Pregnant women’s attitudes and beliefs towards sleep and exercise: A cross-sectional survey

As many as 80% of women report experiencing poor sleep throughout pregnancy. Exercise is associated with many health benefits during pregnancy and is established as a non-pharmacological method to improve sleep in both pregnant and non-pregnant populations. Given the importance of sleep and exercise during pregnancy, the aim of this cross-sectional study was to (1) examine pregnant women’s attitudes and beliefs towards sleep and exercise during pregnancy, and (2) investigate the barriers women face to achieving good sleep and engaging in healthy levels of exercise. Participants were comprised of 258 pregnant Australian women (31.3 ± 5.1 years) who completed a 51-question online survey. Almost all (98%) participants believed exercise during pregnancy to be safe, whilst over half (67%) believed participating in more exercise will improve their sleep. Over 70% of participants reported experiencing barriers such as physical symptoms related to pregnancy that negatively impacted their ability to exercise. Almost all (95%) participants reported experiencing barriers to sleep in their current pregnancy. Present findings suggest that overcoming intrapersonal barriers should be a priority for any intervention aiming to improve sleep or increase exercise levels in pregnant populations. Findings from the present study highlight the need for a better understanding of women’s sleep experiences during pregnancy, and demonstrate how exercise may improve sleep and health outcomes

The association between physical activity and sleep during pregnancy: a systematic review

Objectives: Pregnant women frequently report experiencing poor sleep. Poor sleep during pregnancy is associated with negative health outcomes for both mother and baby. Physical activity (PA), including exercise may be an effective non-pharmacological strategy for improving sleep during pregnancy. The aim of this systematic review was to synthesize the current literature on the association between physical activity (including exercise) and sleep during pregnancy.  Method: A systematic online search was undertaken between 15–16 February 2022 in PsycINFO, CINAHL, Embase and PubMed. To meet the inclusion criteria articles had to; [1] be published in a peer reviewed journal; [2] consist of pregnant participants; and [3] be published in English. Studies were excluded if they were not published in English and did not investigate the association between a type of physical activity (including exercise) and a sleep variable during a trimester of pregnancy.  Results: Ten studies were included in this review. Five of the ten studies used observational data collection measures and the remaining five used intervention based methods. Eight of the ten included studies found PA (including exercise) was positively associated with sleep during pregnancy.  Conclusion: In order to properly establish PA as a strategy to improve sleep during pregnancy, future research should aim to determine the PA characteristics most beneficial to sleep during pregnancy across each trimester.</p

A review of pregnancy information on nutrition, physical activity and sleep websites

Problem: Most pregnant women report using the internet to source health information during pregnancy. However, little is known about the information presented on the internet and whether it is consistent with current evidence-based guidelines. Background: Pregnancy is considered a risk period for women as it is associated with poorer health behaviours including an inadequate diet, decreased physical activity and reduced sleep. As a result, pregnant women and their unborn child are at a greater risk of adverse health outcomes. Aim: The purpose of this study was to review pregnancy related information about nutrition, physical activity and sleep provided on Australian government and leading industry body websites, and to compare this information to current evidence-based guidelines. Methods: A systematic online search was conducted to identify Australian Government, and leading industry websites that provided information on nutrition, physical activity, or sleep during pregnancy. The content of each website was reviewed and compared against current nutrition, physical activity and sleep guidelines. Findings: 27 government and leading industry websites were included in this study. 18 websites included nutritional information, none of which aligned 100% with guidelines. Nine websites included physical activity information, only one of which was 100% in accordance with guidelines. Two websites included information on sleep during pregnancy, however neither were in accordance with guidelines. Conclusion: Women are accessing information via the internet that is not in accordance with current evidence-based guidelines. These results call to attention the need for government and leading industry websites to review and update their website information in accordance with current evidence-based guidelines. © 201

What exercise advice are women receiving from their healthcare practitioners during pregnancy?

© 2019 Australian College of Midwives Background: Exercise during pregnancy is associated with a variety of health benefits for both mother and child. Despite these benefits, few Australian pregnant women are sufficiently active to meet current exercise during pregnancy guidelines. Healthcare practitioners can play an instrumental role in encouraging women to be active during their pregnancy through the provision of clear and accurate exercise advice. However, little is known about the exercise advice that pregnant women receive from Healthcare practitioners. Methods: Regionally-based Australian women were asked to self-report the exercise advice they received from their Healthcare practitioners during their pregnancy via a survey during one of their clinic visits. Results: Of the 131 participants, 53% (n = 70) reported receiving some form of exercise advice from their Healthcare practitioner. Specifically, frequency of exercise was discussed among 34% of the participants (n = 23) while exercise intensity 57% was discussed among 57% of the participants (n = 38). Exercise duration was discussed among 39% of participants (n = 26) and types of exercise was discussed among 84% of the participants (n = 56). In most instances, participants report receiving advice not in accordance with current exercise during pregnancy guidelines. Conclusions: Healthcare practitioners may not be actively providing advice to pregnant women about their exercise behaviours. Of the advice that is provided, it may not in accordance with current evidence-based exercise during pregnancy guidelines. Whilst healthcare practitioners may be uniquely positioned to provide exercise advice to pregnant women, they may not have the necessary knowledge, training or support to provide specific exercise advice

