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Using a combined protection motivation theory and health action process approach intervention to promote exercise during pregnancy

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Abstract

Despite the benefits of exercise during pregnancy, many expectant mothers are inactive. This study examined whether augmenting a protection motivation theory (PMT) intervention with a Health Action Process Approach can enhance exercise behavior change among pregnant women. Sixty inactive pregnant women were randomly assigned to one of three treatment groups: PMT-only, PMT + action-planning, and PMT + action-and-coping-planning. Week-long objective (accelerometer) and subjective (self-report) exercise measures were collected at baseline, and at 1- and 4-weeks post-intervention. Repeated-measures ANOVAs demonstrated that while all participants reported increased exercise from baseline to 1-week post-intervention, participants in both planning groups were significantly more active (p < .001) than those in the PMT-only group by 4-weeks post-intervention (η 2 = .13 and .15 for accelerometer and self-report data, respectively). In conclusion, augmenting a PMT intervention with action or action-and-coping-planning can enhance exercise behavior change in pregnant women.

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Notes

  1. The intervention material can be obtained by contacting the principal investigator (corresponding author).

  2. Please refer to Sniehotta et al. (2006) for a detailed description of the planning sheets.

  3. These data are available upon request from the principal investigator.

References

  • Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27, 379–387.

    Article  PubMed  Google Scholar 

  • Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman.

    Google Scholar 

  • Brawley, L. R. (1993). The practicality of using social psychological theories for exercise and health research and intervention. Journal of Applied Sport Psychology, 5, 99–115.

    Article  Google Scholar 

  • Chasan-Taber, L., Freedson, P. S., Roberts, D. E., Schmidt, M. D., & Fragala, M. S. (2007). Energy expenditure of selected household activities during pregnancy. Research Quarterly for Exercise and Sport, 78, 133–137.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.

    Article  CAS  PubMed  Google Scholar 

  • Colley, R. C., Garriguet, D., Janssen, I., Craig, C. L., Clarke, J., & Tremblay, M. S. (2011). Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian Health Surveys Measure. Health Reports, 22, 1–8.

    Google Scholar 

  • Davidson, K. W., Goldstein, M., Kaplan, R. M., Kaufmann, P. G., Knaterund, G. L., Orleans, C. T., et al. (2003). Evidence-based behavioural medicine: What is it and how do we achieve it? Annals of Behavioral Medicine, 26, 161–171.

    Article  PubMed  Google Scholar 

  • Davies, G. A., Wolfe, L. A., Mottola, M. F., & MacKinnon, C. (2003). Joint SOGC/CSEP clinical practice guideline: Exercise in pregnancy and the postpartum period. Canadian Journal of Applied Physiology, 28, 329–341.

    Article  Google Scholar 

  • Esliger, D., Copeland, J., Barnes, J., & Tremblay, M. S. (2005). Standardizing and optimizing the use of accelerometer data for free-living physical activity monitoring. Journal of Physical Activity and Health, 2, 366–383.

    Google Scholar 

  • Fjeldsoe, B. S., Marshall, A. L., & Miller, Y. D. (2009). Behavior change interventions delivered by mobile telephone short-message service. American Journal of Preventive Medicine, 36, 165–173.

    Article  PubMed  Google Scholar 

  • Gaston, A., & Cramp, A. (2011). Exercise during pregnancy: A review of patterns and determinants. Journal of Science and Medicine in Sport, 14, 299–305.

    Article  PubMed  Google Scholar 

  • Gaston, A., & Prapavessis, H. (2009). Maternal-fetal disease information as a source of exercise motivation during pregnancy. Health Psychology, 28, 726–733.

    Article  PubMed  Google Scholar 

  • Godin, G., & Shephard, R. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sports Science, 10, 141–146.

    CAS  Google Scholar 

  • Gollwitzer, P. M. (1999). Implementation intentions: Strong effects of simple plans. American Psychologist, 54, 493–503.

    Article  Google Scholar 

  • Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A meta-analysis of effects and processes. Experimental Social Psychology, 38, 69–120.

    Article  Google Scholar 

  • Health Canada. (2007). Canada’s food guide. Retrieved February 15, 2010 from http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-base/index-eng.php

  • Heil, D. (2006). Predicting activity energy expenditure using the Actical activity monitor. Research Quarterly for Exercise and Sport, 77, 64–80.

    Article  PubMed  Google Scholar 

  • Hooker, S. P., Freeney, A., Hutto, B., Pfeiffer, K. A., McIver, K., Heil, D. P., et al. (2011). Validation of the Actical activity monitor in middle-aged and older adults. Journal of Physical Activity and Health, 8, 372–381.

    PubMed  Google Scholar 

  • Lewis, B., Avery, M., Jennings, E., Sherwood, N., Martinson, B., & Crain, A. L. (2008). The effect of exercise during pregnancy on maternal outcomes: Practical implications for practice. American Journal of Lifestyle Medicine, 2, 441–455.

    Article  Google Scholar 

  • Maddux, J. E. (1993). Social cognitive models of health and exercise behaviour: An introduction and review of conceptual issues. Journal of Applied Sports Psychology, 5, 116–140.

    Article  Google Scholar 

  • Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D., & Walker, A. (2005). Making psychological theory useful for implementing evidence based practice: a consensus approach. Quality & Safety in Health Care, 14, 26–33.

    Article  CAS  Google Scholar 

  • Milne, S., Orbell, S., & Sheeran, P. (2002). Combining motivational and volitional interventions to promote exercise participation: Protection motivation theory and implementation intentions. British Journal of Health Psychology, 7, 163–184.

