk in more than one generation.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada
| | - Michelle F Mottola
- Faculty of Health Sciences, University of Western Ontario, London, Canada.,R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, University of Western Ontario, London, Canada.,Children's Health Research Institute, University of Western Ontario, London, Canada.,Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
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43
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Goudreau AD, Everest C, Nagpal TS, Puranda JL, Bhattacharjee J, Vasanthan T, Adamo KB. Elucidating the interaction between maternal physical activity and circulating myokines throughout gestation: A scoping review. Am J Reprod Immunol 2021; 86:e13488. [PMID: 34331363 DOI: 10.1111/aji.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/05/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022] Open
Abstract
Physical activity (PA) during pregnancy provides both maternal and fetal health benefits. It has been theorized that myokines, peptides secreted by contracting skeletal muscle, may play an important mechanistic role in facilitating the health benefits obtained from prenatal exercise. The objective of this review was to synthesize the current literature on the relationship between maternal PA and myokine response. A search strategy was developed using the terms pregnancy, PA, IL-6, IL-10, IL-13, and TNF-α. A systematic search was completed in July 2020, in Medline, SPORTDiscus, EMBASE, CENTRAL, and in November 2020 for unpublished dissertations (grey literature; Proquest). Both human- and animal-based studies of any design were included, while commentaries and editorial articles were excluded. Data were extracted by two independent reviewers and summarized narratively. Data were thematically summarized based on the myokine and whether findings were from human or animal studies. Ten studies were included in this review. Findings from studies that examined IL-6, IL-10, and TNF-α suggest a trimester-specific interaction between PA and myokine levels; no studies evaluated IL-13. Future research should investigate the PA-myokine relationship throughout all stages of gestation.
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Affiliation(s)
| | - Catherine Everest
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Taniya S Nagpal
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
| | - Jessica L Puranda
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jayonta Bhattacharjee
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Department of Surgery and Obstetrics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | | | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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44
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Nagpal TS, Souza SCS, da Silva DF, Ferraro ZM, Sharma AM, Adamo KB. Widespread misconceptions about pregnancy for women living with obesity. Can Fam Physician 2021; 67:85-87. [PMID: 33608355 DOI: 10.46747/cfp.670285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Taniya S Nagpal
- Postdoctoral fellow at the University of Ottawa in Ontario and at the Society of Obstetricians and Gynaecologists of Canada.
| | | | | | - Zachary M Ferraro
- Obstetrics and gynecology resident at the University of Toronto in Ontario
| | - Arya M Sharma
- Scientific Director of Obesity Canada and Professor at the University of Alberta in Edmonton
| | - Kristi B Adamo
- Director of the Adamo Lab Prevention in the Early Years Research Program and Associate Professor at the University of Ottawa
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45
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Nagpal TS, Ramos Salas X, Vallis M, Piccinini-Vallis H, Adamo KB, Alberga AS, Bell RC, da Silva DF, Davenport MH, Gaudet L, Incollingo Rodriguez AC, Liu RH, Myre M, Nerenberg K, Nutter S, Russell-Mayhew S, Souza SCS, Vilhan C. Coming Soon: An Internalized Weight Bias Assessment Scale for Use During Pregnancy. Obesity (Silver Spring) 2021; 29:788-789. [PMID: 33797202 DOI: 10.1002/oby.23169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/04/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Taniya S Nagpal
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada
| | | | - Michael Vallis
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Helena Piccinini-Vallis
- Departments of Family Medicine and Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Angela S Alberga
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montréal, Québec, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Danilo F da Silva
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | | | - Rebecca H Liu
- Women's College Hospital Institute of Health System Solutions and Virtual Care, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Maxine Myre
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Kara Nerenberg
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Nutter
- Educational Psychology & Leadership Studies, University of Victoria, Victoria, British Columbia, Canada
| | | | - Sara C S Souza
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Hayman M, Alfrey KL, Cannon S, Alley S, Rebar AL, Williams S, Short CE, Altazan A, Comardelle N, Currie S, Denton C, Harrison CL, Lamerton T, Mena GP, Moran L, Mottola M, Nagpal TS, Vincze L, Schoeppe S. Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth 2021; 9:e23649. [PMID: 33825693 PMCID: PMC8060865 DOI: 10.2196/23649] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/21/2020] [Accepted: 01/17/2021] [Indexed: 12/18/2022] Open
Abstract
