Does action planning improve outcomes in a physical activity intervention for pregnant women?

Objective: To assess impact on adherence, participant satisfaction and physical activity (PA) change of an action planning tool within a web based PA intervention (Fit4Two) for pregnant women. Methods: Adherence was assessed by the number of action plans completed during the online intervention. Satisfaction with the action planswas measured using a five-point Likert scale (1=strongly disagree; 5=strongly agree). Chi-square analyses were used to compare those with a high satisfaction to those with a low satisfaction on adherence. Changes in PA were assessed using the Godin Leisure-Time Exercise Questionnaire. Repeated measures ANOVA's were used to compare PA from baseline to post-intervention in those with a high adherence to the action plans (3-4 AP's) to those with a low adherence (1-2 AP's). Repeated measures ANOVA's also compared changes in PA in those with non-specific action plans to those with specific action plans (day, type, duration, time and partner detailed). Results: Use of the action planning tool was high among the 27 participants, with 65% of the participants formulating at least three/four action plans. However, use of the action planning tool decreased as the intervention progressed. 100% completed Action Plan 1 and 2, 60% completed Action Plan 3 and 30% completed Action Plan 4 and did not significantly influence the change in PA over time. Those participants (37%) who either agreed or strongly agreed that the action planning tool was useful were significantly more likely to complete 3+ action plans (p=0.045, x2=0.037). Participants who developed highly specific action plans significantly increased their PA from module 1 to 2 (p=0.005, F=9.48), but no other significant differences were found for other modules. Overall, almost half of the participants (48%) met or exceeded the amount of PA outlined in their action plans. Conclusions: While adherence to the action planning tool was high and may have helped participants to be active, or more active than they planned, many did not perceive the tool as useful, and it did not improve the overall efficacy of the program.