    Article  PubMed  Google Scholar 

  • Milne, S., Sheeran, P., & Orbell, S. (2000). Prediction and intervention in health related behaviour: A meta-analytic review of protection motivation theory. Journal of Applied Social Psychology, 30, 106–143.

    Article  Google Scholar 

  • Moher, D., Schultz, K. F., Altman, D. G., & The CONSORT Group. (2001). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials. The Lancet, 357, 1191–1194.

    Article  CAS  Google Scholar 

  • Pivarnik, J. M., Chambliss, H., Clapp, J. F., et al. (2006). Impact of physical activity during pregnancy and postpartum on chronic disease risk: An ACSM roundtable consensus statement. Medicine and Science in Sports and Exercise, 38, 989–1005.

    Article  Google Scholar 

  • Prestwich, A., Lawton, R., & Conner, M. (2003). The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. Psychology & Health, 18, 707–721.

    Article  Google Scholar 

  • Puyau, M. R., Adolph, A. L., Vohra, F. A., & Butte, N. F. (2002). Validation and calibration of physical activity monitors in children. Obesity Research, 10, 150–157.

    Article  PubMed  Google Scholar 

  • Rejeski, W. J., Brawley, L. R., McAuley, E., & Rapp, S. (2000). An examination of theory and behavior change in randomized clinical trials. Controlled Clinical Trials, 21, 164–170.

    Article  Google Scholar 

  • Rogers, R. W. (1975). A protection motivation theory of fear appeals and attitude change. Journal of Psychology: Interdisciplinary and Applied, 91, 93–114.

    Article  Google Scholar 

  • Scholz, U., Sniehotta, F. F., Burkert, S., & Schwarzer, R. (2007). Increasing physical exercise levels—Age-specific benefits of planning. Journal of Aging and Health, 19, 851–866.

    Article  PubMed  Google Scholar 

  • Schwarzer, R. (1992). Self-efficacy in the adoption and maintenance of health behaviors: Theoretical approaches and a new model. In R. Schwarzer (Ed.), Self-efficacy: Thought control of action (pp. 217–242). Washington, DC: Hemisphere.

  • Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review, 57, 1–29.

    Google Scholar 

  • Sniehotta, F. F., Scholz, U., & Schwarzer, R. (2006). Action plans and coping plans for physical exercise: A longitudinal intervention study in cardiac rehabilitation. British Journal of Health Psychology, 11, 23–37.

    Article  PubMed  Google Scholar 

  • Sniehotta, F. F., Schwarzer, R., Scholz, U., & Schuz, B. (2005). Action planning and coping planning for long-term lifestyle change: Theory and assessment. European Journal of Social Psychology, 25, 565–576. doi:10.1002/ejsp.258

    Article  Google Scholar 

  • Urbaniak, G., & Plous, S. (2008). Research randomizer. Retrieved April 1, 2010 from http://www.randomizer.org

  • Warburton, D. E., Nicol, C. W., & Bredin, S. (2006). Prescribing exercise as preventive therapy. Canadian Medical Association Journal, 174, 961–974.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wareham, N., & Rennie, K. (1998). The assessment of physical activity in individuals and populations: Why try to be more precise about how physical activity is assessed? International Journal of Obesity Related Metabolic Disorders, 22, S30–S38.

    PubMed  Google Scholar 

  • Webb, T. L., & Sheeran, P. (2006). Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychological Bulletin, 132, 249–268.

    Article  PubMed  Google Scholar 

  • Webb, T. L., & Sheeran, P. (2008). Mechanisms of implementation intention effects: The role of goal intentions, self-efficacy, and accessibility of plan components. British Journal of Social Psychology, 47, 373–395.

    Article  PubMed  Google Scholar 

  • Weissgerber, T., Wolfe, L., Davies, G., & Mottola, M. (2006). Exercise in the prevention and treatment of maternal-fetal disease: A review of the literature. Applied Physiology, Nutrition and Metabolism, 31, 661–674.

    Article  Google Scholar 

  • Wilkin, T. J. (2011). Can we modulate physical activity in children? No. International Journal of Obesity (London), 35, 1270–1276.

    Article  CAS  Google Scholar 

  • World Health Organization. (2005). Handbook for good clinical research practice. Retrieved July 16, 2011 from http://apps.who.int/medicinedocs/index/assoc/s14084e/s14084e.pdf

  • World Medical Assocation. (2008). WMA declaration of HelsinkiEthical principles of research involving human subjects. Retrieved July 16, 2011 from http://www.wma.net/en/30publications/10policies/b3/

  • Zanna, M. P., & Fazio, R. H. (1982). The attitude-behavior relation: Moving toward a third generation of research. In M. P. Zanna, E. T. Higgins, & C. P. Herman (Eds.), Consistency in social behavior: The Ontario symposium (Vol. 2, pp. 283–301). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Zhang, Y., & Cooke, R. (2011). Using a combined motivational and volitional intervention to promote exercise and healthy dietary behaviour among undergraduates. Diabetes Research and Clinical Practice,. doi:10.1016/j.diabres.2011.10.006

    Google Scholar 

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Gaston, A., Prapavessis, H. Using a combined protection motivation theory and health action process approach intervention to promote exercise during pregnancy. J Behav Med 37, 173–184 (2014). https://doi.org/10.1007/s10865-012-9477-2

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