Understanding Change in Physical Activity Postpartum

描述(由申请人提供)： 确定影响体力活动变化的因素很重要，以便为有效的公共卫生干预提供信息。虽然目前的知识有限，但体力活动的中介可能是生理的、心理的和环境的，也可能被某些因素改变，导致健康结果的差异。生命阶段和通过这些阶段的过渡可能是干预和促进预防性健康行为的有效点。怀孕就是这样一种生活事件，因为女性在怀孕期间体重迅速增加，随后在产后减肥，这会影响活动的变化。这项研究建议(I)确定生理、心理社会和环境介质的变化是否与从怀孕到产后的体力活动的变化有关，以及(Ii)在一组女性中检查这段时间内的体力活动的变化是否受到社会人口、健康和邻里措施的调节。为了实现这一目标，将在对怀孕20周至产后12个月的孕妇进行的前瞻性研究中增加一个全面的邻里研究部分。对研究集水区的社区评估将包括街道层面的一般社区特征的清单，并确定所有体育活动设施，如私人和公共设施、公园和步道。除了已经收集的自我报告的体力活动数据外，我们还将使用加速计增加两项衡量产后妇女体力活动的指标。已经收集了大量的生理指标(如人体测量、睡眠模式、母乳喂养)和心理指标(如生活事件、社会支持、抑郁、焦虑)。将采用先进的统计技术，以适应对体力活动变化的多个级别的影响。这项建议直接解决了更好地理解体育活动行为改变所涉及的多层次因素的需要，RFA#CA-04-009“体育活动行为改变的机制”。

DESCRIPTION (provided by applicant): Factors that mediate changes in physical activity are important to identify, for purposes of informing effective public health interventions. While current knowledge is limited, mediators of physical activity are likely physiologic, psychosocial, and environmental in nature, and may also be modified by certain factors, leading to disparities in health outcomes. Life stages and transitions through these stages may be effective points to intervene and to promote preventive health behavior. Pregnancy is one such triggering life event, since women experience rapid weight gain during pregnancy and subsequent weight loss during the postpartum period that influences changes in activity. This study proposes to (i) identify whether changes in physiologic, psychosocial, and environmental mediators are associated with changes in physical activity from pregnancy to postpartum and to (ii) examine whether changes in physical activity during this time are moderated by sociodemographic, health, and neighborhood measures, among a cohort of women. To accomplish this, a comprehensive neighborhood research component will be added to an ongoing prospective study of pregnant women followed from 20 weeks' gestation through 12 months postpartum. Neighborhood assessment of the study catchment area will include a street level inventory of general neighborhood characteristics and identification of all physical activity facilities, such as private and public facilities, parks, and trails. We will also add on two measures of physical activity among women during the postpartum period using accelerometry, in addition to self-report physical activity data already being collected. An extensive array of physiologic (e.g. anthropometric, sleep patterning, breastfeeding) and psychosocial (e.g. life events, social support, depression, anxiety) measures is already being collected. Advanced statistical techniques will be employed to accommodate multiple levels of influence on changes in physical activity. This proposal directly addresses the need to better understand multi-level factors involved in physical activity behavior change, RFA #CA-04-009 "Mechanisms of Physical Activity Behavior Change".