Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Jun 20, 2019
Open Peer Review Period: Jun 24, 2019 - Aug 19, 2019
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A pedometer guided physical activity intervention in obese pregnant women: a randomized feasibility study (The Fit MUM study)
Obesity in pregnancy is a growing problem worldwide, with excessive gestational weight gain (GWG) occurring in the majority of pregnancies. This significantly increases risks to mother and child. A major contributor to both pre-pregnancy obesity and excessive GWG is physical inactivity, however past interventions targeting maternal weight gain and activity levels during the antenatal period have been ineffective in women who are already overweight. Pedometer-guided activity may offer a novel solution to increasing activity levels in this population.
Our aim in this initial feasibility randomized controlled trial was to test a pedometer-based intervention to increase activity and reduce excessive GWG in thirty pregnant women.
Thirty pregnant women with obesity were supplied with a Fitbit Zip® pedometer, and randomized to one of three groups; Control: pedometer-only; App: pedometer-synched to patients’ personal smartphones, with self-monitoring of activity; App-coach: addition of a health-coach delivered behavioral change program. Feasibility outcomes included participant compliance with wearing pedometers, data synching, and data integrity; activity outcomes (step counts, active minutes) were analysed using linear mixed models and generalised estimating equations.
Twenty-seven participants completed the study; mean BMI in all groups was ≥ 35 kg/m2. Recruitment and retention rate were feasible, as was activity data synching to participants’ smartphones, although mean (SD) percentage of missing data days were 23.4% (20.6%), 39.5% (32.4%), and 21.1% (16.0%) in control, App group and App-coach group patients respectively. Estimated mean baseline activity levels were 14.5 active minutes/day and 5455 steps/day, with no significant differences found in activity levels between groups.
Activity data synching with a personal smartphone is feasible in a cohort of pregnant women with obesity. A future definitive study seeking to reduce GWG and improve activity in this population must focus on improving compliance with activity data recording, and behavioural interventions delivered. Clinical Trial: Australian and New Zealand Clinical Trials Registry ACTRN12617000038392.
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