Document Type : Original Article


1 Department of Midwifery, School of Nursing and Midwifery, Zahedan University of Medical Sciences

2 Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran


INTRODUCTION: Many women refuse to exercise during pregnancy due to lack of awareness and
not receiving training. The aim of this study was to investigate and compare the effect of group and
telemedicine education on exercise during pregnancy by using the health belief model (HBM).
MATERIALS AND METHODS: This quasi-experimental study was carried out in 2019 in Zahedan,
and a total of 135 pregnant women participated in it. Samples were randomly assigned to the following
three groups: group training (n = 45), telemedicine (n = 45), and control (n = 45). Group training was
presented in three sessions, and the telemedicine group received the educational content through
mobile applications. The samples completed the HBM questionnaire before and 6 weeks after the
intervention. In addition, within 6 weeks after the intervention, they completed the exercise activity
schedule. SPSS software Ver. 16 (IBM Corp, Armonk, NY, USA) was used for analysis, and data
were analyzed by ANOVA, Tukey’s post-hoc test, Kruskal–Wallis test, and Mann–Whitney test.
RESULTS: After intervention, the scores of HBM constructs and exercise levels in group training,
telemedicine group, and control group, respectively, were as follows: perceived susceptibility
25.91 ± 3.24, 25.51 ± 1.97, and 22.55 ± 3.78; perceived severity 27.48 ± 2.27, 25.13 ± 2.29, and
22.51  ±  3.88; perceived benefits 27.28  ±  2.97, 25.68  ±  3, and 22.8  ±  3.05; perceived barriers
10.69 ± 2.69, 10.66 ± 3.19, and 14.17 ± 3.14; cues to action 24.71 ± 4.35, 23.9 ± 2.48, and
22.84  ±  3.02; self-efficacy 26.17  ±  3.05, 25.2  ±  2.82, and 22.51  ±  3.38; and exercise levels
70.99 ± 20.43, 56.51 ± 21.99, and 37.62 ± 29.66. Group training and telemedicine led to significant
improvement in all HBM constructs and exercise levels (P < 0.05, P < 0.0001, and P = 0.003,
respectively). Group training provided more improvement than telemedicine in the scores of perceived
severity (P < 0.0001), perceived benefits (P = 0.001), cues to action (P = 0.02), and mean exercise
time (P = 0.001).
CONCLUSION: The results of this study showed that the HBM is a proper model for exercise
education in pregnant women. It is recommended to use HBM as a group training and telehealth in
promoting the rate of exercise in pregnant women.


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