A Pregnancy and Postpartum Lifestyle Intervention in Women With Gestational Diabetes Mellitus Reduces Diabetes Risk Factors The pilot study. MobileMums: A Randomized Controlled Trial of an SMS-Based Physical Activity Intervention An Exercise and Education Program Improves Well-Being of New Mothers: A Randomized Controlled Trial Reducing postpartum weight retention – a pilot trial in primary health care Effect of physical activity intervention based on a pedometer on physical activity level and anthropometric measures after childbirth: a randomized controlled trial Social cognitive mediators of the effect of the MobileMums intervention on physical activity. Mediators of physical activity behavior change among women with young children. A parent focused child obesity prevention intervention improves some mother obesity risk behaviors: the Melbourne inFANT Program Reducing postpartum weight retention through a correspondence intervention Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial Moms in motion: a group-mediated cognitive-behavioral physical activity intervention Supporting postpartum weight loss in women living in deprived communities – design implications for a randomised control trial Feasibility of an exercise intervention for women with postnatal depression: a pilot randomised controlled trial. Ethnic-Specific Weight-Loss Interventions for Low-Income Postpartum Women Postpartum exercise and food intake: the importance of behavior-specific self-efficacy. Physical activity patterns in a diverse population of women. The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology for postnatal women. Diet and exercise weight-loss trial in lactating overweight and obese women. Structured diet and physical activity prevent postpartum weight retention. Health-Promoting Behaviors Through Pregnancy, Maternity Leave, and Return to Work: Effects of Role Spillover and Other Correlates lmplementing lifestyle change through phone-based motivational interviewing in rural-based women with previous gestational diabetes mellitus. Physical activity and postpartum well-being. A pilot study evaluating a telephone-based exercise intervention for pregnant and postpartum women. The feasibility and effectiveness of pram walking groups for postpartum women in western Sydney. Sustaining self-regulatory efficacy and psychological outcome expectations for postnatal exercise: effects of a group-mediated cognitive behavioural intervention.
OBJECTIVE To pilot , among women with gestational diabetes mellitus ( GDM ) , the feasibility of a prenatal/postpartum intervention to modify diet and physical activity similar to the Diabetes Prevention Program . The intervention was delivered by telephone , and support for breastfeeding was addressed . RESEARCH DESIGN AND METHODS The goal was to help women return to their prepregnancy weight , if it was normal , or achieve a 5 % reduction from prepregnancy weight if overweight . Eligible participants were identified shortly after a GDM diagnosis ; 83.8 % consented to be r and omly assigned to intervention or usual medical care ( 96 and 101 women , respectively ) . The retention was 85.2 % at 12 months postpartum . RESULTS The proportion of women who reached the postpartum weight goal was higher , although not statistically significant , in the intervention condition than among usual care ( 37.5 vs. 21.4 % , absolute difference 16.1 % , P = 0.07 ) . The intervention was more effective among women who did not exceed the recommended gestational weight gain ( difference in the proportion of women meeting the weight goals : 22.5 % , P = 0.04 ) . The intervention condition decreased dietary fat intake more than the usual care ( condition difference in the mean change in percent of calories from fat : −3.6 % , P = 0.002 ) and increased breastfeeding , although not significantly ( condition difference in proportion : 15.0 % , P = 0.09 ) . No differences in postpartum physical activity were observed between conditions . CONCLUSIONS This study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight . Strategies to help postpartum women overcome barriers to increasing physical activity are needed This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer Background Postnatal women ( < 12 months postpartum ) are at increased risk of physical inactivity . Purpose To evaluate the efficacy and feasibility of a theory-based physical activity ( PA ) intervention delivered to postnatal women primarily via mobile telephone short message service ( SMS ) . Methods Eighty-eight women were r and omized to the intervention ( n = 45 ) or minimal contact control ( n = 43 ) condition . The 12-week intervention consisted of a face-to-face PA goal - setting consultation , a goal - setting magnet , three to five personally tailored SMS/week and a nominated support person who received two SMS per week . SMS content targeted constructs of social cognitive theory . Frequency ( days/week ) and duration ( min/week ) of PA participation and walking for exercise  were assessed via self-report at baseline , 6 and 13 weeks . Results Intervention participants increased PA frequency by 1.82 days/week ( SE ± 0.18 ) by 13 weeks ( F(2,85 ) = 4.46 , p = 0.038 ) and walking for exercise frequency by 1.08 days/week ( SE ± 0.24 ) by 13 weeks ( F(2,85 ) = 5.38 , p = 0.02 ) . Positive trends were observed for duration ( min/week ) of PA and walking for exercise . Conclusions Intervention exposure result ed in increased frequency of PA and walking for exercise in postnatal women Objective The purpose of this study was to evaluate the effect of a physical therapy exercise and health care education program on the  psychological well-being of new mothers . Design This was a r and omized controlled trial . Participants Primiparous and multiparous English-speaking women ready for discharge from The Angliss Hospital postnatal ward were eligible for this study . Women who were receiving psychiatric care were excluded . One hundred sixty-one women were r and omized into the trial . Intervention The experimental group ( n=62 ) received an 8-week “ Mother and Baby ” ( M&B ) program , including