Compliance with wrist-worn accelerometers in primiparous early postpartum women

Background: There are few studies that objectively assess physical activity using accelerometry in postpartum women and none that do so before 3 months postpartum. It is not known whether accelerometry can be successfully used in the early postpartum period and thus benefit studies designed to assess the health benefits and risks of early physical activity. Wear compliance may be substantially lower several weeks after childbirth, given the overwhelming nature of the early postpartum period, particularly for first time mothers. The aims of this study were to 1) describe the methods used to facilitate protocol compliance of wrist-worn accelerometry, 2) describe device usage and wear time in early postpartum primiparous women and 3) to place the compliance characteristics of early postpartum primiparous women in our study in context with that of other studies of postpartum women and standards published by large, physical activity surveillance studies. Methods: Participants were primiparous women who were enrolled at 3rd trimester in a larger ongoing prospective cohort study, delivered vaginally, and lived in a 60 mile radius of the research site. The parent study was designed to evaluate the effects of early physical activity on pelvic floor health. Participants wore a wrist accelerometer (ActiGraph™ GT3XLink device) over two 7-day periods, 2–3 weeks and 5–6 weeks postpartum. We developed a protocol based on best practices to enhance compliance in this population. The Choi (2011) algorithm was used to determine wear time. Results: Of all participants, 82.6% (166 of 201 eligible) and 70.1% (141 of 201 eligible) at 2–3 and 5–6 weeks, respectively, received and wore a functional device in the correct study time-frame for at least 7 days. Of participants that received a functional device, 94.3% (166/176) and 86.5% (141/163) wore the device for at least 7 days, with mean wear times of 1348.0 (135.8) minutes/day and 1313.5 (152) minutes/day, respectively. At 2–3 weeks, 96.1% and 90.4% met the NHANES and Whitehall II Study wear standards, respectively, while at 5–6 weeks, 93.9% and 84.1% did so. Conclusion: Despite challenges in conducting physical activity research in postpartum women, adherence to wrist-worn accelerometry is high with this protocol