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Women with overweight or obesity tend to engage in low levels of exercise and face challenges in initiating and maintaining exercise throughout pregnancy.
This study aimed to evaluate the effectiveness of a peer-led walking and mobile health (mHealth) app intervention on self-efficacy and change in exercise behavior stage, based on the transtheoretical model (TTM), of women with overweight or obesity from pregnancy to one month postpartum.
The study was a randomized controlled trial with an experimental design. A total of 114 pregnant women (BMI ≥ 24 kg/m2 and gestation < 16 weeks) were recruited from prenatal clinics in Taiwan from July 2021 to May 2022. The intervention group (IG) received the peer-led walking program with mHealth support, while the control group (CG) received standard antenatal care. Follow-ups were conducted at 24–28 weeks (T2), 36–40 weeks (T3), and one month postpartum (T4).
The IG had significantly higher exercise self-efficacy scores from T1 to T3 compared to the CG. IG participants showed notable progress in exercise behavior stages, transitioning from the contemplation stage at T1 to preparation and action stages at T2 (χ 2 = 13.208, p < 0.01), with some reaching the maintenance stage by T3 (20.9%, χ 2 = 9.49, p < 0.05). In contrast, most of the CG participants remained at the contemplation stage throughout pregnancy to early postpartum.
The peer-led walking intervention with mHealth has the potential to enhance self-efficacy and promote sustained exercise behavior of women with overweight or obesity during and after pregnancy and is a valuable approach to establishing long-term exercise behavior.
ClinicalTrials.gov: NCT 05022680
This review aims to explore instructional approaches employed in teaching complex procedural skills among caregivers.
Integrative Review.
Electronic searches were conducted across seven databases: CINAHL, PubMed, OVID, ScienceDirect, Web of Science, ProQuest Central and Google Scholar. Manual searches of references within relevant studies were also performed. Original, peer-reviewed studies published in English between 2014 and 2025 were reviewed.
The Whittemore and Knafl method of integrative review was utilised to comprehensively examine literature encompassing various methodological designs. 17 articles that examined the learning of procedural skills among caregivers were included.
The optimal approach to enhancing caregivers' knowledge, competence and confidence involves a learner-centric training model involving multiple phases. Effective caregiving begins with a thorough preparation of the caregiver, which is key to ensuring the success of the training programme. Next, knowledge can be imparted through diverse learning approaches and paradigms to cater to individual learning styles. Subsequently, the translation of knowledge gained to hands-on practice, deepens understanding and enhances caregivers' practical skills competency. Finally, confidence is built through providing opportunities and platforms for repeated practice, leading to mastery and increased confidence over time.
While specific learning pedagogies were not highlighted in the literature, the instructional approaches summarised in the existing literature closely resembled an existing teaching pedagogy: Peyton's Four-Step Approach. This approach is a stepwise teaching framework that has been widely used in healthcare teaching. The approaches used in the studies align with this approach and future interventions should consider designing their training accordingly to enhance its efficacy.
A well-designed training programme fosters caregiver resilience and preparedness, enabling them to navigate challenges effectively and sustainably. Future research could focus on creating an all-encompassing caregiver training that integrates the various approaches. Its feasibility and effectiveness in improving the caregiver preparation process could then be assessed.
No patient or public contribution.
by Mi Lv, Hui Che, Jiayan Hu, Wenxi Yu, Zhaoxia Liu, Xiaolin Zhou, Binduo Zhou, Jinyi Xie, Fengyun Wang
BackgroundThe overlap between non-erosive reflux disease (NERD) and epigastric pain syndrome (EPS, a subtype of functional dyspepsia) is common, yet its associated factors remain poorly defined. We aimed to identify factors associated with symptom severity in NERD-EPS overlap, focusing on psychosocial and somatic factors.
MethodsIn this multicenter cross-sectional study, 800 patients meeting Rome IV criteria for NERD-EPS overlap were enrolled. Standardized questionnaires assessed gastrointestinal symptoms (GSRS), somatic symptoms (PHQ-15), anxiety/depression (PHQ-4), and sleep quality (SRSS). Multivariable regression models identified factors independently associated with GSRS scores, adjusted for demographics and clinical covariates. Interaction terms were tested to assess whether the association between one factor and GSRS scores varied across different levels of another factor.
ResultsOf the 800 patients, 67% were female, and the mean age was (44.50 ± 14.43) years. 67% had mild or more sleep problems, and 47% had anxiety or depression. Somatic symptoms (PHQ-15) showed the strongest association with GSRS scores (β = 0.617, P P P = 0.026). Urban residence (β = 0.071) and mixed labor type (β = −0.066) were also independently associated with symptom burden.
ConclusionSomatic symptoms, psychological distress, and sleep disturbances were the factors most strongly associated with symptom severity in NERD-EPS overlap, with additional contributions from younger age, male sex, and urban residence. Our findings advocate for integrated biopsychosocial interventions to alleviate symptom burden in this population.
FreshRSS 