Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review

Abstract

Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.

Brief physical activity counselling by physiotherapists (BEHAVIOUR): protocol for an effectiveness-implementation hybrid type II cluster randomised controlled trial

“…International [ 9 , 10 ] and national [ 11 ] health organisations recommend that health professionals promote physical activity within their routine practice, and health professionals themselves strongly believe that they should be doing this [ 12 , 13 ]. However, healthcare systems have failed to implement and scale-up physical activity promotion.…”

“…Surveys of health professionals [ 12 – 15 ], audits of medical records [ 16 ] and surveys of patients [ 16 – 19 ] from around the world confirm that physical activity promotion, including counselling, is not routinely delivered in healthcare. Health professionals report that common barriers to delivery of this intervention include insufficient reimbursement, resources, time, knowledge, skills, training, protocols and organisational routines that do not support implementation [ 12 , 13 , 20 , 21 ].…”

Association between perceived partner support and lifestyle in mother-father dyads expecting a first child

“…A study investigating leisure-time PA in women with gestational diabetes showed that more than one fourth of all women reported an absence of encouragement for leisure-time PA from healthcare providers ( 25 ). The lack of professional support and regular advice might be attributed to limited time, knowledge and resources available on this topic among healthcare providers ( 20 , 25 ). Moreover, even though healthcare providers meet with pregnant women on a regular basis, they cannot offer daily or additional support when needed.…”

“…Social support can be categorized into four groups of support: (1) emotional support; (2) informational or cognitive support; (3) instrumental support (i.e., assistance received in terms of tangible goods, services or aid) and (4) appraisal support (i.e., information useful for self-evaluation) ( 18 , 19 ). Professional advice is perceived as important in the promotion of a healthy lifestyle during pregnancy ( 20 ) and might be important for informational support. Family and friends on the other hand seem to be a constant source of information and advice throughout pregnancy ( 21 ).…”

„Move Your Baby“: ein öffentliches Angebot zur Bewegungsförderung in der Schwangerschaft

“…Wenn Frauen über die Bewegungsempfehlungen informiert sind, behalten sie ihr Bewegungsniveau bei oder steigern es sogar [8,25]. Gesundheitsfachkräfte wie Hebammen, Gynäkolog*innen, Allgemeinmediziner*innen, Expert*innen in Sport und Bewegungswissenschaften, Physiotherapeut*innen und Ernährungsberater*innen sind gefordert, Frauen im Hin-blick auf ihre Selbstwirksamkeit ("Empowerment") im Bereich kA und Sport zu unterstützen [20,25]. Gesundheitsfachkräfte, die Schwangere betreuen, sollten deshalb mit den internationalen Empfehlungen für Bewegung vertraut sein.…”