Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its ...motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM).
Randomized control trial with two intervention arms and control (standard care).
Participants (N = 65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ∼20 weeks gestation to delivery. Assessments of exercise and motivational determinants were obtained at baseline (20-weeks gestation) and follow-up (32-weeks gestation). Blood glucose levels (fasting/postprandial mg/dL) and insulin use were extrapolated from medical records.
At the 32-week follow-up, the F2F group had significantly higher exercise min, pedometer steps/day, and motivational determinants (attitude, subjective norm, perceived control, intention) than controls (p's < 0.05) and significantly higher exercise min and subjective norm than the Home group (p's < 0.05); these effect sizes were medium-large (η2 = 0.11-0.23). There was a medium effect (η2 = 0.13) on postprandial blood glucose at 36-weeks gestation with the F2F group having lower values than controls. Although not significant, the F2F group started insulin later (33 weeks gestation) than the Home (27 weeks) and Control (31 weeks) groups.
A theoretically-based, F2F exercise intervention has multiple health benefits and may be the necessary approach for promoting exercise motivation and behavior among GDM women.
•Onsite, structured exercise had a large effect on women’s exercise and medium-large effect on motivational determinants.•Onsite structured exercise had a medium effect on lowering postprandial blood glucose levels in later pregnancy.•Women initiated insulin use later gestation in the structured exercise program compared to the home program and controls.•Onsite structured exercise intervention may promote exercise, motivation, and health in women with gestational diabetes.
Scant research has examined the determinants of primary exercise dependence symptoms in youth. Study purposes were to examine sex differences across leisure-time exercise behavior, motivation, and ...primary exercise dependence symptoms in youth and the extent to which exercise behavior and motivation predicted exercise dependence within the Self-Determination Theory framework.
Adolescents (N = 805; mean age = 15 years; 46% girls) completed measures of exercise behavior, motivation, and exercise dependence in health/PE classes.
One-way ANOVA revealed boys scored higher than girls on leisure-time exercise behavior, exercise dependence symptoms, and most of the exercise motivation subscales. Hierarchical regression analyses indicated a) sex, exercise behavior, motivation, and their interaction terms explained 39% of the variance in primary exercise dependence; b) Integrated Regulation and Introjected Regulation were important determinants of exercise dependence; and c) sex moderated the contributions of External Regulation for predicting exercise dependence such that boys in the high and low external regulation groups had higher symptoms than girls in the high and low external regulation groups.
These preliminary findings support the controlled dimensions of Integrated Regulation (boys, girls), Introjected Regulation (boys, girls), and External Regulation (boys only) are important determinants of primary exercise dependence symptoms.
Purpose: Marital dissatisfaction and conflict often increase for couples after the birth of a child and are evident in fewer positive family interactions and more negative family interactions. ...Because exercise is known to increase positive emotions and decrease negative emotions, the current study examined the extent to which higher levels of mothers' exercise during the postpartum period were related to more positive and fewer negative emotion-expressive behaviors with their infants' fathers. Method: Mothers' (N = 46; M = 8 months postpartum) positive and negative expressive behaviors were coded during couples' discussions of current conflict and positive family experiences. Mothers self-reported their leisure-time exercise behavior. Results: First-time mothers and mothers with higher levels of leisure-time exercise behavior displayed higher levels of positive expressive behaviors during couples' discussions. Conclusions: Exercise may be associated with increased positive emotion and, in turn, can have great potential to improve family relationships during the postpartum period when marital stress normatively increases, particularly for mothers with more than 1 child. Future longitudinal studies are needed to understand exercise patterns across the postpartum period to identify the most effective timing and optimal level of exercise that lead to more positive expressive behaviors.
Body-worn inertial measurement units (IMUs) have been widely used in postural stability and balance studies because of their low cost and high level of convenience. In most studies, single IMU ...sensors are put on the lower back attached to a belt, placing the sensor near the body’s center of mass (COM). For some populations, such as pregnant women, wearing the sensor on a belt over the lower back presents challenges in terms of fit and comfort. Thus, it may be necessary to identify a better location for the sensor and a more comfortable means for attaching the sensor to the body. This study aims to implement and test a novel pendant IMU sensor hanging from the subject’s neck and placed over the sternum. Three standing tasks (double-leg, tandem, and single-leg standing) were performed under open- and closed-eye conditions for preliminary assessments of the ability of the new sensor to discriminate between balance conditions. Standard deviations were analyzed in different conditions, along with ROC curves and ANOVA analysis. The results showed that the pendant sensor can detect the signals as good as the sensor on the waist.
