scholarly journals Engagement in a Multi-Feature Digital Health Lifestyle Change Program as a Predictor of Weight Loss

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A12-A12
Author(s):  
Eldin Dzubur ◽  
Roberta James ◽  
Bimal Shah ◽  
Tejaswi Kompala
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Digital Health ◽  
Vigorous Physical Activity ◽  
Health Lifestyle ◽  
Telephonic Coaching ◽  
The Individual ◽  
Scale Usage ◽  
The Impact ◽  
Time Varying Covariates

Abstract Background: Modern digital health interventions targeting weight loss employ multiple evidence-based strategies, including nutrition tracking, coaching, and activity monitoring, providing users with choice as they set and achieve their own goals. Still, limited research exists on the partial effects of each component of such interventions, and whether participants choose to use all of the features of a program. The objective of this study was to test the individual components of a fully-featured digital health lifestyle intervention as predictors of weight loss in a single statistical model. Methods: Participants in the study (N=25,273) were enrolled in the Livongo for Weight Loss program as part of their employee wellness benefit across 57 states/territories of the US from April, 2019 to January, 2021. Participants received a cellular-connected scale to use daily in the program; they were asked to track their eating via the app and physical activity via smartphones or wearables. Additionally, participants could engage with coaches voluntarily or by receiving feedback from coaches on their recorded food logs. A mixed-effects generalized linear model was used to test the effects of scale usage, physical activity, human telephonic coaching, and food logs without and without coaching feedback on the percent weight loss the following month. Predictors were disaggregated into between- and within-subject components to understand the impact of each component relative to one’s own mean. The month in the program and whether or not that month occurred during the COVID-19 pandemic were entered as time-varying covariates. Baseline age, gender, and BMI were entered as time-invariant covariates. Results: Participants were 45% male and had average age of 54.3 years old (SD =11.4), with an average BMI of 33.10 kg/m2 (SD: 6.2). On average, participants were enrolled in the program for 10.4 months (SD: 5.1). Each additional use of the scale above one’s own average was associated with an overall 7.4% weight loss (z=21.06,p<0.001). Similarly, each additional minute of moderate-vigorous physical activity (MVPA) above one’s own average was associated with an overall 2.4% weight loss (z=3.14, p<0.01). Lastly, coaching and food logging with coaching feedback at a frequency above one’s own average were associated with approximately a 6% weight loss throughout the program (z=3.08 and 2.35, respectively; p<0.05 for both). Conclusion: We found that frequency of use of a scale in a weight loss intervention was most predictive of weight loss, followed by human coaching interaction and physical activity. However, food logging without feedback did not significantly impact weight loss among participants. Additional work is needed to understand drivers associated with increased utilization of beneficial program features, including optimizing the use of coaching, which offers great benefit, but may be costly to scale.

Evaluating the impact of personalized goal setting on engagement levels of government staff in a two-month mHealth intervention (Preprint)

2021 ◽  
Author(s):  
Raoul Nuijten ◽  
Pieter Van Gorp ◽  
Alireza Khanshan ◽  
Pascale Le Blanc ◽  
Pauline Van den Berg ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Goal Setting ◽  
Linear Models ◽  
Digital Health ◽  
Control Treatment ◽  
National Guidelines ◽  
Mhealth Intervention ◽  
The Individual ◽  
The Impact

