scholarly journals Developing a Physical Activity Intervention Strategy for Pregnant Women in Buffalo City Municipality, South Africa: A Study Protocol

Author(s):  
Uchenna Benedine Okafor ◽  
Daniel Ter Goon

Despite global awareness about the importance and health benefits of physical activity (PA) during pregnancy, several studies have reported a low prevalence of PA participation among pregnant women in both developed and developing countries. This means that most pregnant women do not meet the current PA recommended guideline of 150 min of moderate intensity PA per week. The global call to prioritise PA participation levels in the general population necessitates evaluating the factors affecting PA practice. Seemingly, pregnant women mostly from low-to-middle income countries like South Africa are often predisposed to adverse pregnancy outcomes, possibly because of limited access to, and knowledge of, improved pregnancy and health outcomes as a result of PA participation. Physical activity has been sparsely studied among pregnant South African women, and specifically, there is no known study that assesses the PA levels, patterns, beliefs, sources of information, perceived benefits, barriers, attitudes of pregnant women concerning PA and exercise participation; nor one that explores the perspectives of healthcare providers regarding prenatal PA in the Eastern Cape Province. In addition, no PA intervention strategy exists to promote PA participation in the region. This study, in attempting to fill these gaps in knowledge, adopts two phases. In Phase I, a concurrent mixed-method (quantitative and qualitative) approach assesses the following factors related to PA participation in pregnant women: participation levels, beliefs, attitudes, perceived benefits, barriers to uptake and sources of information. It further ascertains if healthcare professionals are sufficiently informed about PA and if they are advising pregnant women about the need for PA participation during pregnancy. Data will be collected through a structured questionnaire, interviews and focus group discussions. Information on socio-demographic and maternal characteristics will be obtained, and the Pregnancy Physical Activity Questionnaire (PPAQ) will assess PA during pregnancy. A sample size of 384 pregnant women is the required minimum sample for an infinite population at a confidence level of 95%, a precision level of ± 5% and at a prevalence of PA or exercise during pregnancy of 50% (p < 0.05); however, a sample size larger than the minimum number necessary will be recruited to account for possible attrition and to protect against possible data loss. Data will be analysed using a multiple logistic regression to determine the factors that predict sedentary or moderate PA levels and chi-squared analysis to determine the associations between the PA levels of the participants and socio-demographic and clinical variables. The study will assess the data collected on the above-mentioned variables and draw conclusions based on patterns and themes that emerge during analysis. Phase II of the study focuses on strategy development and validation to facilitate the promotion of PA during pregnancy. The developed strategy will be validated through the application of the Delphi technique and the administration of a checklist to selected key stakeholders through organised workshops. Understanding the level and correlates of PA participation among this special population is fundamental to designing intervention strategies to enhance their understanding of, and participation in, PA and exercise. Furthermore, this study’s findings will inform facility-based healthcare providers about the need to integrate health education on PA and pregnancy into antenatal and postnatal care visits in the setting.