Emerging evidence has suggested that prenatal resting energy expenditure (REE) may be an important determinant of gestational weight gain. Advancements in technology such as the real-time, mobile ...indirect calorimetry device (Breezing
) have offered the novel opportunity to continuously assess prenatal REE while also potentially capturing fluctuations in REE. The purpose of this study was to examine feasibility and user acceptability of Breezing
to assess weekly REE from 8-36 weeks gestation in pregnant women with overweight or obesity participating in the Healthy Mom Zone intervention study. Participants (N=27) completed REE assessments once per week from 8-36 gestation using Breezing
. Feasibility of the device was calculated as compliance (# of weeks used/total # of weeks). User acceptability was measured by asking women to report on the device's enjoyability and barriers. Median compliance was 68%. However, when weeks women experienced technical difficulties (11 of 702 total events) and the device was unavailable were removed (13 of 702 total events), median compliance increased to 71%. Over half (56%) of the women reported that the device was enjoyable or they had neutral feelings about it whereas the remaining 44% reported that it was not enjoyable. The most common barrier reported (44%) was the experience of technical issues. Study compliance data suggest the feasibility of using Breezing
to assess prenatal REE is promising. However, acceptability data suggest future interventionists should develop transparent and informative protocols to address any barriers prior to implementing the device to increase use.
High gestational weight gain (GWG) in overweight/obese pregnant women increases maternal-fetal complications. We conducted a 6-week GWG intervention based on an energy balance model that includes ...theories of planned behavior (TPB) and self-regulation constructs to promote exercise and healthy eating motivation and behaviors. The purposes of this proof-of-concept feasibility study were to examine: (1) the energy balance model constructs over the intervention, and (2) pre-post intervention, weekly, and dose-response changes in study constructs. Methods. Overweight/obese pregnant women (N=17) were randomized to 1 of 6 conditions, increasing in intensity, and included varied combinations of components (exercise sessions, healthy eating demonstrations, etc.). Exercise and healthy eating TPB (attitude, subjective norm, perceived behavioral control, intention), and self-regulation (prospective, retrospective) constructs were collected weekly. Exercise behavior, energy intake, and GWG were collected daily. Results. We observed: (a) significant increases in exercise TPB constructs, healthy eating attitude (limit unhealthy foods), exercise/healthy eating retrospective self-regulation; (b) significant decrease in healthy eating subjective norm (limit unhealthy foods); (c) trending increases for healthy eating perceived behavioral control (limit unhealthy foods), healthy eating prospective self-regulation, and energy intake; (d) significantly higher active time, steps, and energy expenditure at W3 relative to other weeks; (e) no significant increase in GWG; and, (f) a dose response effect such that women in more intensive dosages had greater gains in exercise and healthy eating perceived behavioral control (eat healthy/limit unhealthy foods). Conclusion. Brief exposure to a theoretically-driven, GWG intervention resulted in changes to exercise and healthy eating TPB and self-regulation motivational determinants, no significant increase in GWG, and suggests intervention intensity can strengthen perceived ability to engage in exercise/healthy eating behaviors; offering initial proof-of-concept for the intervention to regulate GWG in overweight/obese pregnant women. Future research will test this intervention over the course of pregnancy to understand long-term impact on maternal-fetal health outcomes.
Limited research examines women’s beliefs about the value of exercise and their actual exercise behaviors during pregnancy and postpartum. A retrospective study of 74 postpartum women was conducted ...to examine women’s behavioral, normative, and control beliefs about exercising during pregnancy and postpartum and to determine their most salient beliefs. In addition, women’s prepregnancy, pregnancy, and postpartum exercise behavior was examined. We found that 1) the most common exercise beliefs during pregnancy were that exercise improves mood and physical limitations (e.g., nausea) obstructed exercise participation; 2) the most common exercise beliefs during postpartum were that exercise controls weight gain and a lack of time obstructed exercise participation; 3) women’s husband/partner and family members most strongly influenced their pregnancy and postpartum exercise behavior; and 4) women exercised more before they were pregnant than during pregnancy and postpartum. Researchers and health care professionals are encouraged to examine and understand women’s beliefs about exercising during their pregnancy and postpartum and design their interventions accordingly, in an attempt to increase women’s exercise behavior during their childbearing years.