BACKGROUND Although the health benefits of physical activity are well established, it remains challenging for people to adopt a more active lifestyle. mHealth interventions can be effective tools to promote physical activity and reduce sedentary behavior. Promising results have been obtained by using gamification techniques as behavior change strategies, especially when they were tailored towards an individual's preferences and goals. Yet, it remains unclear how goals are most effectively tailored in a gamified health promotion context. OBJECTIVE In this study, we evaluate the impact of personalized goal setting in the context of gamified mHealth interventions. We hypothesized that interventions that suggest health goals tailored towards users’ own self-perceived capabilities and preferences will be more engaging than interventions with generic goals. METHODS The study was designed as a two-arm randomized intervention trial. Participants were recruited among staff members of seven governmental organizations. They participated in an 8-week digital health promotion campaign that was especially designed to promote walks, bike rides and sports sessions. Using an mHealth application, participants could track their performance on two social leaderboards: a leaderboard displaying the individual scores of participants, and a leaderboard displaying the average scores per organizational department. Participants could score points by performing any of the six healthy tasks they got assigned (e.g., walk for at least 2000 m). The level of complexity of three tasks was updated every two weeks; either by changing the suggested task intensity, or the suggested frequency of the task. The two intervention arms—with participants randomly assigned—consisted of: 1) a personalized treatment that tailored the complexity parameters based on the self-perceived capabilities and self-selected goals of participants, and 2) a control treatment where the complexity parameters were set generically based on national guidelines. Measures were collected from the mHealth application as well as from intake and post-test surveys, and analyzed using (hierarchical) linear models. RESULTS Results indicated that engagement with the program inevitably dropped over time. However, engagement was higher for participants who had set themselves a goal at the intake survey. The impact of personalization did especially show for ‘frequency parameters’, as the personalization of sports session frequency did foster higher engagement levels, especially when a participant set a goal to improve himself/herself. Additionally, personalization of suggested ride duration had a positive effect on self-perceived biking performance. CONCLUSIONS Personalization seems particularly promising for promoting the frequency of physical activity (e.g., promoting the number of suggested sports sessions per week), as opposed to the intensity of the physical activity (e.g., distance and/or duration). Replications and variations of our study setup are critical for consolidating and explaining (or refuting) these effects.

scholarly journals The Impact of Prescribed Exercise and Short-Term Caloric Restriction on Moderate-to-Vigorous Physical Activity (P08-011-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alexandra Martin ◽  
Birgit Wallmann-Sperlich ◽  
Billy Sperlich ◽  
Karsten Koehler
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Energy Balance ◽  
Caloric Restriction ◽  
Repeated Measures ◽  
Vigorous Physical Activity ◽  
Energy Deficit ◽  
Short Term ◽  
Food And Agriculture ◽  
The Impact

Abstract Objectives Weight loss, especially when achieved by caloric restriction (CR), reduces total daily energy expenditure (EE), which can attenuate further weight loss. Although exercise is a common countermeasure to the decline in EE, it is unknown whether prescribed exercise leads to compensatory changes in moderate-to-vigorous physical activities (MVPA) during non-exercise periods in the context of CR. The present study sought to quantify changes in MVPA in response to an energetically-matched energy deficit induced by CR alone or combined with exercise. We hypothesized that MVPA outside of prescribed exercise would be greater during non-exercise conditions, regardless of energy balance. Methods In a repeated-measures crossover design, active men (n = 6, 25 ± 1.0 y) underwent four 4-day conditions: CR with exercise (CR + X), CR without exercise (CR–X), energy-balanced control (CON) with exercise (CON + X) and without exercise (CON–X). Dietary intake was manipulated such that energy availability (EA) was 15 kcal·kg FFM−1·day−1 (CR) or 40 kcal·kg FFM−1·day−1 (CON). Prescribed exercise EE was 15 kcal·kg FFM−1·day−1. Physical activity was assessed using the SenseWear Pro3 armband (Bodymedia, Pittsburgh, USA) to quantify time spent in MVPA and light activities (sleep, lying down without sleep, and non-lying light activities) as % of total wear time. Results EA did not differ between CR (P = 0.87) nor CON (P = 0.42). As expected, weight loss was significant (P < 0.001) in CR + EX (–1.8 ± 0.4 kg) and CR-EX (–2.4 ± 0.3 kg). After deducting prescribed exercise, there was a significant effect of exercise on time spent in MVPA (P = 0.02), in that MVPA was lower during CON-EX vs. CON + EX (11.4 ± 2.0% vs. 17.9 ± 2.1%, P = 0.03) and trended lower during CR-EX vs. CR + EX (13.6 ± 1.5% vs. 15.5 ± 1.6%, P = 0.08). In exercise conditions, MVPA was lower during CR + EX when compared to CON + EX (P = 0.03). Conclusions Independent of energy balance, engaging in short-term exercise led to more, not less, time spent in non-exercise MVPA. These findings indicate the prevention of reductions in non-exercise activity as an additional benefit of incorporating exercise into weight loss interventions. Funding Sources The study was supported in part by the USDA National Institute of Food and Agriculture and institutional funding from the University of Nebraska-Lincoln.

