PHYSICAL ACTIVITY DURING PREGNANCY IN PRIMARY CARE: UNDERSTANDING BEHAVIOUR CHANGE FROM TRANSTHEORETICAL MODEL

S. Ramos F.¹, S. Roa-Alcaino¹, J. Leppe¹

Background: Physical Activity (PA) in the appropriate doses provides multiple benefits for the mother and the baby during pregnancy as reduction of risk of gestational diabetes, and pre-eclampsia, reduction of risks of preterm births and control of excess gestational weight gain. Despite the above, the level of PA is often reduced during pregnancy, mainly associated with beliefs, gender roles, and the challenge generated by changing habits. Prenatal care represents an opportunity to encourage women to start a PA program. The Transtheoretical Model (MTT) allows to explain and describe the change in health behaviour

Purpose: This study evaluates the stages of change to perform PA according to MTT and describe the barriers and facilitators for the 5 stages of change of MTT in pregnant women in primary care.

Methods: This study was carried out in healthy pregnant women between 13-40 weeks of gestation, controlled in the primary care centres belonging to “Instituto de Caridad Hermandad de Dolores”. 71 participants completed a registration form, a self-administered questionnaire that addresses five stages of behaviour change: (1) Pre-contemplation stage, (2) Contemplation stage, (3) Preparation stage, (4) Action and (5) Maintenance stage. The participants completed an open-ended questionnaire about barriers and facilitators according to their stage of change of the MTT. For data analysis was used inferential statistics using Chi2 and Wilcoxon tests (α = 0,05).

Results: A 79% of the participants were in “pre-action stages” (Pre-contemplation stage 4,2%, Contemplation stage 56,4% or Preparation stage 18,3%) of the MTT. Being older, having a lower educational level, greater parity, being married/partner is associated with “pre-action stages”, while receiving physical activity counselling during pregnancy is associated with “post-action stages”. The main barriers described were “fatigue associated with pregnancy”, “lack of information about PA” and “lack of time organization”. The main facilitators were “to receive prenatal counselling about PA during pregnancy” and “to have a supporting network”.

Conclusion(s): A high proportion of pregnant women cared for in primary care centres are in “pre-action stages”, where their barriers and facilitators were mainly psychological and physical. Being older, having a lower educational level, being married/in a relationship and multiparity were prevalent variables between “pre-action stages”. However, “receiving PA counselling during pregnancy” increases the likelihood of being between the “post-action stages”.

Implications: The physiotherapist has an important role in counselling and monitoring and promoting PA during pregnancy. There is a special opportunity to engage pregnant women who are in Preparation stage to do PA. This information is an important input to consider to create programs about this topic in primary care.

Funding, acknowledgements: There were no funds involved.

Keywords: Pregnancy, Physical Activity, Primary Care

Topic: Primary health care

Did this work require ethics approval? Yes

Institution: Universidad del Desarrollo

Committee: Comité Ético Científico Facultad de Medicina Clínica Alemana Universidad del Desarrollo

Ethics number: 2019-53