specialized exercise provided by a women 's health physical therapist combined with parenting education . The other group ( education only [ EO ] , n=73 ) received only the same educational material as the experimental group . Main Outcome Measures Psychological well-being ( Positive Affect Balance Scale ) , depressive symptoms ( Edinburgh Postnatal Depression Scale ) , and physical activity levels were assessed at baseline , after 8 weeks ( post-program ) , and then 4 weeks later . Results There was significant improvement in well-being scores and depressive symptoms of the M&B group compared with the EO group over the study period . More specifically , there was a significant positive effect on well-being scores and depressive symptoms at 8 weeks , and this effect was maintained 4 weeks after completion of the program . The number of women identified as “ at risk ” for postnatal depression pre-intervention was reduced by 50 % by the end of the intervention . Limitations Although this study provides promising short-term ( 4-week ) outcomes , further work is needed to explore whether the intervention effects are maintained as sustained psychological and behavioral benefits at 6 months . Conclusions A physical therapy exercise and health education program is effective in improving postnatal well-being . Routine use of this program may reduce longer-term problems such as postnatal depression Background Postpartum weight retention may contribute to the development of obesity . We studied whether individual counselling on diet and physical activity from 2 to 10 months postpartum has positive effects on diet and leisure time physical activity and increases the proportion of primiparas returning to their pre-pregnancy weight . Methods A controlled trial including ninety-two postpartum primiparas was conducted in three intervention and three control child health clinics in primary health care in Finl and . The intervention included individual counselling on diet and physical activity during five routine visits to a public health nurse ; the controls received the usual care . Results In total , 50 % of the intervention group and 30 % of the control group returned to their pre-pregnancy weight ( weight retention ≤ 0 kg ) by 10 months postpartum ( p = 0.06 ) . The confounder-adjusted odds ratio for returning to pre-pregnancy weight was 3.89 ( 95 % CI 1.16–13.04 , p = 0.028 ) for the intervention group compared with the controls . The mean proportion of high-fibre bread ( of total weekly amount of bread ) increased by 16.1 % ( 95 % CI 4.3–27.9 ) by 10 months postpartum in the intervention group compared with the controls when adjusted for confounders ( p = 0.008 ) . No significant differences were observed in changes in leisure time physical activity between the groups . Conclusion The intervention increased the proportion of  primiparas returning to pre-pregnancy weight  and the proportion of high-fibre bread in their diet . Larger r and omized controlled trials are needed to show whether counselling can improve dietary and leisure time physical activity habits in postpartum women and also to confirm the results concerning the effect on reducing postpartum weight retention . Trial registration Current Controlled Trials IS RCT Background Pregnancy and childbirth are associated with weight gain in women , and retention of weight gained during pregnancy can lead to obesity in later life . Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth . Exercise guidelines exist for pregnancy , but recommendations for exercise after childbirth are virtually nonexistent . The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth . Methods We conducted a r and omized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were r and omly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer ( intervention group , n = 32 ) or routine postpartum care ( control group , n = 34 ) . During the 12-week study period , each woman in the intervention group wore a  pedometer and recorded her daily step count .  The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week . Assessed outcomes included anthropometric measures , physical activity level , and energy expenditure per week . Data were analyzed using the paired t-test , independent t-test , Mann-Whitney , chi-square , Wilcoxon , covariance analysis , and the general linear model repeated measures procedure as appropriate . Results After 12 weeks , women in the intervention group had significantly increased their physical activity and energy expenditure per week ( 4394 vs. 1651 calorie , p < 0.001 ) . Significant differences between-group in weight ( P = 0.001 ) , Body Mass Index ( P = 0.001 ) , waist circumference ( P = 0.001 ) , hip circumference ( P = 0.032 ) and waist-hip ratio ( P = 0.02 ) were presented after the intervention . The intervention group significantly increased their mean daily step count over the study period ( from 3249 before , to 9960 after the intervention , p < 0.001 ) . Conclusion A physical activity intervention based on pedometer is an effective means to increase physical activity ; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women . Trial registration IS RCT N : I RCT OBJECTIVE To explore whether improvements in physical activity following the MobileMums intervention were mediated by changes in Social Cognitive Theory ( SCT ) constructs targeted in the intervention ( barrier self efficacy , goal setting skills , outcome expectancy , social support , and perceived environmental opportunity for exercise ) . This paper also examined if the mediating constructs differed between initial ( baseline to 6 weeks ) and overall ( baseline to 13 weeks ) changes in physical activity . METHODS Secondary analysis of data from a r and omized controlled trial involving 88 postnatal women ( < 12 months postpartum ) . Participants were r and omized to receive either the 12-week MobileMums intervention or a minimal-contact control condition .  Physical activity and proposed mediators were assessed by self-report at baseline , 6 weeks , and 13 weeks .  