Using the CALO-RE taxonomy to identify behaviour change techniques associated with physical activity in pregnancy

Abstract

Background: Despite numerous benefits associated with physical activity (PA) during pregnancy, most pregnant women decrease their PA behaviour. It is thus important to identify what intervention components, known as behaviour change techniques (BCTs), may be associated with PA. The aim of this review is to identify which BCTs are associated with PA behaviour during pregnancy. Methods: A search of six databases identified 24 controlled trials reporting PA behaviour. Included interventions had to measure PA at least twice in pregnancy and have a control group. All intervention descriptions were coded with the 40 item CALO-RE taxonomy of BCTs. Meta-analysis and moderator analyses were conducted to examine the association across studies between the presence or absence of specific BCTs within interventions and changes in PA behaviour. Findings: The overall effect size for intervention effects was d = 0.41. Sixteen BCTs were identified in the included interventions, of which ten were associated with a decreased level of PA. Two BCTs (‘prompt self-monitoring of behavioural outcome’ and ‘provide instruction on how to perform the behaviour’) were associated with a higher level of PA compared to when these BCTs were not included in the intervention. Discussion: These findings suggest that interventions should include practical elements such as instructing women how to be active and encourage self-monitoring of the outcomes of their PA (for example weight). These results also suggest that caution may be needed in applying BCTs that are associated with PA behaviour in non-pregnant adults as they may be less suitable for pregnant women.