A mixed-methods exploration of attitudes towards pregnant Facebook fitness influencers

Background: Exercise during pregnancy is associated with various health benefits for both mother and child. Despite these benefits, most pregnant women do not meet physical activity recommendations. A known barrier to engaging in exercise during pregnancy is a lack of knowledge about appropriate and safe exercise. In our current era of social media, many pregnant women are turning to online information sources for guidance, including social media influencers. Little is known about attitudes towards pregnancy exercise information provided by influencers on social media platforms. This study aimed to explore attitudes towards exercise during pregnancy depicted by social media influencers on Facebook, and user engagement with posted content. Methods: A mixed-methods approach was used to analyse data from 10 Facebook video posts of social media influencers exercising during pregnancy. Quantitative descriptive analyses were used to report the number of views, shares, comments and emotive reactions. Qualitative analysis of user comments was achieved using an inductive thematic approach. Results: The 10 video posts analysed were viewed a total of 12,117,200 times, shared on 11,181 occasions, included 13,455 user comments and 128,804 emotive icon reactions, with the most frequently used icon being ‘like’ (81.48%). The thematic analysis identified three themes associated with attitudes including [1] exercise during pregnancy [2] influencers and [3] type of exercise. A fourth theme of community was also identified. Most user comments were associated with positive attitudes towards exercise during pregnancy and the influencer. However, attitudes towards the types of exercise the influencer performed were mixed (aerobic and body weight exercises were positive; resistance-based exercise with weights were negative). Finally, the online community perceived by users was mostly positive and recognised for offering social support and guidance. Conclusions: User comments imply resistance-based exercise with weights as unsafe and unnecessary when pregnant, a perception that does not align with current best practice guidelines. Collectively, the findings from this study highlight the need for continued education regarding exercise during pregnancy and the potential for social media influencers to disseminate evidence-based material to pregnant women who are highly receptive to, and in need of reliable health information

Mobile APPlications targeting exercise in pregnancy: Quality and APPropriateness of behaviour change techniques

Purpose: Pregnancy presents a unique opportunity to positively influence exercise behaviours. Access to information, education and monitoring through m-health, including mobile applications (apps), may facilitate behaviour change. However, app quality and the presence and appropriateness of Behaviour Change Techniques (BCTs) used in apps is unknown. This study reviewed pregnancy apps to assess their quality and the prevalence and appropriateness of BCTs

Quality, features, and presence of behavior change techniques in mobile Apps designed to improve physical activity in pregnant women: Systematic search and content analysis

BACKGROUND: Physical activity during pregnancy is associated with several health benefits for the mother and child. However, very few women participate in regular physical activity during pregnancy. eHealth platforms (internet and mobile apps) have become an important information source for pregnant women. Although the use of pregnancy-related apps has significantly increased among pregnant women, very little is known about their theoretical underpinnings, including their utilization of behavior change techniques (BCTs). This is despite research suggesting that inclusion of BCTs in eHealth interventions are important for promoting healthy behaviors, including physical activity. OBJECTIVE: The aim of this study was to conduct a systematic search and content analysis of app quality, features, and the presence of BCTs in apps designed to promote physical activity among pregnant women. METHODS: A systematic search in the Australian App Store and Google Play store using search terms relating to exercise and pregnancy was performed. App quality and features were assessed using the 19-item Mobile App Rating Scale (MARS), and a taxonomy of BCTs was used to determine the presence of BCTs (26 items). BCTs previously demonstrating efficacy in behavior changes during pregnancy were also identified from a literature review. Spearman correlations were used to investigate the relationships between app quality, app features, and number of BCTs identified. RESULTS: Nineteen exercise apps were deemed eligible for this review and they were accessed via Google Play (n=13) or App Store (n=6). The MARS overall quality scores indicated moderate app quality (mean 3.5 [SD 0.52]). Functionality was the highest scoring MARS domain (mean 4.2 [SD 0.5]), followed by aesthetics (mean 3.7 [SD 0.6]) and information quality (mean 3.16 [SD 0.42]). Subjective app quality (mean 2.54 [SD 0.64]) and likelihood for behavioral impact (mean 2.5 [SD 0.6]) were the lowest scoring MARS domains. All 19 apps were found to incorporate at least two BCTs (mean 4.74, SD 2.51; range 2-10). However, only 11 apps included BCTs that previously demonstrated efficacy for behavior change during pregnancy, the most common being provide opportunities for social comparison (n=8) and prompt self-monitoring of behavior (n=7). There was a significant positive correlation between the number of BCTs with engagement and aesthetics scores, but the number of BCTs was not significantly correlated with functionality, information quality, total MARS quality, or subjective quality. CONCLUSIONS: Our findings showed that apps designed to promote physical activity among pregnant women were functional and aesthetically pleasing, with overall moderate quality. However, the incorporation of BCTs was low, with limited prevalence of BCTs previously demonstrating efficacy in behavior change during pregnancy. Future app development should identify and adopt factors that enhance and encourage user engagement, including the use of BCTs, especially those that have demonstrated efficacy for promoting physical activity behavior change among pregnant women