Walking for Exercise frequency was assessed using the Australian Women 's Activity Survey and frequency of moderate-to-vigorous physical activity ( MVPA ) was assessed using a single-item question . RESULTS Initial improvements in goal - setting skills mediated the relationship between experimental condition and initial changes in MVPA , αβ ( 95 % CI ) = 0.23(0.01 , 0.59 ) , and Walking for Exercise , αβ ( 95 % CI ) = 0.34(0.06 , 0.73 ) . Initial improvements in barrier self efficacy mediated the relationship between experimental condition and initial change in MVPA , αβ ( 95 % CI ) = 0.36(0.12 , 0.65 ) , but not Walking for Exercise . None of the SCT outcomes significantly mediated the relationship between experimental condition and overall ( baseline to 13 weeks ) change in frequency of MVPA or Walking for Exercise . CONCLUSION Future interventions with postnatal women using SCT should target barrier self-efficacy and goal setting skills in order to increase physical activity BACKGROUND Women with children are less likely to engage in  adequate physical activity ( PA )  than women without children . This study aim ed to evaluate the efficacy of two strategies for promoting increased  PA  among mothers of preschool-aged children , and to explore the mediators of any result ing change in PA behavior . DESIGN Controlled intervention trial incorporating repeated data collection from 554 women , r and omized to one of three experimental conditions . Intervention Group 1 served as a control , while women in Groups 2 and 3 were given print information about overcoming PA barriers . Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children . The primary strategies included increasing partner support , social advocacy , and capacity building , and were implemented through collaboration among participants , research ers , and community organizations . MAIN OUTCOME MEASURES Adequate physical activity ( PA ) , self-efficacy ( SE ) and partner support ( PS ) . RESULTS Following the intervention , women in Group 3 were significantly more likely to meet guidelines for PA than controls ( odds ratio [OR]=1.71 , confidence interval [CI]=1.05 - 2.77 ) ] after controlling for age and PA at baseline . After controlling for baseline PA , residualized change in SE ( OR=1.86 , CI=1.17 - 2.94 ) and PS ( OR=2.29 , CI=1.46 - 3.58 ) significantly predicted meeting guidelines . After controlling for residual change in PS and SE , the significant intervention effect was attenuated ( Group 3 OR=1.40 , CI=0.76 - 2.36 ) , indicating that partner support and self-efficacy may be mediators of physical activity behavior change . CONCLUSIONS The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA  among mothers of young children Background The diets , physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal . The family environment , as the first ecological niche of children , exerts an important influence on the onset of children ’s habits . Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives . The focus on parent ’s own behaviors provides a potential opportunity to decrease obesity risk behaviors in parents as well . Objective To assess the effect of a parent-focused  early childhood obesity prevention  intervention on  first-time mothers ’ diets , physical activity and TV viewing time .  Methods The Melbourne InFANT Program is a cluster-r and omized controlled trial which involved 542 mothers over their newborn ’s first 18 months of life . The intervention focused on parenting skills and strategies , including parental modeling , and aim ed to promote development of healthy child and parent behaviors from birth , including healthy diet , increased physical activity and reduced TV viewing time . Data regarding mothers ’ diet ( food frequency question naire ) , physical activity and TV viewing times ( self-reported question naire ) were collected using vali date d tools at both baseline and post-intervention . Four dietary patterns were derived at baseline using principal components analyses including frequencies of 55 food groups . Analysis of covariance was used to measure the impact of the intervention . Results The scores of both the " High-energy snack and processed foods " and the " High-fat foods " dietary patterns decreased more in the intervention group : -0.22 ( −0.42;-0.02 ) and −0.25 ( −0.50;-0.01 ) , respectively . No other significant intervention vs. control effects were observed regarding total physical activity , TV viewing time , and the two other dietary patterns , i.e. “ Fruits and vegetables ” and “ Cereals and sweet foods ” . Conclusions These findings suggest that supporting first-time mothers to promote healthy lifestyle behaviors in their infants impacts maternal dietary intakes positively . Further research needs to assess ways in which we might further enhance those lifestyle behaviors not impacted by the InFANT intervention OBJECTIVE : Since post-pregnancy weight retention may contribute to the development of obesity , we sought to determine whether a behavioral weight loss intervention was effective in returning women to their pre-pregnancy weight . METHOD : Ninety women who had given birth in the past 3–12 months and whose weight exceeded their pre-pregnancy weight by at least 6.8 kg were r and omly assigned to either : a ) a six-month behavioral weight loss intervention , delivered via correspondence or b ) a no-treatment control group . Assessment s of body weight , physical activity and eating patterns were conducted at pre-treatment and six months ( post-treatment ) . RESULTS : During the six month treatment , subjects in the correspondence condition lost significantly more weight than control subjects ( 7.8 kg vs 4.9 kg , P=0.03 ) and lost a greater percentage of their excess postpartum weight ( 79 % vs 44 % , P=0.01 ) . Furthermore , a significantly greater percentage of correspondence subjects than controls returned to their pre-pregnancy weight ( 33 % vs 11.5 % , P<0.05 ) . Weight loss in the correspondence group was correlated with completion of self-monitoring records ( r=0.50 , P<0.005 ) . CONCLUSIONS : A behavioral weight loss intervention , delivered via correspondence , appears to be effective in