Is intensive counseling in maternity care feasible and effective in promoting physical activity among women at risk for gestational diabetes? Secondary analysis of a cluster randomized NELLI study in Finland

International Journal of Behavioral Nutrition and Physical Activity

Riitta Luoto³  Päivi Kolu¹  Katriina Ojala¹  Tarja I Kinnunen²  Jani Raitanen²  Minna Aittasalo¹ 

[1] The UKK Institute for Health Promotion Research, P.O. Box 30 33501, Tampere, Finland;Tampere School of Public Health, University of Tampere, Tampere, Finland;National Institute for Health and Welfare, Helsinki, Finland

关键词: Gestational diabetes;    Maternity care;    Effectiveness;    Intervention;    Pregnancy;    Counseling;    Physical activity;   

Others  :  811916
DOI  :  10.1186/1479-5868-9-104

 received in 2011-10-24, accepted in 2012-08-30,  发布年份 2012

【 摘 要 】

Background

Women who are physically active during early pregnancy have notably lower odds of developing gestational diabetes than do inactive women. The purpose of the intervention was to examine whether intensified physical activity (PA) counseling in Finnish maternity care is feasible and effective in promoting leisure-time PA (LTPA) among pregnant women at risk of gestational diabetes.

Methods

Fourteen municipalities were randomized to intervention (INT) and usual care group (UC). Nurses in INT integrated five PA counseling sessions into routine maternity visits and offered monthly group meetings on PA instructed by physiotherapists. In UC conventional practices were continued. Feasibility evaluation included safety (incidence of PA-related adverse events; questionnaire), realization (timing and duration of sessions, number of sessions missed, attendance at group meetings; systematic record-keeping of the nurses and physiotherapists) and applicability (nurses’ views; telephone interview). Effectiveness outcomes were weekly frequency and duration of total and intensity-specific LTPA and meeting PA recommendation for health self-reported at 8-12 (baseline), 26-28 and 36-37 weeks’ gestation. Multilevel analysis with adjustments was used in testing for between-group differences in PA changes.

Results

The decrease in the weekly days of total and moderate-to-vigorous-intensity LTPA was smaller in INT (N = 219) than in UC (N = 180) from baseline to the first follow-up (0.1 vs. -1.2, p = 0.040 and −0.2 vs. -1.3, p = 0.016). A similar trend was seen in meeting the PA recommendation (−11%-points vs. -28%-points, p = 0.06). INT did not experience more adverse events classified as warning signs to terminate exercise than UC, counseling was implemented as planned and viewed positively by the nurses.

Conclusions

Intensified counseling had no effects on the duration of total or intensity-specific weekly LTPA. However, it was able to reduce the decrease in the weekly frequency of total and moderate-to-vigorous-intensity LTPA from baseline to the end of second trimester and was feasibly embedded into routine practices.

Trial registration

ISRCTN 33885819 ( http://www.isrctn.org webcite)

【 授权许可】

   
2012 Aittasalo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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