Abstract
While the benefits of physical activity (PA) during and after pregnancy have been established, many women do not reach the recommended PA levels during this time. A major barrier found in the literature is a lack of counselling by healthcare providers (HCPs), which is partly caused by the limited knowledge on the topic. The aim of this study was to develop an intervention to improve the promotion of PA by HCPs. We used Intervention Mapping (IM), a theory-based framework to develop an intervention, called “Baby steps”, in a high-income (Austria) and a low-to-middle-income country (South Africa). We applied the following IM steps: (1) A needs assessment to determine the barriers and enablers of PA promotion by HCPs, including a scoping literature review and community needs assessments (qualitative interviews, questionnaires, and focus groups with midwives, obstetricians, and community health workers) to determine the desired outcomes of the intervention. (2) Performance and change objectives were formulated, describing the behaviors that need to change for the intervention to succeed. (3) Based on these objectives, theory-based behavior change techniques were selected, and practical applications were developed. (4) The applications were combined into two evidence-based interventions tailored to each country’s needs. Step (5) and (6) consist of an implementation and evaluation plan, respectively. The intervention is aimed at HCPs, such as midwives and community health workers, consisting of a two-day training course, including practical resources. Combining didactic and interactive education, it addresses both PA knowledge and the skills needed to transfer knowledge and facilitate behavior change. In the future, the intervention’s effect on women’s activity levels during and after pregnancy needs to be studied.
Highlights
There is a wealth of evidence for the beneficial effects of physical activity (PA) during the prenatal period for both mothers and offspring
Description of the Intervention Target Group In Austria, the majority of prenatal care is supplied by obstetricians, including five compulsory prenatal check-ups, which are part of the “Mother-Child-Program” [38]
As part of standard care after birth, all women are entitled to home visits by a midwife up to 8 weeks postpartum
Summary
There is a wealth of evidence for the beneficial effects of physical activity (PA) during the prenatal period for both mothers and offspring. Research has shown that being active during pregnancy is safe [1,2,3] and reduces the risk of gestational diabetes mellitus [4], as well as gestational hypertension and preeclampsia [5]. PA can play an important role in reducing weight gain during pregnancy and in the postpartum period [6]. On the back of this evidence, women with uncomplicated pregnancies are recommended to participate in 150 min of moderate physical activity per week during pregnancy [7,8] and as soon as medically safe postpartum [9].
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