reducing  women ’s postpartum weight retention . Future studies should examine the acceptability and the long-term impact of a correspondence postpartum weight loss intervention Abstract Objective : To assess the long term effectiveness of the “ green prescription ” programme , a clinician based initiative in general practice that provides counselling on physical activity . Design : Cluster r and omised controlled trial . Practice s were r and omised before systematic screening and recruitment of patients . Setting : 42 rural and urban general practice s in one region of New Zeal and . Subjects : All sedentary 40–79 year old patients visiting their general practitioner during the study 's recruitment period . Intervention : General practitioners were prompted by the patient to give oral and written advice on physical activity during usual consultations . Exercise specialists continued support by telephone and post . Control patients received usual care . Main outcome measures : Change in physical activity , quality of life ( as measured by the “ short form 36 ” ( SF-36 ) question naire ) , cardiovascular risk ( Framingham and D'Agostino equations ) , and blood pressure over a 12 month period . Results : 74 % ( 117/159 ) of general practitioners and 66 % ( 878/1322 ) of screened eligible patients participated in the study . The follow up rate was 85 % ( 750/878 ) . Mean total energy expenditure increased by 9.4 kcal/kg/week ( P=0.001 ) and leisure exercise by 2.7 kcal/kg/week ( P=0.02 ) or 34 minutes/week more in the intervention group than in the control group ( P=0.04 ) . The proportion of the intervention group undertaking 2.5 hours/week of leisure exercise  increased by 9.72 % ( P=0.003 ) more than in the control group ( number needed to treat=10.3 ) . SF-36 measures of self rated “ general health , ” “ role physical , ” “ vitality , ” and “ bodily pain ” improved significantly more in the intervention group ( P<0.05 ) . A trend towards decreasing blood pressure became apparent but no significant difference in four year risk of coronary heart disease . Conclusion : Counselling patients in general practice on exercise is effective in increasing physical activity and improving quality of life over 12 months . What is already known on this topic Counselling patients in general practice on exercise has result ed in gains in physical fitness and activity , but no health benefits have been found What this study adds Counselling patients in general practice on exercise is effective in increasing physical activity and improving quality of life over 12 months without evidence of adverse effects The intervention may reduce blood pressure by an average of 1–2 mm Hg over 12 months No changes in the risk of coronary heart disease were observed The intervention is sustainable in usual general practice Prompting practice staff to deliver the intervention may have increased its Background When examining the prevalence of physical inactivity by gender and age , women over the age of 25 are at an increased risk for sedentary behavior . Childbearing and motherhood have been explored as one possible explanation for this increased risk . Post natal exercise studies to date demonstrate promising physical and psychological outcomes , however few physical activity interventions have been theory-driven and tailored to post natal exercise initiates . The purpose of this study was to compare the effects of a group-mediated cognitive behavioral intervention based upon social-cognitive theory and group dynamics ( GMCB ) to a st and ard care postnatal exercise program ( SE ) . Method A r and omized , two-arm intervention design was used . Fifty-seven post natal women were r and omized to one of two conditions : ( 1 ) a st and ard exercise treatment ( SE ) and ( 2 ) a st and ard exercise treatment plus group-mediated cognitive behavioral intervention ( GMCB ) . Participants in both conditions participated in a four-week intensive phase where participants received st and ard exercise training . In addition , GMCB participants received self-regulatory behavioral skills training via six group-mediated counseling sessions . Following the intensive phase , participants engaged in a four-week home-based phase of self-structured exercise . Measures of physical activity , barrier efficacy , and proximal outcome expectations were administered and data were analyzed using ANCOVA procedures . Results and discussion ANCOVA of change scores for frequency , minutes , and volume of physical activity revealed significant treatment effects over the intensive and home-based phases ( p 's < 0.01 ) . In addition , ANCOVA of change in mean barrier efficacy and proximal outcome expectations at the conclusion of the intensive phase demonstrated that GMCB participants increased their initial level of barrier efficacy and outcome expectations while SE participants decreased ( p < 0.05 ) . Conclusion While both exercise programs result ed in improvements to exercise participation , the GMCB intervention produced greater improvement in overall physical activity , barrier efficacy and proximal outcome expectations Background / Objectives : Pregnancy is a life stage where excess weight gain may occur and the postpartum period is often characterised by weight retention . The aim of the current study was to evaluate the feasibility of undertaking a r and omised controlled trial of a weight loss intervention ( WeighWell ) in postpartum women living in areas of social disadvantage . Subjects/ Methods : The study aim ed to recruit 60 women who were not pregnant , 6–18 months postpartum with a body mass index > 25 kg/m2 living in areas of deprivation within Tayside , UK . Recruitment strategies focused on visits to community groups ; writing directly to postpartum women living in areas of deprivation and primary care teams who covered the most deprived 15 % of the population and advertising in community setting s. The 12-week intervention used motivational interviewing techniques to promote an energy deficit diet and increased physical activity , delivered by three face-to-face consultations plus three structured telephone