Antenatal physical activity counseling among healthcare providers

Jenn Leiferman, Margaret Gutilla, James Paulson, Jim Pivarnik

Colorado School of Public Health, Department of Community and Behavioral Health, Aurora, USA.
Colorado School of Public Health, Department of Epidemiology, Aurora, USA.
Michigan State University, East Lansing, USA.
Old Dominion University, Norfolk, USA.

DOI: 10.4236/ojog.2012.24073                

Abstract

Objective: Pregnant women often report a lack of knowledge concerning the safety of exercising during pregnancy. Healthcare providers play an integral role in providing pregnant women with the necessary knowledge to promote antenatal physical activity. Thus, the objective of this study was to assess healthcare providers’ beliefs, attitudes, knowledge and practices related to antenatal physical activity counseling. Study Design: 188 Providers (i.e. obstetricians, midwives, and family medicine physicians) completed a 39 closed-item survey. Characteristics among healthcare providers’ physical activity counseling practices as well as belief, attitudes and knowledge were explored. Results: The majority of all providers agreed that physical activity during pregnancy will result in numerous improved health outcomes for mother and baby. Approximately half of the providers (48%, n = 89) were not familiar with the current national guides recommending that women free of obstetric complications should engage in at least 150 minutes of exercise per week. Only 43% of providers believed their patients followed the advice they are given about physical activity. Over half of the providers reported that they provide in-office physical activity counseling, and FMs provide individualized counseling less often than OBs and CNMs (i.e. 33%, 60%, and 65%, respectively; p = 0.0014). Importantly, 17% (n = 31) of providers reported that they never received professional training in antenatal physical activity counseling and of those that did receive training, 69% (n = 107) claimed their training was “fair” or “poor”. Conclusion: Findings from the pre- sent study demonstrate a need for further continuing education opportunities on the current national guide- lines on antenatal physical activity.

