A systematic review of postpartum physical activity intervention mediators

Area of Science:

• Public Health
• Behavioral Science
• Exercise Science

Background:

• Regular physical activity (PA) offers significant health benefits.
• A large majority of postpartum individuals (up to 94%) do not meet recommended PA guidelines.
• Understanding mediators is crucial for effective postpartum PA interventions.

Purpose of the Study:

• To identify potential mediators of physical activity (PA) behavior change in postpartum interventions.
• To inform the development of more effective strategies to increase PA participation after childbirth.

Main Methods:

• A systematic review of six databases was conducted, including literature up to December 2023.
• Included studies involved postpartum individuals (≤ 12 months), PA interventions, and measured PA and mediator outcomes classified by the Theoretical Domains Framework (TDF).
• Mediation paths (AB, A, B, C) and TDF domains were analyzed.

Main Results:

• Twenty-eight articles (3,328 participants) were analyzed.
• Very small effects were found for mediation Path AB across domains: beliefs about capabilities (r = .08), beliefs about consequences (r = .02), environmental context and resources (r = .01), and social influences (r = .08).
• A small total effect (Path C, r = .12) was observed for postpartum PA interventions on PA.

Conclusions:

• Future postpartum PA interventions should incorporate strategies targeting beliefs about capabilities and consequences, environmental context, and social influences.
• Further research is recommended to explore nonconscious mediators such as PA habit and identity.
• Enhancing these mediators could lead to more impactful interventions for postpartum physical activity.