calls . Results : Of 142 women screened , 63 were eligible and 52 ( 83 % ) were recruited and r and omised to an intervention ( n=29 ) or comparison group ( n=23 ) . Over the 12-week intervention , body weight changed significantly by −1.6±2.0 kg in the intervention group compared with + 0.2±2.2 kg in the comparison group , indicating the potential efficacy of the intervention . Loss to follow-up was 24 % in the intervention group and 39 % for the comparison group . Conclusions : The findings support the development of a definitive trial that embraces personalised recruitment strategies and the development of approaches to improve retention over a clinical ly relevant intervention period BACKGROUND Postnatal depression is a serious mental health problem that may be reduced by exercise . AIM This study examined the feasibility of an exercise intervention  for women with postnatal depression  , and assessed which methods of recruitment are most effective . DESIGN OF STUDY R and omised controlled trial . SETTING General practice and the community . METHOD Participants were recruited from various sources and r and omised to an exercise intervention or usual care with follow-up at 12 weeks . As well as assessing feasibility , other trial outcomes included  exercise participation and self-efficacy for exercise . Levels of depression were assessed but the study was not powered to show a difference in this . RESULTS The  recruitment rate of eligible patients was 23.1 % . The highest recruitment rate was via referral from the psychiatric mother and baby unit ( 9/28 ; 32.1 % ) , followed by invitation letters from GPs ( 24/93 ; 25.8 % ) . Thirty-eight eligible participants were r and omised . At follow-up there was no significant difference in  exercise participation between groups . The intervention group reported significantly higher self-efficacy for exercise  compared to usual care , but depression scores did not differ . CONCLUSION  Exercise participation over the 12-week period was not significantly increased , possibly because it is difficult to motivate women with postnatal depression to exercise , or the intervention was not sufficiently intensive . Eligible patients were recruited into this study but response rates were low . Optimum methods of recruitment in this difficult-to-reach population are required prior to a substantive trial . Further research is imperative given poorly- evidence d recommendations by the National Institute for Health and Clinical Excellence to consider this treatment Promoting  weight loss among overweight low-income postpartum women has proven difficult . The study ’s aims were to pilot-test ethnic-specific weight-loss interventions using r and omized control-group design s for White/Anglo ( n = 23 ) , African American ( n = 25 ) , and Hispanic low-income postpartum women ( n = 23 ) and draw lessons from psychosocial data and follow-up interviews . Interventions lasting 13 weeks were offered in group setting s in the community . Similar to other r and omized trials with low-income mothers , weight changes between intervention and control groups were nonsignificant in each ethnic group ; however , changes correlated significantly with self-efficacy ( Spearman r = .50 ) for White/Anglo women and self-efficacy ( Spearman r = −.48 ) and perceived stress ( Spearman r = .48 ) for African American women . In follow-up interviews , women felt interventions gave a good foundation for weight loss , but program and situational factors affected participation and weight loss . Control groups ( mailed interventions later ) were generally more pleased with their assignment than intervention groups OBJECTIVE To examine the relationships between psychosocial characteristics and change in  exercise and food intake of women during the first year postpartum . DESIGN A prospect i ve cohort study following women from pregnancy until 1 year postpartum .  Psychosocial variables , change in food intake , and exercise frequency were assessed using anonymous mailed question naires during pregnancy and at 1 year postpartum . Sociodemographic and anthropometric information was obtained from the medical record . SUBJECTS/ SETTING Six hundred twenty-two women who enrolled for prenatal care in the Bassett Healthcare system between November 7 , 1994 , and November 15 , 1996 , and who met the eligibility criteria . The attrition rate for completing the question naire at 1 year postpartum was 20 % . STATISTICAL ANALYSES PERFORMED Multivariate linear regression with  exercise frequency at 1 year postpartum and change in food intake during the second 6 months postpartum as the dependent variables and psychosocial factors assessed at 1 year postpartum as the independent variables , controlling for sociodemographic variables , body mass index , and gestational weight gain . RESULTS Higher exercise self-efficacy and having the intention to exercise were associated with more frequent exercise at 1 year postpartum in the multivariate regression analysis ( r2 = 20 % ) . Food intake self-efficacy , body satisfaction , weight gain acceptance , and drive for thinness were all significant in the multivariate analysis ( r2 = 7 % ) and higher scores on these variables were associated with reductions in food intake . APPLICATIONS/ CONCLUSIONS Interventions that aim to help women get regular exercise and make appropriate reductions in food intake during the postpartum period should focus on self-efficacy specific to the targeted behaviors . For example , dietitians may strengthen exercise self-efficacy by providing postpartum women with mastery experiences of setting realistic exercise goals . Likewise , dietitians can focus on food intake self-efficacy by modeling strategies that women can use to avoid overeating in stressful situations BACKGROUND Demographic and psychosocial correlates of activity in domains other than recreational activity have not been well characterized and may be particularly relevant for health promotion efforts aim ed at women . METHODS Cross-sectional relationships between recreational , occupational , and household/caregiving physical activity and