Activity Tracking Devices in Group Prenatal Care: A Feasibility Study

Abstract

To evaluate the feasibility (adherence to the study protocol and satisfaction) of using an activity tracking device (ATD) in group prenatal care. Women participated if they (1) were in group prenatal care, (2) owned a smartphone, and (3) had no activity restrictions. Women were instructed to wear and sync the ATD daily. Protocol adherence and satisfaction were assessed via surveys. Mixed models assessed the relationship between gestational age and ATD data. Self-reported energy expenditure from the Pregnancy Physical Activity Questionnaire (PPAQ) was compared with ATD-calculated energy expenditure. The baseline characteristics of the 49 women were as follows: 24 years old, prepregnancy body mass index 28, 80% Hispanic, 86% nulliparas, and 21 weeks of gestation. Of the 30 women who completed the follow-up survey, 47% self-reported wearing the ATD daily, 27% reported a lost or broken ATD, and 22% reported technical problems; however, 97% enjoyed wearing it, 100% would recommend it to a pregnant friend, and 77% thought it helped them reach activity goals. According to ATD data, the median active days were 47 (interquartile range [IQR] 21-79) and the median proportion of active days of potential days was 43.7% (IQR 15.4-77.1). For women who wore the ATD for the first 7 days, mean steps/day were 7574 (range 3076-15,828), active minutes/day were 277 (range 145-475), and sedentary hours/day were 12 (range 7.8-16.2). As gestational age increased, mean log steps decreased, mean active minutes decreased, and mean sedentary hours increased in unadjusted and adjusted models (p < 0.001 all comparisons). There were no differences in mean energy expenditure (MET-h/week) by PPAQ or ATD data at 28 weeks of gestation [231 (62-927 range) vs. 238 (212-290 range), p = 0.74] and at 36 weeks of gestation [145 (35-581 range) vs. 222 (196-272 range), p = 0.27]. Most women reported high satisfaction with an ATD in group prenatal care, yet adherence to the study protocol was low and ATD technical problems were common. As gestational age increased, activity decreased while sedentary time increased, suggesting that additional research is needed to find ways to engage women in physical activity during pregnancy.

Keywords: activity tracking devices; feasibility study; group prenatal care; physical activity; pregnancy.

Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.

Active days of ATD use, defined as at least 1000 steps/day (red bars), as a proportion of total potential active days (blue bars) from date of enrollment to date of delivery for 38 participants who did not report permanent ATD or cell phone problems (e.g., lost or broken ATD or charger, loss of cell phone access). ATD, activity tracking device.

FIG. 2.

Mean (blue dots) and range (red bars) of (a) steps and (b) sedentary hours for 25 participants who wore the ATD consecutively for the first 7 days.

FIG. 3.

Mean (a) steps, (b) active minutes, and (c) sedentary hours plotted against gestational age for all 49 participants. Each dot represents the mean steps, active minutes, or sedentary hours for any participant who had ATD data during the corresponding gestational week. The blue line, or LOESS curve, is a nonparametric method for fitting a curve through points on a scatter plot, revealing trends in the data.

FIG. 4.

Longitudinal modeling for ATD data with predicted (a) logarithmic steps, (b) sedentary hours, and (c) active minutes as denoted by black lines with 95% CI (shaded area) plotted against gestational age with p < 0.001 for change over time for all comparisons.