Attitudes and Barriers to Physical Activity and Exercise Self-Efficacy Among Chinese Pregnant Women: A Cross-Sectional Study

Xingchen Shang,1,2,* Linfei Ye,1,* Xiaohua Gu,3 Aihua Zhou,4 Yunmei Xu,5 Yiran Zhang,1 Yuexia Liao,1 Lin Li6 1School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China; 2School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China; 3Delivery Room, Yangzhou Maternal and Child Care Service Centre, Yangzhou, People’s Republic of China; 4Delivery Room, Taizhou Second People’s Hospital, Taizhou, People’s Republic of China; 5Obstetrics and Gynecology Department, Baoying People’s Hospital, Yangzhou, People’s Republic of China; 6Department of Nursing, The Affiliated Hospital of Yangzhou University, Yangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lin Li, Department of Nursing, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou, 225000, People’s Republic of China, Tel +86 13585233313, Email 361350908@qq.comBackground: Most pregnant women do not reach the recommendation for physical activity (PA). As a subcategory of PA, exercise is also essential. Evidence on pregnant women’s attitudes and barriers to PA and exercise self-efficacy in China is scarce.Aim: To explore the levels and influencing factors of attitudes and barriers to PA and exercise self-efficacy among pregnant women.Methods: A cross-sectional study of 311 pregnant women was conducted from August to December 2022. Individual characteristics, pregnant women’s attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy were measured using the self-designed demographic questionnaire, pregnant women’s attitudes toward exercise questionnaire, barriers to prenatal PA and exercise questionnaire, and the pregnancy exercise self-efficacy scale, respectively.Results: More than 90% of pregnant women believed exercise benefits themselves and their babies, and 40.8% of pregnant women did not know how to exercise. Women encounter different types of barriers to PA and exercise. Intrapersonal barriers included the proportion of feelings of tiredness (56.6%), low energy (54.7%), lack of interest or motivation (49.2%), feelings of illness and morning sickness (46.6%), and large body weight (43.7%). Interpersonal barriers included pregnant women being advised to avoid PA and exercise (49.2%), lack of clear advice about the intensity and dose of exercise (41.8%), no one to exercise with (38.9%), and lack of advice from healthcare professionals (38.6%). Weather conditions were the most significant environmental barriers (41.2%). The total score of pregnancy exercise self-efficacy was (38.50± 7.33). Education level, parity, and attitudes toward exercise independently predict pregnant women’s attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy, respectively.Conclusion: Pregnant women have a favorable attitude toward exercise and relatively good exercise self-efficacy but lack knowledge of exercise. They face numerous barriers. Medical professionals should encourage pregnant women with lower levels of education to exercise and assist multipara in overcoming obstacles.Keywords: attitudes, barriers, exercise self-efficacy, physical activity, pregnanc