demographic and psychosocial factors were assessed with a mail survey in a r and om sample of 2,636 ethnically diverse women members of a large health maintenance organization , ages 20 - 65 . Activity was assessed with a modified Baecke question naire that uses categorical responses regarding frequency of domain-specific activities to create four semicontinuous activity indices ( sports/exercise , active living , occupational , household/caregiving ) . RESULTS Multivariable logistic regression analysis showed that the likelihood of being in the highest quartile of the sports/exercise and active-living indices , compared with the other three quartiles , was decreased among older , nonwhite , less well educated , heavier women who had young children at home , lacked motivation to exercise , and perceived external obstacles to exercise behavior . The odds ratios ( ORs ) ranged from 0.38 , 95 % confidence interval ( CI ) 0.33 - 0.45 , associated with low motivation , to 0.95 , 95 % CI 0.93 - 0.98 , associated with increasing body mass index . Social support and confidence in one 's ability to continue to exercise , even when faced with other pressures and dem and s ( termed self-efficacy ) , were associated with increased likelihood of high levels of sports/exercise and active living ( OR = 2.34 , 95 % CI 1 . 83 - 2.98 and OR = 3.96 , 95 % CI 2.92 - 5.38 , respectively ) . In contrast , the highest quartile of household/caregiving activity was positively associated with increasing age ( OR = 1.28 , 95 % CI 1.16 - 1.42 ) , Hispanic ethnicity ( OR = 1.58 , 95 % CI 0.55 - 1.01 ) , being married ( OR = 1.70 , 95 % CI 1.33 - 2.18 ) ,  having young children at home ( OR = 6.99 , 95 % CI 4.33 - 11 ) , and greater time constraints as a barrier to exercise ( OR = 1.55 , 95 % CI 1.38 - 1.74 ) and was negatively associated with employment ( OR = 0.38 , 95 % CI 0.30 - 0.47 ) . Increased likelihood of the highest quartile of occupational activity was associated with high school education or less ( OR = 2.26 , 95 % CI 1.74 - 2.94 ) and current smoking ( OR = 1.66 , 95 % CI 1.23 - 2.23 ) , while self-efficacy regarding exercise was associated with decreased likelihood ( OR = 0 . 77 , 95 % CI 0.61 - 0.96 ) . CONCLUSIONS These findings suggest that demographic and psychosocial correlates of physical activity vary by domain and that initiatives to promote physical activity in the population need to take these differences into account The purpose of the research project was to examine the effects of exercise , social support and depression on postnatal women who reported experiencing postnatal depression . A 12-week r and omized , controlled trial was conducted investigating the effects of an exercise intervention group ( a pram-walking programme for mothers and their babies ) compared to a social support group ( non-structured sessions , similar to a playgroup ) .  Participants in both groups had given birth in the past 12 months . Pretest data of physical fitness and structured question naires were compared to post-test effects . The primary outcomes were to reduce the depressive symptomatology and improve fitness levels of participants in the pram-walking group . Secondary outcomes were to improve the social support levels of the participants in both groups and explore women 's views about the programmes . It was hypothesized that the pram-walking group participants would improve their feelings of depression and fitness levels compared to the social support group , but that both groups would improve their perceived levels of social support . The results showed that mothers in the pram-walking intervention group improved their fitness levels and reduced their level of depressive symptomatology significantly more than the social support group . There were no significant changes to social support levels for both groups . Therefore , a direct association between improvement in fitness was related to improvement in depression for the pram-walking group . However , it is also suggested that other factors in combination with improvements in fitness influenced improvements in depression levels . It is recommended that pram-walking programmes for mothers with postnatal depression be implemented as pilot research into existing available services BACKGROUND Current evidence suggests a combined treatment of postpartum weight loss of diet and exercise . However , to our knowledge , neither their separate and interactive effects nor long-term outcomes have been evaluated . OBJECTIVE We evaluated whether a 12-wk dietary behavior modification ( D ) treatment to decrease energy intake , physical exercise behavior modification ( E ) treatment to implement moderate aerobic exercise , or combined dietary and physical exercise behavior modification ( DE ) treatment compared with control ( usual care ) ( C ) reduces body weight in lactating women measured at the end of treatment and at a 1-y follow-up 9 mo after treatment termination . DESIGN At 10 - 14 wk postpartum , 68 lactating Swedish women with a prepregnancy BMI ( in kg/m² ) of 25 - 35 were r and omly assigned to D , E , DE , or C groups . Measurements were made at baseline , after the intervention , and again at a 1-y follow-up 9 mo later . A 2 × 2 factorial approach was used to analyze main and interaction effects of treatments . RESULTS Weight changes after the intervention and 1-y follow-up were -8.3 ± 4.2 and -10.2 ± 5.7 kg , respectively , in the D group ; -2.4 ± 3.2 and -2.7 ± 5.9 kg , respectively , in the E group ; -6.9 ± 3.0 and -7.3 ± 6.3 kg , respectively , in the DE group ; and -0.8 ± 3.0 and -0.9 ± 6.6 kg , respectively , in the C group . The main effects of D treatment , but not of E treatment , on weight were significant at both times ( P < 0.001 ) . CONCLUSIONS Dietary treatment provided clinical ly relevant weight loss in lactating postpartum women , which was sustained at 9 mo after treatment . The combined treatment did not yield significant weight or body-composition changes beyond those of dietary treatment alone BACKGROUND Postpregnancy weight retention contributes to the near-epidemic prevalence of obesity in the United