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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/m2. 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：
孕妇很少达到中等至剧烈强度的体力活动建议。目的减少妊娠久坐行为干预（SPRING）试点和可行性随机试验旨在证明可行性，可接受性,低强度干预的初始疗效减少了久坐行为，增加了站立和步伐。方法将具有高久坐行为和不良妊娠结局（APO）风险的孕早期个体随机分为2：1，分为多组分久坐行为减少干预或非接触控制。干预部分包括双周远程健康指导，可穿戴活动监测器，高度可调的工作站，和一个私人Facebook小组。循证行为目标包括久坐时间<9小时/天，增加站立2-3小时/天，≥7500步/天。参与者完成了所有远程评估(基线，中期妊娠,妊娠晚期）久坐的行为和活动（大腿磨损的activPAL）以及从医疗记录中提取的探索性妊娠健康结局。干预效果与对照组采用广义混合模型和意向治疗方法进行评估.干预参与者还提供了有关感知收益和可接受性的反馈。结果参与者（34名干预；17名对照）的平均年龄为32岁，83%是白人,平均孕前BMI为28kg/m2。保留率很高（妊娠中期和晚期随访时分别为90％和83％）。干预参与者久坐时间减少(-0.84小时/天，p=0.019）和增加的站立（+0.77小时/天，p=0.003),但与对照组相比，没有增加步数/天（+710，p=0.257）。干预参与者报告了许多感知到的好处，并确定了可穿戴设备，高度可调的工作站，和最有用的行为课程。结论对于有高度久坐行为和APO风险的孕妇，久坐行为减少干预是可行的，可接受,并可能为怀孕期间更强烈的体育锻炼建议提供可行的替代方案。在完全有效的临床试验中进行进一步的测试是必要的。在clinicaltrials.gov上试用注册NCT05093842