2017 ◽  
Author(s):  
◽  
Nazmeera Noor Mahomed

Introduction: Evidence suggests that pregnant women who lead sedentary lifestyles and have a poor knowledge of exercise during pregnancy are at risk of developing diseases like gestational diabetes, pre-eclampsia and low back pain along with many other chronic conditions. An exercise program during pregnancy has benefits for both the mother and the child. No studies have ascertained the knowledge and practices of exercise in pregnant women in South Africa, furthermore, there was a need to conduct research regarding exercise amongst South African pregnant women, particularly to determine whether any barriers to physical activity exist. Aim: To compare the knowledge and practices of pregnant women regarding exercise during pregnancy between a selected private practice and public clinic. Methodology: A quantitative, descriptive, cross sectional survey was used in this research study. The population consisted of pregnant women (n = 400) attending both public and private sector antenatal care in the Ethekwini municipal area of KwaZulu-Natal, South Africa. Public sector participants were drawn from the Addington Hospital public antenatal clinic and private sector participants were drawn from the gynaecological practice of Dr D Sankar. Purposive, stratified sampling was used. Following the signing of an informed consent form, data was collected by means of a self-administered questionnaire. A minimum sample size of 324 patients was calculated by the statistician. Descriptive statistics, such as frequencies and percentages were used to describe the demographic profile of respondents and their physical activities. Inferential statistics, including Chi-Square tests of association and student t-tests were used to determine differences in proportions and means respectively between the two categories of participants. Odds ratios (OR) were calculated to ascertain the measure of association between a risk factor and an outcome. Results: There were 198 (57.6%) participants from the private gynaecological practice and 146 (42.4%) from the public clinic at Addington Hospital. The mean age of the study population was 27.65 ± 5.3 years. Almost half of the study population were Indians (46.2%). Blacks made up the second largest proportion of the study population (39.2%). More than half of the study participants were involved in exercise during their pregnancy (57.1%). However, only 37% of the study population met the international criteria of physical activity, which is 30 minutes of moderate -intensity aerobic exercise, per day, for 5 days a week, during pregnancy as set out by the American College of Obstetrics and Gynecologists (2002). However, there was evidence of unstructured physical activity which increased the level of acceptable physical activity in the majority of participants 82.1%. Walking was the most common activity that the women engaged in from both the private sector (88.8%) and public clinic (89.3%). The average time spent on walking was more than 30 minutes a day. Household chores and climbing stairs also increased the levels of physical activity within the participants. Only a minority of participants (35.4%) stated that they were diagnosed with an adverse health condition, which prevented them from exercising. Some participants who did not exercise reported that fatigue was the reason for not being physically active (51.6%). Conclusion: Interventions need to be implemented to increase the knowledge of physical activity amongst pregnant women and the benefits that are associated with it. An attempt needs to be made by health practitioners to try and increase the level of physical activity among pregnant women, so that they may benefit from its effects.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Uchenna Benedine Okafor ◽  
Daniel Ter Goon

Abstract Background Pregnancy is an important phase in a woman’s life, with health status at this stage affecting both the woman and her child’s life. Global evidence suggests that many women engage in low levels of physical activity (PA) and exercise during pregnancy despite its beneficial effects. This is particularly the case in Africa. Methods This article reviews the literature on levels of PA and exercise among pregnant women in Africa, highlighting the level of PA or exercise participation during pregnancy in Africa, including types of PA, factors affecting PA, beliefs about and benefits of prenatal activity, advice or counselling on PA during pregnancy in Africa, and PA interventions proposed to promote the uptake of prenatal PA. Electronic search databases used were Google Scholar, Science Direct, Scopus, EMBASE, ERIC, Medline, Web of Science, EBSCOhost, PubMed, BIOMED Central, and African Journal Online. The basic search terms were: ‘Physical activity’, ‘Exercise’, ‘Pregnancy’, ‘Pregnant women’ and ‘Africa’. A total of 40 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 11 articles were rejected, and 29 articles were fully read, although two had to be rejected due to a lack of access to the full version. Finally, 27 references were included in the review. Results Few studies exist on PA during pregnancy in Africa. The limited data available suggests that, compared to the Western world, pregnant women in Africa do not adhere to the recommendations for PA during pregnancy. Levels of participation in PA during pregnancy are low and decline as the pregnancy progresses. The majority of the studies used direct, objective measures to assess PA during pregnancy. Personal and environmental factors such as lack of time, lack of knowledge, inadequate information from healthcare providers, feelings of tiredness and an absence of social support constituted the main barriers to PA during pregnancy. The types of PA participation among pregnant women varied across studies and geographical settings. Conclusions While published data is limited, it seems clear that the participation of pregnant women in PA during pregnancy in Africa is low and declines with advancing pregnancy. There is a need for more studies to examine the dynamics of PA during pregnancy in Africa to guide contextual interventions to improve and promote maternal health on the continent.


Author(s):  
Uchenna Benedine Okafor ◽  
Daniel Ter Goon

Physical activity participation during pregnancy confers many maternal and foetal health benefits to the woman and her infant and is recommended by various health bodies and institutions. However, in South Africa, scant information exists about the physical activity status and its determinants among pregnant women. The aim of this study was to assess the physical activity level and associated factors among pregnant women. This cross-sectional study enrolled 1082 pregnant women attending public health facilities in Buffalo City Municipality, Eastern Cape, South Africa. Information on socio-demographic and maternal characteristics were obtained, and the Pregnancy Physical Activity Questionnaire was used to assess physical activity during pregnancy. Multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels. Statistical significance was set at p < 0.05. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2–156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Factors negatively associated with prenatal physical activity were lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31). However, prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. The findings of this study demonstrated low levels of physical activity during pregnancy in South Africa. The majority of women did not meet the recommendation of 150 min of moderate intensity activity per week. Light intensity and household activities were the most preferred form of activity. The factors affecting physical activity of women in this present study include lower age, semi-urban setting, low educational level, unemployment and nulliparity. In order to increase activity levels, future work should seek to improve knowledge, access and support for physical activity in pregnant women in South Africa. This should include education and advocacy regarding physical activity for professionals involved in maternal health provision.


