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Randomized Controlled Trial
. 2024 Apr 11;24(1):261.
doi: 10.1186/s12884-024-06474-3.

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

Bethany Barone Gibbs  1 , Andrea C Kozai  2   3 , Shannon N McAdoo  3 , Kelliann D Davis  3 , Meghan B Savidge  4 , Joshua L Paley  3 , Alisse Hauspurg  5 , Janet M Catov  2   5
Affiliations
Randomized Controlled Trial

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

Bethany Barone Gibbs et al. BMC Pregnancy Childbirth. .

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.

Keywords: Acceptability; Health coaching; Multi-level intervention; Thigh-worn accelerometer.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
SPRING study CONSORT diagram
Fig. 2
Fig. 2
APO, gestational weight gain, and screening glucose by randomized group (ITT, n = 47). Differences (d) and odds ratios (OR) were calculated from generalized linear models and compare outcomes in the intervention group vs. the control group. 95% confidence intervals are reported in the brackets following estimates. Abbreviations: APO, adverse pregnancy outcomes (composite); HDP, hypertensive disorders of pregnancy
Fig. 3
Fig. 3
Proportion of participants reporting benefits from the SPRING intervention (n = 24)
See this image and copyright information in PMC

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