Abstract
Taking a patient-oriented approach to developing lifestyle interventions includes incorporating the patient into the program’s design, delivery, and evaluation. This commentary assumes that a patient-oriented approach has not yet been implemented and tested in exercise-based interventions designed for pregnant women. We outline and define a patient-oriented approach to conduct exercise-based research and review previous physical activity interventions designed for pregnant women to determine whether a patient-oriented approach was applied. In addition, pregnant women living with obesity may have unique barriers to engaging in prenatal exercise interventions that have not been previously addressed, such as having experienced weight stigma before pregnancy in healthcare and fitness settings. We propose suggestions for future trials to effectively take a patient-oriented approach when designing and implementing prenatal exercise interventions to address patient-informed barriers and incorporate suggested facilitators for physical activity. Given that prenatal activity levels are low and pregnant women may have unique barriers to engaging in exercise interventions, a patient-oriented approach may be an effective strategy to improve inclusivity and equity and, as a result, increase uptake and adherence to the intervention.
Résumé
L’adoption d’une démarche axée sur le patient ou la patiente, dans l’élaboration d’interventions sur le mode de vie, consiste à intégrer celui-ci ou celle-ci dans la conception, l’exécution et l’évaluation des programmes. Dans notre commentaire, nous présumons qu’une démarche axée sur la patiente n’a pas encore été appliquée et testée dans les interventions fondées sur l’exercice conçues pour les femmes enceintes. Nous décrivons et définissons une démarche axée sur la patiente pour faire de la recherche fondée sur l’exercice, et nous examinons des interventions antérieures d’activité physique conçues pour les femmes enceintes afin de déterminer si une démarche axée sur la patiente a été appliquée. Par ailleurs, les femmes enceintes vivant avec l’obésité peuvent faire face à des obstacles particuliers qui n’ont pas encore été étudiés avant de pouvoir participer à des interventions d’exercice prénatales, comme d’avoir été stigmatisées en raison de leur poids, avant la grossesse, dans des milieux de soins de santé et de conditionnement physique. Nous avançons des suggestions pour que les essais futurs adoptent bien une démarche axée sur la patiente lors de la conception et de la mise en œuvre d’interventions d’exercices prénatals, afin de tenir compte des obstacles mentionnés par les patientes et d’intégrer les moyens qu’elles suggèrent pour favoriser l’activité physique. Comme les niveaux d’activité prénatals sont faibles et que les femmes enceintes peuvent faire face à des obstacles particuliers avant de pouvoir participer à des interventions fondées sur l’exercice, une démarche axée sur la patiente pourrait être un moyen efficace d’améliorer l’inclusivité et l’équité, et par conséquent, d’accroître le recours et l’assiduité à l’intervention.
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TSN is funded by a Mitacs Fellowship supported by the Society of Obstetricians and Gynaecologists of Canada.
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Nagpal, T.S., Souza, S.C.S., da Silva, D.F. et al. Taking a patient-oriented approach in exercise interventions for pregnant women: a commentary. Can J Public Health 112, 498–501 (2021). https://doi.org/10.17269/s41997-020-00438-8
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DOI: https://doi.org/10.17269/s41997-020-00438-8