Author(s):  
Katarzyna Kwiatkowska ◽  
Katarzyna Kosińska-Kaczyńska ◽  
Izabela Walasik ◽  
Agnieszka Osińska ◽  
Iwona Szymusik

Background: No specific physical activity guidelines are available for women in multiple pregnancy. Aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest twin pregnancy. Methods: A cross-sectional study including women after a twin delivery was conducted in Poland. A questionnaire was distributed in 2018 via web pages and Facebook groups designed for pregnant women. Results: 652 women filled out the questionnaire completely. Only 25% of women performed any physical exercises during twin gestation. The frequency of preterm delivery was similar in physically active and non-active participants. 35% of the respondents claimed to have gained information on proper activity from obstetricians during antenatal counselling while 11% claimed to be unable to identify the reliable sources of information. 7% of women admitted to feel discriminated by social opinion on exercising during a twin pregnancy. Conclusions: The population of women with a twin gestation is not sufficiently physically active and is often discouraged from performing exercises during gestation. Therefore, it is crucial to inform obstetricians to recommend active lifestyle during a twin gestation and to provide reliable information on physical activity to pregnant women. Further research on this topic is necessary in order for obstetric providers to counsel women on appropriate exercise with a twin pregnancy.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 609
Author(s):  
Uchenna Benedine Okafor ◽  
Daniel Ter Goon

Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.


2021 ◽  
Author(s):  
Ching-Fang Lee ◽  
Li-Kang Chi ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang

BACKGROUND Overweight and obese women’s excessive gestational weight gain (GWG) may be a health risk for both the mother and the fetus; excessive GWG leads to the retention of weight postpartum and thus obesity. Given the overwhelming number of existing pregnancy-related applications (apps), we lack only a few methodological guidelines for integrating theory, evidence and previously validated apps to help overweight and obese women manage their GWG during pregnancy. OBJECTIVE This two-phase study aimed to develop the MyHealthyWeight (MHW) app based on social-cognitive theory (SCT) and evaluate its effectiveness for overweight and obese women in helping prevent excessive GWG by enhancing adherence to optimal GWG goals and healthy behavior during pregnancy. METHODS First, we constructed and developed the MHW app based on SCT theory, and we later employed a mixed-method study to evaluate the effects of the app on overweight and obese pregnant women. RESULTS All participating overweight and obese pregnant women (100%) achieved their optimal GWG through increased self-efficacy and physical activity. Their total and moderate-intensity physical activity expenditures improved, while their sedentary and light-intensity levels of physical activity decreased. CONCLUSIONS This theory-based MHW app for weight management was greatly valued by the pregnant users. Its usefulness for health-care professionals in assisting overweight and obese pregnant women in preventing excessive GWG by promoting healthy behavior, in particular through physical exercise and a healthy diet, during pregnancy was also confirmed. CLINICALTRIAL NCT04553718


2020 ◽  
Vol 45 (5) ◽  
pp. 493-499 ◽  
Author(s):  
Kathryn M. Denize ◽  
Pegah Akbari ◽  
Danilo Fernandes da Silva ◽  
Francois Haman ◽  
Kristi B. Adamo

Pregnant women are recommended to engage in 150 min of moderate-intensity physical activity per week to reduce pregnancy complications. Many women struggle to remain physically active throughout pregnancy, and there is no consensus about whether women adopt a less efficient movement pattern as they progress through pregnancy and experience gestational weight gain. This study assessed the change in energy expenditure and mechanical efficiency in pregnant women (PREG; n = 10) when performing a walking treadmill task in early, mid, and late pregnancy and also compared with an age- and body mass index-matched, nonpregnant (CON; n = 10) group. On average, the PREG group gained within the Institute of Medicine’s gestational weight gain guidelines (11.6 ± 3.6 kg) and were all inactive (measured using accelerometry), except for 1 participant, by the third trimester, as per the 2019 Canadian physical activity guidelines for pregnant women. Energy expended to complete the walking task increased throughout pregnancy and was higher than the controls (111.5 ± 24.6 kcal) in mid and late pregnancy (139.0 ± 22.2 kcal, p = 0.02, and 147.3 ± 24.6 kcal, p = 0.005, respectively), but not early pregnancy (129.9 ± 18.9 kcal, p = 0.08). Walking mechanical efficiency was similar within pregnant women at each time point and compared to nonpregnant controls. Our findings add to the growing body of evidence demonstrating that pregnant women can safely perform physical activity by showing that walking mechanical efficiency is unchanged at low to moderate intensities. Novelty Energy demand during exercise increases proportionally to weight gain across pregnancy trimesters. However, mechanical efficiency remains unchanged during low- to moderate-intensity walking.


