Baseline results from Hawaii's Nā Mikimiki Project: a physical activity intervention tailored to multiethnic postpartum women

Abstract

During the postpartum period, ethnic minority women have higher rates of inactivity/under-activity than white women. The Nā Mikimiki ("the active ones") Project is designed to increase moderate-to-vigorous physical activity over 18 months among multiethnic women with infants 2-12 months old. The study was designed to test, via a randomized controlled trial, the effectiveness of a tailored telephone counseling of moderate-to-vigorous physical activity intervention compared to a print/website materials-only condition. Healthy, underactive women (mean age = 32 ± 5.6 years) with a baby (mean age = 5.7 ± 2.8 months) were enrolled from 2008-2009 (N = 278). Of the total sample, 84% were ethnic minority women, predominantly Asian-American and Native Hawaiian. Mean self-reported baseline level of moderate-to-vigorous physical activity was 40 minutes/week with no significant differences by study condition, ethnicity, infant's age, maternal body mass index, or maternal employment. Women had high scores on perceived benefits, self-efficacy, and environmental support for exercise but low scores on social support for exercise. This multiethnic sample's demographic and psychosocial characteristics and their perceived barriers to exercise were comparable to previous physical activity studies conducted largely with white postpartum women. The Nā Mikimiki Project's innovative tailored technology-based intervention and unique population are significant contributions to the literature on moderate-to-vigorous physical activity in postpartum women.

Trial registration: ClinicalTrials.gov NCT00810342.

FIGURE 1

Accrual by recruitment method. Note. ^aParenting magazines (readership): Island Family/Island Baby (45,000), Hawaii Parent (45,000), Hawaii Baby & Toddler (20,000). ^bNewspapers (readership): The University of Hawaii student newspaper (10,000), Honolulu Weekly (38,000), Star Bulletin (63,000), Star Bulletin: Progress (177,000), Midweek (268,000), Hawaii People (189,000), and Honolulu Advertiser (158,155). ^cKaiser Permanente staff sent a maximum of 3 postcards to mothers who met the basic eligibility criteria as determined by electronic medical records. For each recruitment attempt, eligible mothers were mailed a returnable postcard, followed by a phone call to nonresponders. ^dDid not meet inclusion criteria because they were already exercising (n = 58), pregnant/planning to become pregnant (n = 13), using insulin (n = 1), planning to leave Oahu (n = 7), unwilling to complete assessments or office visits (n = 4), or BMI <18.5 (n = 8) or BMI >40 (n = 6), no health insurance (n = 7), cancer (n = 4), infant >12 mo (n = 7), or twins (n = 1). ^eActive Decline = Declined to be scheduled for a baseline visit; Passive Decline = Failed to attend scheduled baseline visit or failed to attend baseline visit after being rescheduled 3 times.

FIGURE 2

Website page for print/website materials comparison condition (color figure available online).

FIGURE 3

Website page for tailored telephone counseling and technology condition (color figure available online).