Background Physical activity during pregnancy is associated with several health benefits for the mother and child. However, very few women participate in regular physical activity during pregnancy. eHealth platforms (internet and mobile apps) have become an important information source for pregnant women. Although the use of pregnancy-related apps has significantly increased among pregnant women, very little is known about their theoretical underpinnings, including their utilization of behavior change techniques (BCTs). This is despite research suggesting that inclusion of BCTs in eHealth interventions are important for promoting healthy behaviors, including physical activity. Objective The aim of this study was to conduct a systematic search and content analysis of app quality, features, and the presence of BCTs in apps designed to promote physical activity among pregnant women. Methods A systematic search in the Australian App Store and Google Play store using search terms relating to exercise and pregnancy was performed. App quality and features were assessed using the 19-item Mobile App Rating Scale (MARS), and a taxonomy of BCTs was used to determine the presence of BCTs (26 items). BCTs previously demonstrating efficacy in behavior changes during pregnancy were also identified from a literature review. Spearman correlations were used to investigate the relationships between app quality, app features, and number of BCTs identified. Results Nineteen exercise apps were deemed eligible for this review and they were accessed via Google Play (n=13) or App Store (n=6). The MARS overall quality scores indicated moderate app quality (mean 3.5 [SD 0.52]). Functionality was the highest scoring MARS domain (mean 4.2 [SD 0.5]), followed by aesthetics (mean 3.7 [SD 0.6]) and information quality (mean 3.16 [SD 0.42]). Subjective app quality (mean 2.54 [SD 0.64]) and likelihood for behavioral impact (mean 2.5 [SD 0.6]) were the lowest scoring MARS domains. All 19 apps were found to incorporate at least two BCTs (mean 4.74, SD 2.51; range 2-10). However, only 11 apps included BCTs that previously demonstrated efficacy for behavior change during pregnancy, the most common being provide opportunities for social comparison (n=8) and prompt self-monitoring of behavior (n=7). There was a significant positive correlation between the number of BCTs with engagement and aesthetics scores, but the number of BCTs was not significantly correlated with functionality, information quality, total MARS quality, or subjective quality. Conclusions Our findings showed that apps designed to promote physical activity among pregnant women were functional and aesthetically pleasing, with overall moderate quality. However, the incorporation of BCTs was low, with limited prevalence of BCTs previously demonstrating efficacy in behavior change during pregnancy. Future app development should identify and adopt factors that enhance and encourage user engagement, including the use of BCTs, especially those that have demonstrated efficacy for promoting physical activity behavior change among pregnant women.
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Affiliation(s)
- Melanie Hayman
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Kristie-Lee Alfrey
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Summer Cannon
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Stephanie Alley
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Amanda L Rebar
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Susan Williams
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Camille E Short
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Abby Altazan
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Natalie Comardelle
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Sinead Currie
- Division of Psychology, Stirling University, Scotland, United Kingdom
| | - Caitlin Denton
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cheryce L Harrison
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tayla Lamerton
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Gabriela P Mena
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Lisa Moran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michelle Mottola
- Faculty of Health Sciences in Kinesiology, University of Western Ontario, London, ON, Canada
| | - Taniya S Nagpal
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Lisa Vincze
- School of Allied Health Sciences - Nutrition and Dietetics, Griffith University, Gold Coast, Australia
| | - Stephanie Schoeppe
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
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Everest C, Nagpal TS, Souza SCS, DA Silva DF, Gaudet L, Mohammad S, Bhattacharjee J, Adamo KB. The Effect of Maternal Physical Activity and Gestational Weight Gain on Placental Efficiency. Med Sci Sports Exerc 2021; 53:756-762. [PMID: 32991347 DOI: 10.1249/mss.0000000000002524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Adherence to physical activity (PA) and gestational weight gain (GWG) recommendations during pregnancy has been shown to improve maternal and fetal health outcomes, including reducing the risk for chronic diseases. Limited research has evaluated the effect of meeting PA in combination with GWG recommendations on placental efficiency (Pl-E), a surrogate marker of the placenta's ability to exchange nutrients and gas based on surface area. The purpose of this study was to measure and compare Pl-E based on meeting PA and GWG recommendations. METHOD Healthy pregnant women (n = 61) wore accelerometers in their second and third trimesters to objectively measure PA. Women were classified as active or inactive at each time point based on meeting the 2019 Canadian prenatal PA guidelines. Total GWG was calculated as weight measured in the third trimester minus self-reported prepregnancy weight, and were categorized as insufficient (n = 19), adequate (n = 22), and excessive (n = 20) according to the 2009 Institute of Medicine guidelines. Placental weight (PW) and birth weight (BW) were measured within 30 min of delivery and 24-48 h postdelivery, respectively. Pl-E was determined in three ways: BW:PW ratio, residual BW, and measured BW, with a higher value indicating better Pl-E. Pl-E was compared by PA and GWG status using a two-way ANOVA. RESULTS No differences were found in the BW:PW ratio or residual BW corresponding to PA and GWG status. Measured BW was significantly higher in newborns of women who gained weight excessively compared with those who gained insufficient weight (P < 0.05). CONCLUSION These findings suggest that prenatal PA does not compromise Pl-E; however, further research is required to evaluate the potential mechanistic benefits of meeting PA and GWG guidelines on the placenta.
