Barriers to physical activity in pregnant women living in Iran and its predictors: a cross sectional study.

BACKGROUND AND AIMS: Despite the benefits of physical activity (PA) on maternal and fetal health, the level of PA is low among pregnant women globally. The aim of this study was to determine the barriers to PA and its predictors in Iranian pregnant women specifically. METHODS: This cross-sectional study included 300 pregnant women referred to the Ilam health centers of Iran. The sampling strategy used stratified random proportional allocation sampling from both comprehensive health centers and health bases. Data were collected from September to December 2018 in relation to individual characteristics. Data collection tools used included the Pregnancy Physical Activity Questionnaire and the Barriers to Physical Activity during Pregnancy Scale. To analyze the data, descriptive statistics and statistical tests of analysis including variance, independent t-test and multiple linear regression were used. RESULTS: The mean and SD of the total score of PA barriers was 88.55 and 19.28, respectively. The highest and lowest mean scores of the subscale of PA barriers were related to interpersonal and environmental barriers, respectively. Among the intrapersonal barriers related to pregnancy; fear of pregnancy complications, drowsiness, and nausea and vomiting, heaviness or swelling barriers scored higher than other barriers. Lack of regular schedule, insufficient time, and lack of motivation received the highest score in terms of intrapersonal barriers non-related to pregnancy. In the interpersonal subscale; lack of knowledge about how to be physically active during pregnancy, forbiddance of PA by friends and family, as well as lack of advice from physicians and midwives scored higher than other barriers. Lack of adequate facilities and air pollution were identified as barriers to PA in the environmental subscale. PA barriers were significantly associated with pre-pregnancy or early pregnancy body mass index (B = - 14.643), level of education (B = 17.215), and habitual exercise pre-pregnancy (B = - 7.15). CONCLUSION: Interpersonal barriers were reported to be the most common barriers to PA during pregnancy. Perinatal care providers should encourage, educate and reassure pregnant women, their spouses and their families about the benefits, type and frequency of safe PA in pregnancy. PA interventions focused on women with lower levels of education and income in particular are required.

Exploring the intensity, barriers and correlates of physical activity In Iranian pregnant women: a cross-sectional study.

OBJECTIVES: To determine the intensity, barriers and correlates of physical activity (PA) in Iranian pregnant women. METHODS: This cross-sectional study was carried out with 300 eligible pregnant women referred to the Ilam health centres and bases using stratified random sampling with proportional allocation. Data collection tools included a demographic and obstetrical history questionnaire, the Pregnancy Physical Activity Questionnaire and the Exercise Benefits/Barriers Scale. The association between demographic and obstetrical characteristics and PA intensity and barriers were studied using multiple linear regression models. RESULTS: The mean and SD of the total score of PA intensity were 47.15 and 26.25 metabolic equivalent of task (MET)-hour/week, respectively. The highest and the lowest barriers were related to the time expenditure (42.77±18.04) and family discouragement (50.72±24.99) constructs, respectively. The PA intensity was significantly associated with prepregnancy or early pregnancy body mass index (B=25.6), ethnicity (B=16.94), level of education (B=-8.77), number of children (B=5.95), gestational age (B=0.81), participation in childbirth preparation classes (B=-11.27), habitual exercise before pregnancy (B=6.09), income (B=-9.22). The PA barriers were significantly associated with ethnicity (B=-4.96), income (B=2.23) and habitual exercise before pregnancy (B =-1.35). CONCLUSION: PA intensity may be enhanced by encouraging individuals to be more physically active before pregnancy. Additionally, strategies to enhance support from friends and family to engage in PA throughout pregnancy and PA interventions focused on women with lower levels of income and education are required.

Development and psychometric testing of the 'barriers to physical activity during pregnancy scale' (BPAPS).

BACKGROUND: Pregnancy can affect the amount of physical activity that women engage in, so ensuring adequate physical activity in pregnant women can be a challenge. Therefore, there is a need to explore and identify barriers to physical activity in this population. Consequently, this study was conducted in order to develop and validate a scale to assess barriers to physical activity in pregnant populations. METHODS: The study was conducted in two phases. During phase 1, a comprehensive review of the most relevant literature from electronic databases on barriers to physical activity was carried out and appropriate scale items were extracted using a deductive approach. During phase 2, the psychometric properties of the extracted scale items were determined using face, content and construct validity, internal consistency and stability. Qualitative and quantitative face validity was assessed via face-to-face interviews with 30 and 10 pregnant women, respectively. To confirm the qualitative and quantitative content validity, 10 experts in the field of research and instrument design were invited to complete the resulting scale. To assess construct validity, the scale items were further tested among 320 pregnant women attending perinatal clinics at health centers in Ilam, Iran, where data were collected via continuous sampling. The internal consistency and stability of the study were measured by Cronbach's alpha and intra-class correlation coefficient (ICC), respectively. RESULTS: Following a review of the relevant literature, 48 items for the BPAPS were extracted. Subsequent to the assessment of face and content validity, the number of items was reduced to 38. Through a subsequent exploratory factor analysis, the number of items dropped further to 29. These items were then structured under four major factors. Finally, the internal consistency and stability of the scale was confirmed by a Cronbach alpha coefficient of 0.824 and a test-retest reliability score of 0.87. CONCLUSION: Findings show that the 29-item scale to assess barriers to physical activity in pregnant populations is a valid and appropriate instrument.