Feasibility, acceptability, and preliminary efficacy of a single-arm, remotely-delivered health coaching intervention to increase physical activity and reduce sedentary behavior during pregnancy

Background Interventions targeting physical activity and sedentary behavior concurrently in pregnancy may be an ideal strategy to reduce the risk of pregnancy complications. We assessed the feasibility, acceptability, and preliminary efficacy of a single-arm, remotely-delivered health coaching intervention to promote physical activity and reduce sedentary behavior in pregnancy. Methods Women (n = 34) between 8 and 12 weeks gestation were recruited to take part in the INcreasing Steps in PREgnancy (INSPiRE) study. Participants were given an activity tracker (Fitbit Inspire) and met virtually with their health coach throughout the second and third trimesters of pregnancy. Feasibility was based on enrollment, retention, and adherence rates. Acceptance was assessed using a process evaluation survey. Intervention efficacy was based on activPAL data obtained at baseline and the end of the second trimester. Results Feasibility objectives were met, with greater than 70% enrollment, 97% retention, and 99% adherence. All participants reported high levels of satisfaction with the program. ActivPAL data indicated statistically significant increases in daily steps (+ 1715.8 steps/day, Cohen's d = 0.97), stepping time (+ 1.9%, d = 0.75), standing time (+ 2.3%, d = 0.29), and decreases in total sedentary time (- 4.2%, d = 0.43) and sedentary bouts of 30 minutes (- 4.1%, d = 0.36) from baseline to the end of the second trimester, all p < 0.05. Decreases were also observed in sedentary bouts of 60 minutes (- 3.9%, d = 0.40), but this was not statistically significant. Conclusions The INSPiRE study demonstrated feasibility, high acceptability, and preliminary efficacy for improving movement behaviors in women during pregnancy, supporting future testing in a randomized controlled trial.

Automated summary

The study demonstrated the feasibility, high acceptability, and preliminary efficacy of a remotely-delivered health coaching intervention to improve movement behaviors in women during pregnancy. All participants reported high levels of satisfaction with the program, and statistically significant improvements in physical activity and reductions in sedentary behavior were observed.