SENEK, Michaela (2018). An mHealth Walking Intervention for Pregnant Women with Obesity. Doctoral, Sheffield Hallam University. [Thesis]
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Senek_2018_PhD_mHealthWalkingIntervention(VoR).pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Senek_2018_PhD_mHealthWalkingIntervention(VoR).pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.
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Abstract
Introduction: Adverse maternal and infant health outcomes are associated with
a rise in obesity and excessive gestational weight gain, which may be modified
with physical activity in pregnancy. Using mobile health technology has the
potential to reach widely at a low cost, to deliver physical activity interventions
founded upon behaviour change theory to support women with gestational weight
gain management.
Aim: To establish the feasibility, practicality and acceptability of a walking-based
intervention for women who are pregnant and obese. Specific objectives were to;
conduct a systematic literature review; develop and test the feasibility, of a
walking intervention for women who are pregnant and obese using mobile health
technology; qualitatively evaluate participants' and health professionals' views on
the intervention design; design a protocol for a definitive RCT intervention.
Methods: A systematic review was conducted investigating the components and
effectiveness of walking interventions for women who are pregnant and obese.
Following this, feasibility randomised controlled trial, of a physical activity
intervention to women who are pregnant and obese, delivered via Facebook, was
implemented. It was developed using the Capability, Opportunity, Motivation-
Behaviour model as per National Institute of Health and Care Excellence
guidelines, to deliver self-monitoring, goal-setting and 'information about health
consequences' behaviour change techniques. Semi-structured interviews with
participants and health professionals assessed the acceptability of the
intervention. Primary outcome measures were feasibility of recruitment, attrition,
and trial procedures. Secondary outcomes were: engagement in Facebook
group, physical activity, gestational weight gain, maternal and infant outcomes.
Results: The systematic review identified two eligible studies, both
underpowered but showing a trend in improved maternal outcomes. For the
feasibility trial, 40 women were recruited. Retention rate was 85% in the
intervention and 75% in the control group. Participants were compliant to wearing
Fitbit (intervention arm 32/35 days and the control 28/35 days). In the intervention
arm, 20/20 participants joined the Facebook group. The level of engagement
varied, with some active and some 'lurking' participants. The interviews revealed
that participants found it practical and convenient to access health information via
a closed Facebook group.
Conclusion: Recruitment and adherence rates and Facebook participation,
suggest that the study is feasible and acceptable. Findings from the feasibility
study informed the final protocol of a large size randomised controlled trial, to test
the effectiveness of a mobile health-based walking intervention.
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