Keywords

Exercise; Pregnancy; Physical Activity; Primary Care

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Zhang, J. and Savitz, D.A. (1996) Exercise during pregnancy among US women. Annals of Epidemiology, 6, 53-59. doi:10.1016/1047-2797(95)00093-3
[2]	Evenson, K.R., Savitz, D.A. and Huston, S.L. (2004) Leisure-time physical activity among pregnant women in the US. Paediatric and Perinatal Epidemiology, 18, 141-149. doi:10.1111/j.1365-3016.2004.00595.x
[3]	Poudevigne, M.S. and O’Connor, P.J. (2006) A review of physical activity patterns in pregnancy women and their relationship to psychological health. Sports Medicine, 36, 19-38. doi:10.2165/00007256-200636010-00003
[4]	Collings, C.A., Curet, L.B. and Mullin, J.P. (1983) Maternal and fetal responses to a maternal aerobic exercise program. American Journal of Obstetrics & Gynecology, 145, 702-707.
[5]	Clapp III, J.F. (1990) The course of labor after endurance exercise during pregnancy. American Journal of Obstetrics & Gynecology, 163, 1799-1805.
[6]	Sternfeld, B., Quesenberry, C.P. and Eskenazi, B. (1995) Exercise during pregnancy and pregnancy outcome. MSSE, 27, 634-640.
[7]	Da Costa, D., Rippen, N., Dritsa, M. and Ring, A. (2003) Self-reported leisure-time physical activity during pregnancy a relationship to psychological well-being. Journal of Psychosomatic Obstetrics & Gynecology, 24, 111-119.
[8]	US Department of Health and Human Services (2008) Physical Activity Guidelines for Americans.
[9]	Galper, D.I., Trivedi, M.H., Barlow, C.E., Dunn, A.L. and Kampert, J.B. (2006) Inverse association between physiccal inactivity and mental health in men and women. MSSE, 38, 173-178.
[10]	Marcus, B.H., Williams, D.M., Dubbert, P.M., Sallis, J.F., King, A.C., Yancey, A.K., Franklin, B.A., Buchner, D., Daniels, S.R. and Claytor, R.P. (2006) Physical activity intervention studies: What we know and what we need to know: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research
[11]	Manson, J.E., Hu, F.B. and Rich-Edwards, J.W. (1999) A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease. New England Journal of Medicine, 341, 650-658. doi:10.1056/NEJM199908263410904
[12]	Clarke, P.E. and Gross, H. (2004) Women’s behaviour, beliefs and information sources about physical exercise in pregnancy. American Journal of Obstetrics & Gynecology, 20, 133-141.
[13]	Kieffer, E.C., Willis, S.K., Arellano, N. and Guzman, R. (2002) Perspectives of pregnant and postpartum latino women on diabetes, physical activity and health. Health Education & Behavior, 29, 542-556. doi:10.1177/109019802237023
[14]	Doran, F. and O’Brien, A.P. (2007) A brief report of attitudes towards physical activity during pregnancy. Australian Health Promotion Association, 18, 155-158.
[15]	Krans, E.E. and Gearhart, J.G. (2005) Pregnant women’s beliefs and influences regarding exercise during pregnancy. Journal of the Mississippi State Medical Association, 46, 67-73.
[16]	Aittasalo, M., Pasanen, M., Fogelholm, M., Kinnunen, T.I., Ojala, K. and Luoto, R. (2008) Physical activity counseling in maternity and child health care—A controlled trial. BMC Women’s Health, 8, 14. doi:10.1186/1472-6874-8-14
[17]	Entin, P.L. and Munhall, K.M. (2006) Recommendations regarding exercise during pregnancy made by private/ small group practice obstetricians in the USA. Journal of Sports Science and Medicine, 5, 449-458.
[18]	Bauer, P.W., Broman, C.L. and Pivarnik, J.M. (2004) Exercise and pregnancy survey for health care providers. MSSE, 36, S113.
[19]	Herring, S.J., Platek, D.N., Elliot, P., Riley, L.E., Stuebe, A.M. and Oken, E. (2010) Addressing obesity in pregnancy: What do obstetric providers recommend? Journal of Women’s Health, 19, 65-70. doi:10.1089/jwh.2008.1343
[20]	Hughes, R., Maher, J., Baillie, E. and Shelton, D. (2011) Nutrition and physical activity guidance for women in the pre- and post-natal period: a continuing education needs assessment in primary health care. Australian Journal of Primary Health, 17, 135-141. doi:10.1071/PY10012
[21]	Power, M.L., Cogswell, M.E. and Schulkin, J. (2006) Obesity prevention and treatment practices of US obstetrician-gynecologists. Obstetrics & Gynecology, 108, 961-968. doi:10.1097/01.AOG.0000233171.20484.db
[22]	Harris, P.A., Taylor, R., Thielke, R., Payne, J., Gonzales, N. and Conde, J.G. (2009) A metadata-driven methodology and work flow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377-381. doi:10.1016/j.jbi.2008.08.010
[23]	Presser, S., Rothgeb, J., Couper, M.P., et al. (2004) Methods for testing and evaluating survey questionnaires. John Wiley & Sons, Hoboken. doi:10.1002/0471654728
[24]	Daley, E.M., McDermott, R.J., McCormack-Brown, K.R. and Kittleson, M.J. (2003) Conducting web-based survey research: A lesson in internet designs. American Journal of Health Behavior, 27, 116-124. doi:10.5993/AJHB.27.2.3
[25]	ACOG (2002) ACOG committee opinion: Exercise during pregnancy and postpartum period. Obstetrics & Gynecology, 99, 171-173. doi:10.1016/S0029-7844(01)01749-5
[26]	American Congress of Obstetricians and Gynecologists (1985) Women and Exercise during pregnancy and the postnatal period. ACOG, Washington.
[27]	Douglas, F., Torrance, N., van Teijlingen, E., Meloni, S. and Kerr, A. (2006) Primary care staff’s views and experiences related to routinely advising patients about physical activity. A questionnaire survey. BMC Public Health, 6, 138-148. doi:10.1186/1471-2458-6-138
[28]	Glanz, K., Rimer, B.K. and Viswanath, K., Eds. (2008) Health Behavior and Health Education. 4th Edition, Jossey-Bass Publishers, San Franciso.
[29]	Easton, A.N., Price, J.H. and Telljohann, S.K. (1997) An informational versus monetary incentive in increasing physicians’ response rates. Psychological Reports, 81, 968-970. doi:10.2466/pr0.1997.81.3.968