Enrolling Caregivers in Obesity Interventions to Improve Obesity-Related Outcomes in Children

2021 ◽  
pp. 019394592110370
Author(s):  
Hannah Bessette ◽  
MinKyoung Song ◽  
Karen S. Lyons ◽  
Sydnee Stoyles ◽  
Christopher S. Lee ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Weight Loss ◽  
Linear Regression ◽  
Body Mass ◽  
Sedentary Time ◽  
Vigorous Physical Activity ◽  
Weight Loss Program ◽  
Weight Loss Programs ◽  
Obesity Interventions

In this study, we assessed the influences of change in moderate-to-vigorous physical activity (MVPA)/sedentary time (ST) of caregivers participating in a commercial weight-loss program on their children’s change in MVPA/ST. Data from 29 caregivers and their children were collected over 8 weeks. We used multivariable linear regression to assess associations of changes in caregiver’s percent of time spent in MVPA/ST and changes in their child’s percent of time spent in MVPA/ST. For caregivers that decreased body mass index (BMI) over 8 weeks, changes in caregivers’ MVPA was strongly associated with the change in children’s MVPA (β = 2.61 [95% CI: 0.45, 4.77]) compared to caregivers who maintained/increased BMI (β = 0.24 [–2.16, 2.64]). Changes in caregivers’ ST was strongly associated with changes in children’s ST (β = 2.42 [1.02, 3.81]) compared to caregivers who maintained/increased BMI (β = 0.35 [–0.45, 1.14]). Findings reinforce encouraging caregivers to enroll in weight-loss programs for the benefit of their children as well as for themselves.

Impact of the implantable cardioverter defibrillator on confidence to undertake physical activity in inherited heart disease: A cross-sectional study

2017 ◽  
Vol 16 (8) ◽  
pp. 742-752 ◽  
Author(s):  
Joanna Sweeting ◽  
Kylie Ball ◽  
Julie McGaughran ◽  
John Atherton ◽  
Christopher Semsarian ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Vigorous Physical Activity ◽  
Survey Study ◽  
Accelerometer Data ◽  
Cross Sectional ◽  
Physical Activity Guidelines ◽  
Cardioverter Defibrillator ◽  
The Impact

Background: Physical activity is associated with improved quality of life. Patients with an implantable cardioverter defibrillator (ICD) face unique clinical and psychological challenges. Factors such as fear of ICD shock may negatively impact on physical activity, while a sense of protection gained from the ICD may instil confidence to be active. Aim: We aimed to examine the impact of an ICD on physical activity levels and factors associated with amount of activity. Methods: Two cross-sectional studies were conducted. Accelerometer data (seven-day) was collected in March–November 2015 for 63 consecutively recruited hypertrophic cardiomyopathy patients, with or without an ICD, aged ⩾18 years. A survey study was conducted in July–August 2016 of 155 individuals aged ⩾18 years with an inherited heart disease and an ICD in situ. Results: Based on the International Physical Activity Questionnaire, mean leisure time physical activity was 239 ± 300 min/week with 51% meeting physical activity guidelines. Accelerometry showed that mean moderate–vigorous physical activity was the same for patients with and without an ICD (254 ± 139 min/week versus 300 ± 150 min/week, p=0.23). Nearly half of survey participants ( n=73) said their device made them more confident to exercise. Being anxious about ICD shocks was the only factor associated with not meeting physical activity guidelines. Conclusions: Patients with inherited heart disease adjust differently to their ICD device, and for many it has no impact on physical activity. Discussion regarding the appropriate level of physical activity and potential barriers will ensure best possible outcomes in this unique patient group.

scholarly journals Objective Behavioral Measures in Children before, during, and after the COVID-19 Lockdown in Israel

