Fit4Two: Feasibility, acceptability and efficacy of a tailored eHealth physical activity intervention for pregnant women integrated into clinical practice – a randomised controlled trial

Participants complete a 10 minute online questionnaire on physical activity levels before pregnancy and current physical activity levels via an iPad Kiosk whilst waiting in the reception area prior to their appointment with their practitioner. Intervention Group 1: Tailored advice without practitioner endorsement. Once participants complete their baseline survey, they will be instructed to collect their print-based personally-tailored physical activity advice (based on participant information collected during baseline survey) from the reception desk at the conclusion of the consultation with their medical practitioner. Their highly personalised tailored physical activity advice will cover the same content as those in the control group received, however the information will be tailored and personalise, as well as additional information on the benefits of physical activity during pregnancy, aerobic and resistance-based exercise recommendations, advice for active living during pregnancy and a number of strategies to help increase physical activity levels. Furthermore, all of this information will be presented in a highly personalised and tailored way in relation to the individual’s physical activity behaviours. The physical activity advice will include a summary page at the beginning of the document of personalised and tailored physical activity recommendations and will also encourage participants to visit the Fit4Two website. Intervention Group 2: Tailored advice with practitioner endorsement (Obstetrician or Midwife). Upon completing the baseline assessment, participants in this group will be provided with the same print-based personally-tailored physical activity advice and information as those in intervention group 1. However, their tailored physical activity advice will be instantaneously sent from the iPad to a wireless printer located within the practitioners’ consultation office, where the practitioner has the opportunity to briefly look over the contents provided prior to the patient coming in. The tailored physical activity advice can then be directly handed to participant by their practitioner. Practitioners will then be asked to go over the advice with the patients and to endorse the contents. Practitioners will also endorse the Fit4Two website and encourage participants in this group to log into the Fit4Two website and actively participate in each of the weekly modules. The Fit4Two Website: The Fit4Two website consists of four weekly behaviour change modules, guided by the Social Cognitive Theory (SCT), that have previously been identified as successful at increasing physical activity in pregnant women. At the completion of each module, participants are provided with tailored feedback that is based on their responses to the survey questions that participants answer at the beginning of each weekly module. The four additional Fit4Two website modules include: (1) goal setting and action planning where participants are encouraged to make physical activity plans including when they will exercise, who they might exercise with, where the exercise will take place, and what barrier/s might come up and how they will overcome them; (2) overcoming barriers such as environmental barriers and lack of time; (3) developing social support networks including work colleagues, family and friends; and (4) physical activity reinforcement such as identifying the exercise during pregnancy guidelines, the benefits associated with meeting the guidelines and the participants exercise behaviours. Each of these modules apply behaviour change constructs that have previously been identified as effective to increasing physical activity among pregnant women. In addition to the weekly module, participants will also receive access to a weekly action planning tool, which guides participants in setting detailed SMART goals and an action plan for their physical activity over the coming week. The tailored advise is developed and generated by the Fit4Two web-based software (based on algorithms and coding), and developed in conjunction with behaviour change and exercise during pregnancy experts. For the purpose of this study practitioners are referred to as Obstetricians and Midwives. Data collected at baseline includes activity behaviours (aerobic and resistance-based activity) before pregnancy and current activity behaviours.