Albright Cheryl L, Wilkens Lynne R, Saiki Kara, White Kami K, Steffen Alana D
School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, USA.
Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii, USA.
Transl J Am Coll Sports Med. 2019 Oct;4(19):215-224. doi: 10.1249/TJX.0000000000000106.
Understanding theoretically derived social and behavioral mediators of long-term increases in physical activity (PA) in a vulnerable population at risk for being underactive is needed to inform future research, clinical applications, and public health efforts. This is an analysis of potential mediators of an intervention that increased long-term (12-month) moderate-to-vigorous physical activity (MVPA) in postpartum (2-12months) women in a randomized trial, using a longitudinal analysis.
Healthy, underactive (i.e., not meeting national guidelines for MVPA) women (n = 311; mean age = 32 ± 5.6 years, 85% minorities) with infants (mean age: 5.7 ± 2.8 months) were randomly assigned to either a tailored eHealth condition consisting of personalized telephone counseling plus access to a website tailored to new mothers' MVPA issues or to a standard MVPA materials-only website. MVPA was assessed via surveys completed at baseline, then 6 and 12 months later. Theoretically derived mediators included social support for MVPA, self-efficacy to increase MVPA, barriers to increasing MVPA, and benefits of increasing MVPA.
All mediators, except benefits, improved over the 12 months in the tailored eHealth condition. The tailored condition's effect on increasing MVPA from 6 months to 12 months was mediated by an increase in social support from baseline to six months. No other hypothesized mediators were significant.
Our results demonstrated that learning strategies to increase social support for MVPA was instrumental in new mothers' increase in MVPA over a 12 month intervention. During this brief but impactful life-stage, where the focus can understandably be on her baby, being able to elicit support from friends and family may facilitate women's efforts to focus on their own needs with respect to MVPA.
ClinicalTrials.gov number.
为了指导未来的研究、临床应用和公共卫生工作，需要从理论上理解身体活动不足风险较高的脆弱人群中身体活动（PA）长期增加的社会和行为调节因素。这是一项对一项干预措施潜在调节因素的分析，该干预措施在一项随机试验中增加了产后（2至12个月）女性的长期（12个月）中度至剧烈身体活动（MVPA），采用纵向分析方法。
健康但身体活动不足（即未达到国家MVPA指南）的女性（n = 311；平均年龄 = 32 ± 5.6岁，85%为少数族裔）及其婴儿（平均年龄：5.7 ± 2.8个月）被随机分配到两种情况之一：一种是量身定制的电子健康干预，包括个性化电话咨询以及访问一个针对新妈妈MVPA问题量身定制的网站；另一种是仅提供标准MVPA材料的网站。通过在基线时以及之后6个月和12个月完成的调查来评估MVPA。从理论上推导的调节因素包括对MVPA的社会支持、增加MVPA的自我效能感、增加MVPA的障碍以及增加MVPA的益处。
除了益处之外，在量身定制的电子健康干预组中，所有调节因素在12个月内都有所改善。量身定制组从六个月到12个月增加MVPA的效果是由从基线到六个月社会支持的增加所介导的。没有其他假设的调节因素具有显著性。
我们的结果表明，学习增加对MVPA社会支持的策略有助于新妈妈在12个月的干预期间增加MVPA。在这个短暂但有影响力的生命阶段，人们的注意力可以理解地集中在婴儿身上，能够从朋友和家人那里获得支持可能会促进女性关注自身在MVPA方面的需求。
ClinicalTrials.gov编号。