States . This study examines the impact of an individualized , structured diet and physical activity intervention on weight loss in overweight women during the first year postpartum . METHODS Forty overweight postpartum women were r and omized to either a structured ( STR ) or a self-directed ( SELF ) intervention . Measurements included body weight , percent body fat , daily caloric intake , habitual physical activity , and cardiorespiratory fitness . Subjects in STR received individualized diet and physical activity prescriptions derived from baseline measurements . They met weekly for the first 12 weeks and kept daily food and activity diaries . Subjects in SELF received a single 1-hour educational session about diet and activity . RESULTS Only 23 of 40 participants remained in the study at 1 year postpartum . Of those , STR ( n = 13 ) had a significant weight loss ( 7.3 kg , p < 0.01 ) , a significant decrease in percent body fat ( 6 % , p < 0.01 ) , and no change in fat-free mass . SELF ( n = 10 ) had no significant change in weight , percent body fat , or fat-free mass . CONCLUSIONS Women who committed to this one class per week for 12 weeks postpartum had a high likelihood of successful weight loss that persisted at 1 year . Women who were overweight before pregnancy were unlikely to lose the pregnancy-related weight without the help of a formal intervention . This suggests that healthcare professionals should strongly encourage postpartum women to enroll in a structured diet and exercise program ABSTRACT Women 's health-promoting behavior changes and their correlates across the transition to motherhood and return to work are insufficiently understood . The purpose of this study was to describe and compare women 's health-promoting behaviors , particularly physical activity ( PA )  , across these transitions . A prospect i ve , observational design was employed to assess 243 female healthcare workers from 3 sites with regard to health-promoting behaviors , and their demographic ( e.g. , age , parity ) and psychosocial ( i.e. , work-family role spillover ) correlates . Forty-two participants were recruited while pregnant and re-assessed during maternity leave and upon return to work , and compared to 201 non-pregnant participants . No significant changes in health-promoting behaviors were observed from pregnancy through the postpartum . Pregnant participants reported better nutrition than comparison participants ( p = .001 ) , and were more likely to check their pulse when exercising ( p = .004 ) . During pregnancy , health-promoting behaviors were related to parental status , with first-time mothers engaging in more positive behaviors . Correlates of PA during maternity leave and return to work included family income and exercise history . Positive family-to-work spillover was significantly greater among pregnant women than among comparison participants ( p < .001 ) , and positive work-to-family spillover was related to greater  PA  upon return to work ( p < .01 ) . This study reveals little variability in health-promoting behaviors from the prenatal to the postpartum period . Both demographic and psychosocial factors have effects on health-promoting behaviors , and we must look to these correlates to promote increased PA ISSUE ADDRESSED Substantial numbers of women with past gestational diabetes mellitus ( GDM ) develop type 2 diabetes mellitus ( T2DM ) . In northern New South Wales 23 % of women attending diabetes services between 2007 and 2010 with T2DM previously had GDM . This study investigated whether phone-based lifestyle education using motivational interviewing result ed in positive lifestyle change post GDM for women in a large rural area . METHOD Thirty-eight women were recruited to this pilot study following GDM diagnosis and r and omly allocated to either the control or intervention group . Following baseline assessment , the intervention group received a 6-month phone-based motivational interviewing program , and access to usual care . The control group received usual care only . Measures were collected at baseline ( 6 weeks postnatal ) , and at 6 months follow-up . Outcome measures included body mass index , diet , and physical activity . RESULTS At follow-up , the intervention group compared to the control group significantly reduced total fat intake by -19 g/d ( 95%CI : -37 to -1 ) , total carbohydrate intake by -42 g/d ( 95%CI : -82 to -1 ) , and glycaemic load by -26 units ( 95%CI : -48 to -4 ) . These women also increased leisure physical activity compared to the control group by 11 min/d ( 95%CI : 1 to 22 ) ; no significant change in total physical activity levels occurred . At follow-up , body mass index in the intervention group improved by -1.5 kg/m2 ( 95%CI : -2.8 to -0.1 ) compared to the control group . CONCLUSION The intervention group showed positive trends across lifestyle variables compared to the control group . Further large-scale research on the effectiveness of phone-based lifestyle counselling following GDM is warranted OBJECTIVE To describe reported patterns of postpartum physical activity and to identify benefits or risks associated with postpartum physical activity at 6 weeks postpartum . DESIGN Secondary analysis of longitudinal data collected prenatally and postpartum in a study of obstetric outcomes at a midwestern tertiary-care center and its ambulatory satellite and hospital clinics . PARTICIPANTS One thous and three women completed a question naire at the 6-week postpartum clinic visit . Mean age was 29.7 years , and mean education level was 15.3 years . VARIABLES OF INTEREST Participation in vigorous exercise , change in postpartum activity level , postpartum weight retention , infant feeding method , maternal postpartum adaptation , and participation in activities for fun . RESULTS Nearly 35 % reported doing vigorous exercise with a modal frequency of three times per week . More active women had retained significantly less weight ( 8.6 lb [ 3.9 kg ] ) than their less active counterparts ( 11.3 lb [ 5.1 kg ] ) . Vigorous exercisers demonstrated a consistent pattern of better scores on measures of