Impact of an intervention aimed to promote physical activity and healthy eating in prenatal care: a cohort study.

Abstract

Objective: To evaluate the impact of an intervention aimed to promote walking and healthy eating in pregnant women attending the Family Health Strategy (FHS). Methods: A controlled nonrandomized cohort study will be conducted with pregnant women, age> = 18 years, attended in the public low-risk prenatal care, in Botucatu-SP, since the first trimester. Intervention cohort (IC): 140 pregnant women attended by eight FHS units; Control cohort (CC): 140 pregnant women assisted by eight primary care units (PCU). A previous study found no statistically significant differences between the FHS group and the PCU group regarding the practice of walking, healthy eating and guidance received. All professional workers in the prenatal care will be studied: 16 general physicians, 14 nurses and 67 community health agents from the FHS and 10 obstetricians from the PCU. After training, the professionals of the FHS will guide the pregnant women from the IC monthly based on the Transtheoretical Model of Behavior Change. The PCU professionals will give the CC group routine guidance. The "process evaluation" will focus on the acquisition of knowledge and the adequacy of practices. The "impact assessment" will use information from household interviews conducted in the three trimesters of pregnancy regarding the women's characteristics (covariates) and the outcomes. The outcomes are: the practice of walking during leisure time (yes or no), weekly walking period > = 150 minutes (yes or no) and diet score (healthy or unhealthy). Statistical analysis will be conducted by multilevel logistic regressions models.