Discussion
GDM
GDM, RECRUITMENT
According to the MRC framework, this study successfully developed and pilot-tested a theory-guided and evidence-based physical activity intervention in women with high risk for GDM. The intervention development process is comprehensively supported by theory, clinical practice recommendations, evidence from systematic reviews and RCTs, consideration of context’s characteristics and economics, and healthcare providers’ multi-professional involvement as key stakeholders to identify the content validity of the intervention protocol. The intervention development process ensures the intervention protocol is research-informed, theoretically appropriate, and practically feasible. The pilot clinical trial further indicated the feasibility and the acceptability of the intervention protocol.Systematic reviews of clinical practice guidelines [This physical activity intervention protocol for pregnant women with GDM is developed based on the self-efficacy theory [The intervention protocol was developed as blended interventions together with face-to-face and mHealth. Based on evidence and the communication habits of the Chinese population, WeChat and Tencent meetings were selected as delivery channels for daily communication and online group discussion sessions, respectively. In addition, the physical activity video will be uploaded on the small program of WeChat. Participants could follow the video to perform physical activity every day. Then they could record their daily weight and exercise diary on the small program of WeChat. The blended interventions in the present study would be more convenient and cost-effective for participants.In addition, excellent reliability and content validity of the intervention protocol was demonstrated among the expert panel. To promote physical activity during pregnancy, obstetric care providers and exercise specialists are recommended to cooperate closely [To improve the intervention and study design, a pilot trial was designed to examine the feasibility and the acceptability of the intervention protocol. The utilization of the intervention protocol was found to be feasible, with a high recruitment rate of the eligible participants, retention rate of the enrolled participants, and completion rate of the total intervention sessions. The lower incidence of GDM in the intervention group highlights the necessity to improve physical activity to prevent GDM in pregnant women with a high risk for GDM. There was one participant dropped from the study due to the contraindications of exercise during pregnancy. This information reminds researchers to dynamically evaluate pregnancy progress and closely consider the medical records of the participants. The participants should know safety precautions regarding physical activity during pregnancy.Concerning acceptability, the respondents to the satisfaction questionnaire were great. The blended intervention was described as easy and clear to use, and easy to understand. The participants claimed that this program met their needs and was helpful. They were willing to recommend this program to other pregnant women. High satisfaction rates (100%) were achieved in this intervention.