Abstract Objective To examine the relationship between Theory of Planned Behavior (TPB) beliefs and eating behavior, explore which beliefs have the greatest association with eating behavior, and ...explore differences between adults without children and first-time parents. Design Longitudinal evaluation via questionnaires and food records at baseline and 6 and 12 months. Participants Couples without children (n = 72) and first-time parents (n = 100). Main Outcome Measures Dependent variables: fruit and vegetable consumption and fat consumption. Independent variables: TPB beliefs. Analysis Pearson correlations between TPB beliefs and eating behavior; exploratory data reduction via linear regression. Results Control beliefs were associated with eating behavior ( r = .26–.46; P < .05). After controlling for past behavior, control beliefs were associated with eating behavior for first-time parents only. Control beliefs regarding preparation and time had the strongest associations with fruit and vegetable consumption for mothers (β = .26; P < .05) and fathers (β = .38; P < .01). The absence of a ceiling effect for control beliefs suggests room for improvement via intervention. Conclusions and Implications Interventions guided by TPB should target control beliefs to enhance healthy eating among new parents. Strategies (eg, individual, environmental, policy) to enhance control beliefs regarding healthy eating despite limited time and opportunity for preparation may be particularly valuable.
Exercise dependence: a systematic review Hausenblas, Heather A; Symons Downs, Danielle
Psychology of sport and exercise,
04/2002, Letnik:
3, Številka:
2
Journal Article
Recenzirano
Background and Purpose: The purpose of this paper was to review the equivocal literature examining exercise dependence and deprivation.
Method: A comprehensive literature search yielded 77 exercise ...dependence and 11 exercise deprivation studies, spanning 29 years (range=1970 to 1999), were reviewed.
Results and conclusions: The research was characterized by three general approaches: (a) comparing exercisers to eating disorder patients, (b) comparing “excessive” to “less excessive” exercisers, and (c) comparing exercisers to nonexercisers. Study results have been inconclusive due, in part, to a lack of experimental research, inconsistent or nonexistent control groups, discrepant operational criteria for exercise dependence, and/or invalidated or inappropriate measures of exercise dependence. More systematic theory based research is required to understand the precipitating and perpetuating factors associated with exercise dependence, as well as effective treatment regimens.
Although cortisol levels increase during normal pregnancy, particularly high levels of cortisol or stress have been associated with adverse maternal/child outcomes. Obesity is associated with altered ...cortisol metabolism, but there is limited information on pregnancy-related changes in cortisol in pregnant women with overweight/obesity. The objective of this study was to examine weekly measures of urinary cortisol and perceived stress throughout ~10-36 weeks gestation, if levels differ by pre-pregnancy BMI categories, and whether concurrent measures of urinary cortisol and perceived stress are associated.
Longitudinal observational data from Healthy Mom Zone, a gestational weight management intervention, and an ancillary fetal growth study were combined. Pregnant women with normal (n=7), overweight (n=11), or obese (n=14) pre-pregnancy BMI were recruited at >8 weeks gestation. Overnight urinary cortisol and Perceived Stress Scale were measured weekly from ~10-36 weeks gestation.
Higher pre-pregnancy BMI was associated with overall lower urinary cortisol throughout gestation, but rate of increase in urinary cortisol across pregnancy was similar across weight status groups. Women with obesity reported higher levels of overall perceived stress than normal weight women. Regardless of weight status, perceived stress was not associated with gestational age or cortisol.
Although women with obesity reported higher perceived stress, they had lower urinary cortisol than women with normal BMI, and gestation-related increases in cortisol were similar across weight groups and unrelated to perceived stress, suggesting that physiological factors that drive increases in cortisol as pregnancy may outweigh effects of stress and adiposity.
https://clinicaltrials.gov/ct2/show/NCT03945266, identifier (NCT03945266).
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