Feasibility, acceptability and efficacy of a web-based computer-tailored physical activity intervention for pregnant women - the Fit4Two randomised controlled trial

Abstract

BackgroundPhysical activity (PA) during pregnancy is associated with a variety of health benefits including a reduced risk of pregnancy related conditions such as pre-eclampsia and pregnancy-induced hypertension and leads to greater control over gestational weight gain. Despite these associated health benefits, very few pregnant women are sufficiently active. In an attempt to increase health outcomes, it is important to explore innovative ways to increase PA among pregnant women. Therefore, the aim of this study was to assess the feasibility, acceptability and efficacy of a four week web-based computer-tailored PA intervention among pregnant women.MethodsSeventy-seven participants were randomised into either: (1) an intervention group that received tailored PA advice and access to a resource library of articles relating to PA during pregnancy; or (2) a standard information group that only received access to the resources library. Objective moderate-to-vigorous physical activity (MVPA) was assessed at baseline and immediately post-intervention. Recruitment, attrition, intervention adherence, and website engagement were assessed. Questions on usability and satisfaction were administered post-intervention.ResultsFeasibility was demonstrated through acceptable recruitment (8.5 participants recruited and randomised/month), and attrition (25%). Acceptability among intervention group participants was positive with high intervention adherence (96% of 4 modules completed). High website engagement (participants logged in 1.6 times/week although only required to log in once per week), usability (75/100), and satisfaction outcomes were reported in both groups. However, participants in the intervention group viewed significantly more pages on the website (p < 0.05), reported that the website felt more personally relevant (p < 0.05), and significantly increased their MVPA from baseline to post-intervention (mean difference = 35.87 min), compared to the control group (mean difference = 9.83 min) (p < 0.05), suggesting efficacy.ConclusionsThe delivery of a computer-tailored web-based intervention designed to increase PA in pregnant women is feasible, well accepted and associated with increases in short-term MVPA. Findings suggest the use of computer-tailored information leads to greater website engagement, satisfaction and greater PA levels among pregnant women compared to a generic information only website.Trial registrationThe trial was ‘retrospectively registered’ with the Australian New Zealand Clinical Trials Registry (ACTRN12614001105639) on 17th October, 2014.

Feasibility and acceptability of a remotely‐delivered behavioural health coaching intervention to limit gestational weight gain

“…In addition, incorporating technologies, such as web-based platforms and mobile applications for behavioural tracking and intervention delivery, are desirable and effective in younger populations, including reproductive-age women. [18][19][20][21][22][23][24][25][26] Although remotely-delivered counselling has been shown to be effective for weight loss in adults, 27 few studies have assessed its feasibility and effectiveness for weight management in pregnant and postnatal women. [28][29][30][31] The aim of this pilot study was to evaluate the feasibility, acceptability and preliminary effectiveness of "Healthy for Two/Healthy for You" (H42/H4U), a remotely-delivered, behavioural health coaching program to limit GWG and PPWR in pregnant and postpartum women engaged in prenatal care.…”

A Comprehensive Evaluation of a Home Visitation Program Model's Prenatal Physical Activity Curriculum Modules Delivered Primarily to Low-income Women

“…At present, 10 intervention studies, where the primary intent was to improve prenatal PA levels, provide information about participant income. [26][27][28][29][30][31][32][33][34][35] Given the inconsistencies in reporting income levels, these studies are compared in the following paragraphs using three income classifications: low income (less than $25,000), middle income ($25,000-$49,999), and high income ($50,000 or more). This classification scheme was based on the household income groupings used in PRAMS (i.e., < $10,000; $10,000-$24,999; $25,000-$49,999; and > $50,000).…”

“…with an income from $100,000 to $150,000). 34 Of particular interest to this review, three of the 10 studies were delivered primarily or exclusively to low-income pregnant women. 27,28,30 These three studies will be described in greater detail in the following paragraphs.…”

“…[23][24][25] Therefore, this researcher identified and examined 10 prenatal PA intervention studies that reported information on income and had a primary intent to improve prenatal PA levels post-intervention. [26][27][28][29][30][31][32][33][34][35] Six of these studies [26][27][28][29][30][31] were in at least one of the earlier systematic reviews by Craike and colleagues, 25 Currie and colleagues, 24 and Pearce and colleagues. 23 Also, one study 34 was excluded from this review due to the way it operationalized income, as described in paragraph two of the prior section.…”

“…[26][27][28][29][30][31][32][33][34][35] Six of these studies [26][27][28][29][30][31] were in at least one of the earlier systematic reviews by Craike and colleagues, 25 Currie and colleagues, 24 and Pearce and colleagues. 23 Also, one study 34 was excluded from this review due to the way it operationalized income, as described in paragraph two of the prior section. Among the remaining nine studies, the following design subcategories were explored in relation to income level: race/ethnicity, locale, setting, PA intervention structure, intervention delivery method, and measurement of PA outcomes.…”