2021 ◽  
Vol 18 (16) ◽  
pp. 8732
Author(s):  
Einat Shneor ◽  
Ravid Doron ◽  
Jonathan Levine ◽  
Deena Rachel Zimmerman ◽  
Julia S. Benoit ◽  
...  
Keyword(s):  
Physical Activity ◽  
Light Exposure ◽  
Vigorous Physical Activity ◽  
Rank Test ◽  
Long Term Effects ◽  
Wake Time ◽  
Signed Rank ◽  
Social Restriction ◽  
Signed Rank Test ◽  
The Impact

Studies using questionnaires report that COVID-19 restrictions resulted in children spending significantly less time outdoors. This study used objective measures to assess the impact of pandemic-related restrictions on children’s behavior. A total of 19 healthy 8–12-year-old boys were observed before and during social restriction periods. Of these, 11 boys were reassessed after restrictions were lifted. For each session, Actiwatches were dispensed for measures of time outdoors, activity, and sleep. Changes overall and by school status were assessed using signed-rank test and Wilcoxon rank sum tests. During restrictions, children spent significantly less time outdoors (p = 0.001), were less active (p = 0.001), and spent less time engaged in moderate-to-vigorous physical activity (p = 0.004). Sleep duration was not significantly different between sessions (p > 0.99), but bedtime and wake time shifted to a later time during restrictions (p < 0.05 for both). Time outdoors and activity returned close to pre-pandemic levels after restrictions were lifted (p > 0.05 for both). Children’s behaviors significantly changed during the COVID-19 pandemic. The reduction in outdoor light exposure is of importance due to the role of light in the etiology of myopia and vitamin D production. The reduction in physical activity may have negative health effects in terms of obesity and depression, although further research is required to ascertain the long-term effects.

Abstract P267: New Urbanism and Its Impact on Active Living among Inner City Children/Youth

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Gregory W Heath ◽  
Sarah White-Woerner
Keyword(s):  
Physical Activity ◽  
Inner City ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
Active Living ◽  
The South ◽  
City Community ◽  
New Urbanist ◽  
The Impact ◽  
Urban Trail

Introduction: Although it is known that urban design and land use at the community level contributes to active living, there remains a paucity of such information among low income and diverse populations affected by such infrastructure. Reconstruction of an inner city community in Chattanooga, Tennessee afforded the opportunity to assess the impact of new urbanist construction on active living among African-American children/youth living in the inner city. Hypothesis: Transportation and recreational physical activity levels among children/youth residing in a new urbanist community was hypothesized to be higher compared to demographically similar children/youth who reside in a more traditional inner city community. Methods: Using the System for Observing Physical Activity and Recreation in Communities (SOPARC) we examined an urban trail and recreational park areas of two distinct communities to assess physical activity, sports, and recreational of children/youth. SOPARC data were collected in each of 4 settings in each community (East, a traditional and South, a new urbanist) during four 1-h observation periods during 7 days of clement weather. Observations were made during each day of the week in each setting (i.e., Sunday through Saturday). Results: The SOPARC assessments of the urban trail and pedestrian/bicycle routes in the South and East yielded a total of 672 and 436 children/youth observations, respectively. South children/youth were over three times more likely to engage in vigorous physical activity compared to their East counterparts (Mantel-Haenszel Chi Square = 19.67; P< 0.00001). Conclusions: The present findings support the hypothesis that enhanced environmental supports, such as those found within the South community, increase the likelihood of greater levels of activity among children/youth compared to children/youth that were not exposed to these environmental enhancements. This comparative difference was most remarkable when examining the SOPARC assessment differences along the transport path/sidewalk routes, with South children/youth being significantly more likely than the East children/youth to engage in more vigorous forms of physical activity along this transport/recreational corridor, providing evidence that access to these types of ‘urban’ trails appears to translate into increased opportunities for physical activity among children/youth.