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Affiliation(s)
- Catherine Everest
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
| | - Taniya S Nagpal
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
| | - Sara C S Souza
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
| | - Danilo F DA Silva
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
| | - Laura Gaudet
- Faculty of Health Sciences, School of Medicine, Department of Obstetrics and Gynaecology, Queen's University, Kingston, ON, CANADA
| | - Shuhiba Mohammad
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
| | - Jayonta Bhattacharjee
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
| | - Kristi B Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA
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Nagpal TS, da Silva DF, Liu RH, Myre M, Gaudet L, Cook J, Adamo KB. Women's Suggestions for How To Reduce Weight Stigma in Prenatal Clinical Settings. Nurs Womens Health 2021; 25:112-121. [PMID: 33675687 DOI: 10.1016/j.nwh.2021.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/01/2020] [Accepted: 01/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe the experiences of weight stigma in prenatal clinical settings among high-risk pregnant women living with obesity and to obtain women's perspectives regarding changes to prenatal health care practices that may reduce weight stigma. DESIGN Qualitative descriptive study. SETTING/LOCAL PROBLEM High-risk obstetrics clinic. Weight stigma experienced in prenatal clinical settings can negatively influence maternal health and well-being as well as communication with health care providers. PARTICIPANTS Nine pregnant women with obesity who were receiving specialized prenatal care in their third trimester. INTERVENTION/MEASUREMENTS Women participated in semistructured telephone interviews. Data were inductively analyzed using a content analysis, whereby coded data were organized to represent experiences of or suggestions provided by pregnant women to reduce weight stigma in prenatal clinical settings. RESULTS Experiences of weight stigma included poor communication, generalizations made about health and lifestyle behaviors, and focusing only on excess body weight during clinical appointments as the cause of negative health outcomes. To reduce weight stigma, women suggested that health care providers practice sensitive communication, offer individualized care for weight management, and reduce the focus on body weight by also independently addressing comorbidities or other health indicators. CONCLUSION Women interviewed for this study provided suggestions that can be implemented in prenatal clinical settings to reduce weight stigma and improve the delivery of equitable health care.
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Vargas-Terrones M, Nagpal TS, Perales M, Prapavessis H, Mottola MF, Barakat R. Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change. Psychol Med 2021; 51:688-693. [PMID: 32102723 DOI: 10.1017/s0033291719003714] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria. METHODS This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9-16 and 36-38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention. RESULTS Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36-38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05). CONCLUSIONS A structured exercise program might be a useful treatment option for women at risk for prenatal depression.
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Affiliation(s)
- Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Taniya S Nagpal
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Maria Perales
- Camilo José Cela University, Madrid, Spain
- Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Harry Prapavessis
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
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Nagpal TS, Everest C, Goudreau AD, Manicks M, Adamo KB. To HIIT or not to HIIT? The question pregnant women may be searching for online: a descriptive observational study. Perspect Public Health 2021; 141:81-88. [PMID: 33579178 DOI: 10.1177/1757913920985898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS An increasingly popular exercise modality for women is high-intensity interval training (HIIT). Limited research has assessed HIIT during pregnancy, and as a result, pregnant women may inquire about HIIT on their own through online searches. The purpose of this study was to systematically search and critically evaluate online resources that women may access when inquiring about performing HIIT during pregnancy. METHODS Following previously published methodology, we systematically examined the online search engine Google with the terms 'HIIT' and 'pregnancy'. Using the 2019 Canadian Guideline for Physical Activity throughout Pregnancy as a reference, we identified evidence-based safety recommendations that apply to all prenatal exercise regimes. All selected links were assessed for whether or not they included evidence-based exercise and pregnancy safety recommendations. Descriptive analyses were performed to report the frequency of each construct. RESULTS Seventy-six links were retrieved, and 33 relevant links were selected for inclusion. The majority of the retrieved links recommended that women should consult a healthcare provider before beginning any exercise programme (67%), and modify the intensity and types of exercises in the active HIIT bout based on general pregnancy-related changes (73%) and individual comfort level (55%). Just under half of the links recommended modifying intensity based on prepregnancy activity level (46%), offered trimester-specific recommendations (42%), and only 12% mentioned contraindications to exercise. CONCLUSION Publicly accessible information online on HIIT during pregnancy does not routinely adhere to evidence-based safety recommendations for prenatal exercise. Further research on HIIT during pregnancy and public dissemination of findings is required.
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Affiliation(s)
- T S Nagpal
- Post-Doctoral Fellow, Faculty of Health Sciences, University of Ottawa, 200 Lees Ave, Ottawa, ON K1S 5L5, Canada
| | - C Everest
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - A D Goudreau
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - M Manicks
- Faculty of Health Sciences, University of Western Ontario, Ontario, ON, Canada
| | - K B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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