Understanding Change in Physical Activity Postpartum

描述（由申请人提供）： 为了提供有效的公共卫生干预措施，必须确定介导身体活动变化的因素。 虽然目前的知识是有限的，身体活动的介质可能是生理，心理和环境的性质，也可能被某些因素修改，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。 怀孕是一个这样的触发生活事件，因为妇女在怀孕期间体重迅速增加，随后在产后期间体重减轻，影响活动的变化。 本研究建议（i）确定生理，心理和环境介质的变化是否与从怀孕到产后的身体活动变化相关，（ii）检查在此期间身体活动的变化是否受到社会人口，健康和邻里措施的调节，在一组妇女中。 为了实现这一目标，一个全面的社区研究组成部分将被添加到一个正在进行的前瞻性研究的孕妇从怀孕20周到产后12个月。 研究集水区的邻里评估将包括一般邻里特征的街道级清单和所有体育活动设施的识别，如私人和公共设施、公园和小径。 除了已经收集的自我报告身体活动数据外，我们还将使用加速度计在产后期间增加两项女性身体活动措施。 已经收集了一系列广泛的生理（例如人体测量、睡眠模式、母乳喂养）和心理社会（例如生活事件、社会支持、抑郁、焦虑）指标。 将采用先进的统计技术，以适应对身体活动变化的多层次影响。 该提案直接解决了更好地理解体力活动行为变化所涉及的多层次因素的需求，RFA #CA-04-009“体力活动行为变化的机制”。

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".