Abstract P495: Trends in Physical Activity Among US Older Adults With Heart Failure 2007-2016

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Fan Ye ◽  
Li Zhou ◽  
Joseph Yeboah ◽  
Peter H Brubaker ◽  
Alain G Bertoni
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Older Adults ◽  
Vigorous Physical Activity ◽  
Public Health Problem ◽  
Moderate Intensity ◽  
Recreational Activities ◽  
Aerobic Activity ◽  
Vigorous Intensity ◽  
The Impact

Introduction: Heart failure (HF) is a growing public health problem which is the leading cause of hospitalization. About half of people who develop HF die within 5 years of diagnosis. Recent evidence suggests that physical inactivity may be an important risk for HF. However, the importance of physical activity in the prevention and treatment have not been adequately recognized. Self-reported physical activity can provide insights into the impact of lifestyle behaviors on mortality. The objective of this study was to determine the relationship between physical activity and HF in a nationally representative sample of United States (US) adults. Methods: The 2007-2016 National Health and Nutrition Examination Survey data collection cycles were used for this analysis. Participants aged 65 and older with HF were defined as those who answered “yes” to the question: “Has a doctor or other health professional ever told you that you had congestive HF?” Frequency and duration of self-reported moderate-intensity (“Days moderate recreational activities” and “Minutes moderate recreational activities”) and vigorous-intensity Days vigorous recreational activities” and “Minutes vigorous recreational activities”) physical activity were collected through questionnaires as well in all data cycles. We used 2018 Physical Activity Guidelines for Americans Older Adults, which recommended that most older adults (age≥65 years) participate in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week as our cut-off points for calculating moderate-to-vigorous physical activity. Results: Between 2007-2008 and 2015-2016, the percentage of US adults ≥65 years with HF increased from 2.76% to 3.69% (p=0.04). Although a similar percentage of participants who met the criteria of at least 150 minutes of moderate-intensity activity per week was noted in both groups from 2007 to 2016 (on average, HF: 56.9% vs. HF-free: 56.7%, respectively, p>0.05), more HF-free participants reported at least 75 minutes of vigorous-intensity recreational activities per week compared to HF participants in each calendar year (82.8% vs. 66.7%, 85.0% vs. 70.0%, 83.5% vs. 55.0%, 87.0% vs.75%, 85.2% vs. 63.6%, respectively, p<0.01). Additionally, among those who reported activities, older adults with HF were less than 20 times as likely to report moderate or vigorous recreational activities compared to those without HF. Conclusions: Our findings illustrate lower self-reported physical recreational activities, especially vigorous activities, in older participants who report a diagnosis of HF and more participants without HF report vigorous-intensity recreational activities. Future study should focus on understanding the physical limitations of HF patients, which is paramount in developing cardiac rehabilitation strategies to improve their function capacity.

scholarly journals Is missing geographic positioning system data in accelerometry studies a problem, and is imputation the solution?

2016 ◽  
Vol 11 (2) ◽  
Author(s):  
Kristin Meseck ◽  
Marta M. Jankowska ◽  
Jasper Schipperijn ◽  
Loki Natarajan ◽  
Suneeta Godbole ◽  
...  
Keyword(s):  
Physical Activity ◽  
Built Environment ◽  
Linear Mixed Model ◽  
Vigorous Physical Activity ◽  
Gps Data ◽  
Positioning System ◽  
Accelerometer Data ◽  
Generalised Linear Mixed Model ◽  
Significant Difference ◽  
The Impact

The main purpose of the present study was to assess the impact of global positioning system (GPS) signal lapse on physical activity analyses, discover any existing associations between missing GPS data and environmental and demographics attributes, and to determine whether imputation is an accurate and viable method for correcting GPS data loss. Accelerometer and GPS data of 782 participants from 8 studies were pooled to represent a range of lifestyles and interactions with the built environment. Periods of GPS signal lapse were identified and extracted. Generalised linear mixed models were run with the number of lapses and the length of lapses as outcomes. The signal lapses were imputed using a simple ruleset, and imputation was validated against person-worn camera imagery. A final generalised linear mixed model was used to identify the difference between the amount of GPS minutes pre- and post-imputation for the activity categories of sedentary, light, and moderate-to-vigorous physical activity. Over 17% of the dataset was comprised of GPS data lapses. No strong associations were found between increasing lapse length and number of lapses and the demographic and built environment variables. A significant difference was found between the pre- and postimputation minutes for each activity category. No demographic or environmental bias was found for length or number of lapses, but imputation of GPS data may make a significant difference for inclusion of physical activity data that occurred during a lapse. Imputing GPS data lapses is a viable technique for returning spatial context to accelerometer data and improving the completeness of the dataset.

