Department of Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: The positive effects of physical activities during pregnancy are totally recognized
but due to lack of knowledge and negative aspect toward it, physical activities decrease throughout
the pregnancy period. To find the appropriate model to enhance physical activity during pregnancy,
the education that are focused on health belief constructs about physical activity during pregnancy,
were assessed.
MATERIALS AND METHODS: This was a semi‑experimental study conducted on 90 pregnant
women in their first trimester that were divided into two groups of control and intervention.
After assessing health belief model (HBM) constructs and measuring the duration of severe/
moderate‑intensity) physical activity through a questionnaire, participants were divided into
two groups of 45. The intervention group received education about physical activity based on
HBM and the control group received dental health education. In the second trimester again, the
constructs of HBM and the duration of physical activities were evaluated. Significant level was
set at P < 0.05.
RESULTS: Data analysis showed that level of perceived susceptibility/severity and perceived
benefits and also the level of appealing physical activity (P < 0.05), had a significant increase in
the intervention group after the education, but the mean of the severe/moderate‑intensity physical
activity with did not rise to 150 min/week.
CONCLUSION: Study results showed that education based on HBM could lead to an increase in
physical activity during pregnancy by increasing the level of health beliefs in pregnant women, but
this increase does not reach the adequate level.


1. Hawkins M, Hosker M, Marcus BH, Rosal MC, Braun B,
Stanek EJ 3rd, et al. A pregnancy lifestyle intervention to prevent
gestational diabetes risk factors in overweight Hispanic women: A
feasibility randomized controlled trial. Diabet Med 2015;32:108‑15.
2. Aune D, Saugstad OD, Henriksen T, Tonstad S. Physical
activity and the risk of preeclampsia: A systematic review and
meta‑analysis. Epidemiology 2014;25:331‑43.
3. Nordhagen IH, Sundgot‑Borgen J. Physical activity among
pregnant women in relation to pregnancy‑related complaints and
symptoms of depression. Tidsskr Nor Laegeforen 2002;122:470‑4.
4. Haakstad LA, Voldner N, Henriksen T, Bø K. Physical activity
level and weight gain in a cohort of pregnant Norwegian women.
Acta Obstet Gynecol Scand 2007;86:559‑64.
5. Ruifrok AE, Althuizen E, Oostdam N, van Mechelen W, Mol BW,
de Groot CJ, et al. The relationship of objectively measured
physical activity and sedentary behaviour with gestational weight
gain and birth weight. J Pregnancy 2014;2014:567379.
6. Artal R, O’Toole M. Guidelines of the American College of
Obstetricians and Gynecologists for exercise during pregnancy
and the postpartum period. Br J Sports Med 2003;37:6‑12.
7. Davari Tanha F, Ghajarzadeh M, Mohseni M, Shariat M,
Ranjbar M. Is ACOG guideline helpful for encouraging pregnant
women to do exercise during pregnancy? Acta Med Iran
8. Evenson KR. Towards an understanding of change in physical
activity from pregnancy through postpartum. Psychol Sport Exerc
9. Doran F, O’Brien AP. A brief report of attitudes towards physical
activity during pregnancy. Health Promot J Austr 2007;18:155‑8.
10. Moosazadeh M, Nekoei‑Moghadam M, EmraniZ, Amiresmaili M.
Prevalence of unwanted pregnancy in Iran: A systematic review
and meta‑analysis. Int J Health Plann Manage 2014;29:e277‑90.
11. Ohman SG, Grunewald C, Waldenström U. Women’s worries
during pregnancy: Testing the Cambridge Worry Scale on 200
Swedish women. Scand J Caring Sci 2003;17:148‑52.
12. Glanz K, Rimer BK, Viswanath K. Models of individual health
behavior. In: Health Behavior and Health Education: Theory,
Research, and Practice. 4th ed. San Fransisco, CA: Wiley & Sons;
13. Chasan‑Taber L, Schmidt MD, Roberts DE, Hosmer D,
Markenson G, Freedson PS. Development and validation of a
Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc
14. Symons Downs D, Hausenblas HA. Women’s exercise beliefs and
behaviors during their pregnancy and postpartum. J Midwifery
Womens Health 2004;49:138‑44.
15. Thornton PL, Kieffer EC, Salabarría‑Peña Y, Odoms‑Young A,
Willis SK, Kim H, et al. Weight, diet, and physical activity‑related
beliefs and practices among pregnant and postpartum Latino
women: The role of social support. Matern Child Health J
16. Sui Z, Turnbull DA, Dodd JM. Overweight and obese women’s
perceptions about making healthy change during pregnancy: A
mixed method study. Matern Child Health J 2013;17:1879‑87.
17. Noohi E, Nazemzadeh M, Nakhei N. The study of knowledge,
attitude and practice of puerperal women about exercise during
pregnancy. Iran J Nurs 2010;23:64‑72.
18. Weir Z, Bush J, Robson SC, McParlin C, Rankin J, Bell R.
Physical activity in pregnancy: A qualitative study of the beliefs
of overweight and obese pregnant women. BMC Pregnancy
Childbirth 2010;10:18.
19. Clarke PE, Gross H. Women’s behaviour, beliefs and information
sources about physical exercise in pregnancy. Midwifery
20. Duncombe D, Wertheim EH, Skouteris H, Paxton SJ, Kelly L.
Factors related to exercise over the course of pregnancy including
women’s beliefs about the safety of exercise during pregnancy.
Midwifery 2009;25:430‑8.
21. Hausenblas H, Downs DS, Giacobbi P, Tuccitto D, Cook B.
A multilevel examination of exercise intention and behavior
during pregnancy. Soc Sci Med 2008;66:2555‑61.