postpartum adaptation and were more likely than nonexercisers to participate in fun activities , such as socializing , hobbies , and entertainment . Breastfeeding was not adversely affected by vigorous exercise . CONCLUSIONS These exploratory results indicate that physical and psychologic benefits may accrue to postpartum women who are able to exercise vigorously and avoid decreasing their usual level of activity . A prospect i ve r and omized test of this relationship is warranted . Although positive outcomes of physical activity have been demonstrated in the population at large , exercise has rarely been an element in postpartum care plans . Nurses who care for women after childbirth should assess women 's exercise goals and support them in their desired activities INTRODUCTION Exercise during pregnancy is associated with reduced rates of preeclampsia , gestational diabetes , anxiety , insomnia , and excessive weight gain . Continued exercise during the postpartum period is important for healthy weight loss and reduced anxiety . Unfortunately , pregnant and postpartum women are significantly less active than nonpregnant women . The purpose of this pilot study was to evaluate a telephone-based exercise intervention design ed for pregnant and postpartum women . METHODS Healthy women ( N = 37 ) who were pregnant ( 16 weeks ' gestation or less ) or postpartum ( 6 months or less ) participated in a 3-month , telephone-based exercise intervention based on the transtheoretical model and social cognitive theory . Exercise was assessed by using the 7-Day Physical Activity Recall Interview . RESULTS Pregnant participants significantly increased their exercise from a mean ( st and ard deviation [ SD ] ) of 60.47 ( 63.1 ) minutes per week at baseline to 132.9 ( 82.3 ) minutes at 3 months , F(1,13 ) = 9.96 , P < .01 . Postpartum participants significantly increased their exercise from a mean ( SD ) of 68.9 ( 63.5 ) minutes per week at baseline to 123.8 ( 48.8 ) minutes at 3 months , F(1,15 ) = 6.56 , P < .05 . DISCUSSION Participants responded positively to the intervention by significantly increasing their exercise levels . There is a need for a large , r and omized controlled trial examining the efficacy of telephone-based exercise interventions for pregnant and postpartum women ISSUE ADDRESSED Women with children under five are the least physically active population group . We provided postpartum women living in western Sydney with the opportunity to participate in weekly pram walking groups and evaluated the effect of the intervention on self-reported physical activity , mental health and social indicators . METHODS Mothers living in the intervention area ( Blacktown LGA ) and control area ( Holroyd and Parramatta LGAs ) completed a baseline question naire . Women in the intervention community were invited to participate in a pram walking group starting in the next month . The control group ( n = 60 ) were also invited to participate in a pram walking group starting six months later . A follow-up question naire was completed by all mothers . RESULTS There was no significant increase in the proportion of mothers in the intervention or control groups engaging in adequate physical activity from baseline to follow-up . However , intervention mothers increased their sessions of vigorous exercise and control mothers increased the amount of time spent walking . There were no significant differences at baseline or follow-up between the intervention and control groups in frequency of social contact or size of social networks . Nor was there a significant difference in satisfaction with social contact at baseline between the two groups . However , at follow-up women in the intervention group were more satisfied with the quality of their social contacts than the controls . CONCLUSIONS Providing organised , community-based pram walking was not sufficient to increase overall physical activity levels among this group of postpartum women . The results suggest that the friendships formed in the pram walking group boosted mothers ' satisfaction with social contact and possibly their mental health OBJECTIVE The objective of the current investigation was to examine if the effects of a group-mediated cognitive behavioural counselling plus exercise intervention were superior to the effects of a st and ard exercise care condition on postnatal mothers ' self-regulatory efficacy ( SRE ) , outcome expectations ( OEs ) and self-directed physical activity ( PA ) . DESIGN The design of the study consisted of two intervention conditions ; group-mediated cognitive behavioural counselling plus exercise ( GMCB ) and st and ard exercise ( SE ) . Each condition consisted of two phases ; a 4-week supervised , centre-based intensive exercise training phase followed by a 4-week home-based phase . METHODS Participants were 57 postnatal women r and omly assigned to conditions ( SE : N=31 ; GMCB : N=26 ) .  Measures of SRE and OEs were assessed prior to and following the centre-based aspect of the intervention . Physical activity was measured following the intensive exercise training phase as well as the home-based phase . RESULTS GMCB participants ' SRE and OEs were sustained during the intervention whereas those of SE participants declined . GMCB participants also reported significantly greater time spent engaging in self-directed PA at the conclusion of the intensive and home-based phases . Mediation analysis revealed that SRE partially mediated the relationship between intervention condition and post home-based PA as confirmed by a significant sobel test . CONCLUSIONS These findings suggest that a theory-based GMCB counselling plus exercise intervention is superior to the SE condition in sustaining SRE and OEs , and in promoting greater self-directed PA . SRE partially mediated the relationship between intervention condition and post home-based PA supporting the targeting of that variable for change as part of the intervention
This systematic review and meta- analysis reports the efficacy of  post-natal physical activity change interventions  with content coding of behaviour change techniques ( BCTs ) .