scholarly journals Impact of first and second eye cataract surgery on physical activity: a prospective study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024491 ◽  
Author(s):  
Lynn B Meuleners ◽  
Ying Ru Feng ◽  
Michelle Fraser ◽  
Kate Brameld ◽  
Kyle Chow
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cataract Surgery ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Vigorous Physical Activity ◽  
Moderate Physical Activity ◽  
Bilateral Cataract ◽  
Eye Surgery ◽  
The Impact

ObjectivesTo investigate the impact of first eye and second eye cataract surgery on the level of physical activity undertaken by older adults with bilateral cataract.DesignProspective cohort study.SettingThree public ophthalmology clinics in Western Australia.ParticipantsFifty-five older adults with bilateral cataract aged 55+ years, awaiting first eye cataract surgery.Outcome measuresThe primary outcome measure was participation in moderate leisure-time physical activity. The secondary outcomes were participation in walking, gardening and vigorous leisure-time physical activity. Participants completed a researcher-administered questionnaire, containing the Active Australia Survey and visual tests before first eye cataract surgery, after first eye surgery and after second eye surgery. A Generalised Estimating Equation linear regression model was undertaken to analyse the change in moderate leisure-time physical activity participation before first eye surgery, after first eye surgery and after second eye surgery, after accounting for relevant confounders.ResultsParticipants spent significantly less time per week (20 min) on moderate leisure-time physical activity before first eye cataract surgery compared with after first eye surgery (p=0.04) after accounting for confounders. After second eye cataract surgery, participants spent significantly more time per week (32 min) on moderate physical activity compared with after first eye surgery (p=0.02). There were no significant changes in walking, gardening and vigorous physical activity throughout the cataract surgery process.ConclusionFirst and second eye cataract surgery each independently increased participation in moderate leisure-time physical activity. This provides a rationale for timely first and second eye cataract surgery for bilateral cataract patients, even when they have relatively good vision.

Examining the Impact of Body Satisfaction and Physical Activity Change on Postpartum Depressive Symptoms

2020 ◽  
Vol 17 (2) ◽  
pp. 141-148
Author(s):  
Rebecca A. Schlaff ◽  
Meghan Baruth ◽  
Faith C. LaFramboise ◽  
Samantha J. Deere
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Body Satisfaction ◽  
Vigorous Physical Activity ◽  
Time Points ◽  
Physical Activity Change ◽  
Postpartum Depressive Symptoms ◽  
Pregnancy And Postpartum ◽  
The Impact ◽  
The Relationship

Background: Relationships among moderate to vigorous physical activity (MVPA), body satisfaction, and postpartum depressive symptoms are not well understood. The purpose of this study is to examine the (1) impact of postpartum body satisfaction and changes in MVPA on postpartum depressive symptoms and (2) moderating effect of changes in MVPA over time on the relationship between postpartum body satisfaction and depressive symptoms. Methods: Participants (N = 269) self-reported body satisfaction, MVPA (prepregnancy through postpartum), and postpartum depressive symptoms. Differences in MVPA at 3 time points (prepregnancy, third trimester, and postpartum) were calculated to create change scores. Main effects and interactions (body satisfaction × MVPA change) were examined using multiple regression. Results: A majority of the sample did not meet MVPA recommendations at all time points. All body satisfaction measures were inversely related to postpartum depressive symptoms (P = .01 to <.001). MVPA change did not predict postpartum depressive symptoms (P = .43–.90) or moderate the relationship between body satisfaction and postpartum depressive symptoms (P = .14–.94). Conclusions: Given the relationship between postpartum body satisfaction and depressive symptoms, intervention research should include strategies that promote positive postpartum body image; clinicians should consider screening for body dissatisfaction. Although not a predictor or moderator, pregnancy and postpartum MVPA promotion should continue, as it has numerous other benefits.

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