2005 ◽  
Vol 11 (3) ◽  
pp. 79 ◽  
Author(s):  
Sonya Brownie

One of the aims of this study was to examine the relationship between gender, health profile and physical activity patterns of older Australians. Using a self-administered postal questionnaire, data were obtained from 1,263 Australians (641 males, 622 females), aged 65-98 years, randomly selected from the 2000 Australian Electoral Commission roll. Participants provided general demographic data in addition to information about key health features and self-reported weekly participation in various physical activities. More than half (55%) of the sample averaged at least 30 minutes' exercise most days, excluding gardening and housework. Men participated in a wider range of physical activities and were more likely to average at least 30 minutes' exercise most days compared to women. Living arrangements, ethnicity, education and income were important sociological determinants of low, medium, or high levels of exercise participation. Perceived poor health, chronic disease, lack of motivation and energy, were barriers to achieving regular exercise. Gym training (4%) and tai chi/yoga (2%) were the least popular forms of exercise, yet weight resistance training and Tai chi are associated with improvements in strength, balance, flexibility and range of motion, and could play an important role in reducing the morbidity associated with ageing. General practitioners are well positioned to help older Australians take the first steps towards achieving the national target of at least 30 minutes' moderate-intensity activity most days.


Author(s):  
José Alberto Laredo-Aguilera ◽  
María Gallardo-Bravo ◽  
Joseba Aingerun Rabanales-Sotos ◽  
Ana Isabel Cobo-Cuenca ◽  
Juan Manuel Carmona-Torres

Gestational diabetes mellitus has an incidence of 14% worldwide and nursing is responsible for its monitoring during pregnancy. Excessive weight gain during pregnancy is directly related to gestational diabetes mellitus development. Gestational diabetes mellitus (GDM) has negative repercussions on the evolution of the pregnancy and the fetus. The objective of this systematic review is to establish how physical activity influences pregnant women with gestational diabetes mellitus and to analyze what benefits physical activity has in the control of gestational diabetes mellitus. A systematic search was carried out in different databases (Cochrane, Superior Council of Scientific Investigations (CSIC), EBSCOhost, Pubmed, Scopus, Web os Science, and Proquest) for papers published within the last 12 years, taking into account different inclusion and exclusion criteria. Six randomized controlled studies and one observational case-control study of a high quality were selected. Fasting, postprandial glucose and HbcA1 were assessed, as well as the requirement and amount of insulin used. Thus, there is a positive relationship between the performance of physical activity and the control of gestational diabetes mellitus. Resistance, aerobic exercise, or a combination of both are effective for the control of glucose, HbcA1, and insulin. Due to the variability of the exercises of the analyzed studies and the variability of the shape of the different pregnant women, it does not permit the recommendation of a particular type of exercise. However, any type of physical activity of sufficient intensity and duration can have benefits for pregnant women with GDM. Pregnant women with gestational diabetes mellitus should exercise for at least 20–50 min a minimum of 2 times a week with at a least moderate intensity.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miguel Rodriguez ◽  
Antoinette A. Danvers ◽  
Carolina Sanabia ◽  
Siobhan M. Dolan

Abstract Background The objective of the study was to understand how pregnant women learned about Zika infection and to identify what sources of information were likely to influence them during their pregnancy. Methods We conducted 13 semi-structed interviews in English and Spanish with women receiving prenatal care who were tested for Zika virus infection. We analyzed the qualitative data using descriptive approach. Results Pregnant women in the Bronx learned about Zika from family, television, the internet and their doctor. Informational sources played different roles. Television, specifically Spanish language networks, was often the initial source of information. Women searched the internet for additional information about Zika. Later, they engaged in further discussions with their healthcare providers. Conclusions Television played an important role in providing awareness about Zika to pregnant women in the Bronx, but that information was incomplete. The internet and healthcare providers were sources of more complete information and are likely the most influential. Efforts to educate pregnant women about emerging infectious diseases will benefit from using a variety of approaches including television messages that promote public awareness followed up by reliable information via the internet and healthcare providers.


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