孕期干预减少久坐行为（SPRING）试验的预试验和可行性随机试验。

The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial.

机构信息

Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, PO Box 9190, 64 Medical Center Drive, Morgantown, WV, 26506, USA.

Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

BMC Pregnancy Childbirth. 2024 Apr 11;24(1):261. doi: 10.1186/s12884-024-06474-3.

DOI:10.1186/s12884-024-06474-3

PMID:38605328

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11007988/

Abstract

Pregnant individuals rarely achieve moderate-to-vigorous intensity physical activity recommendations.Purpose The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial aimed to demonstrate feasibility, acceptability, and initial efficacy of a lower intensity intervention targeting reduced sedentary behavior and increased standing and steps.Methods First trimester pregnant individuals at risk for high sedentary behavior and adverse pregnancy outcomes (APO) were randomized 2:1 to a multi-component sedentary behavior reduction intervention or no-contact control. Intervention components included biweekly remote health coaching, wearable activity monitor, height-adjustable workstation, and a private Facebook group. Evidence-based behavioral targets included sedentary time < 9 h/day, increasing standing by 2-3 h/day, and ≥ 7500 steps/day. Participants completed all-remote assessments (baseline, second trimester, third trimester) of sedentary behavior and activity (thigh-worn activPAL) along with exploratory pregnancy health outcomes abstracted from medical records. Intervention effects vs. control were evaluated using generalized mixed models and an intention-to-treat approach. Intervention participants also provided feedback on perceived benefits and acceptability.Results Participants (34 intervention; 17 control) had mean age 32 years, were 83% White, with mean pre-pregnancy BMI 28 kg/m. Retention was high (90% and 83% at second and third trimester follow-up visits). Intervention participants decreased sedentary time (-0.84 h/day, p = 0.019) and increased standing (+0.77 h/day, p = 0.003), but did not increase steps/day (+710, p = 0.257) compared to controls. Intervention participants reported many perceived benefits and identified the wearable, height-adjustable workstation, and behavioral lessons as most useful.Conclusion For pregnant individuals at risk for high sedentary behavior and APOs, a sedentary behavior reduction intervention is feasible, acceptable, and may offer a viable alternative to more intense physical activity recommendations during pregnancy. Further testing in a fully powered clinical trial is warranted.Trial registration NCT05093842 on clinicaltrials.gov.

摘要

孕妇很少能达到中等至剧烈强度的身体活动建议。目的：妊娠期间减少久坐行为干预（SPRING）试验旨在展示一种低强度干预的可行性、可接受性和初步效果，该干预旨在减少久坐行为，增加站立和步数。方法：处于高久坐行为和不良妊娠结局（APO）风险的妊娠初期孕妇按 2:1 随机分为多组分减少久坐行为干预组或无接触对照组。干预措施包括每两周进行一次远程健康指导、可穿戴活动监测器、可调节高度的工作站和私人 Facebook 群组。基于证据的行为目标包括每天久坐时间<9 小时、每天增加站立时间 2-3 小时、每天步数≥7500 步。参与者完成了所有远程评估（基线、孕中期、孕晚期），评估久坐行为和活动（大腿佩戴的 activPAL），以及从病历中提取的探索性妊娠健康结果。使用广义混合模型和意向治疗方法评估干预与对照组的效果。干预参与者还提供了对感知益处和可接受性的反馈。结果：参与者（34 名干预组；17 名对照组）的平均年龄为 32 岁，83%为白人，平均孕前 BMI 为 28kg/m。保留率高（第二次和第三次孕期随访时分别为 90%和 83%）。与对照组相比，干预组减少了久坐时间（-0.84 小时/天，p=0.019），增加了站立时间（+0.77 小时/天，p=0.003），但每天的步数没有增加（+710，p=0.257）。干预组参与者报告了许多感知到的益处，并认为可穿戴、可调节高度的工作站和行为课程最有用。结论：对于处于高久坐行为和 APO 风险的孕妇，减少久坐行为的干预是可行的、可接受的，并且可能为妊娠期间更强烈的身体活动建议提供了一种可行的替代方案。在一项充分的临床试验中进一步测试是必要的。试验注册：clinicaltrials.gov 上的 NCT05093842。