Intrinsic motivation for physical activity, healthy eating, and self-weighing in association with corresponding behaviors in early pregnancy

Susan D Brown; Michaela Kiernan; Samantha F Ehrlich; Yeyi Zhu; Monique M Hedderson; Saher Daredia; Juanran Feng; Andrea Millman; Charles P Quesenberry; Assiamira Ferrara

doi:10.1016/j.pmedr.2023.102456

Intrinsic motivation for physical activity, healthy eating, and self-weighing in association with corresponding behaviors in early pregnancy

Prev Med Rep. 2023 Oct 4:36:102456. doi: 10.1016/j.pmedr.2023.102456. eCollection 2023 Dec.

Authors

Susan D Brown^{1

2

3

4}, Michaela Kiernan⁵, Samantha F Ehrlich⁶, Yeyi Zhu^{2

7}, Monique M Hedderson^{2

3

4}, Saher Daredia², Juanran Feng², Andrea Millman², Charles P Quesenberry², Assiamira Ferrara^{2

4}

Affiliations

¹ Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA.
² Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
³ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
⁴ Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁵ Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
⁶ Department of Public Health, University of Tennessee, Knoxville, TN, USA.
⁷ Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.

Abstract

Healthy lifestyle behaviors influence maternal cardiovascular health, but motivation for them in pregnancy is poorly understood. We examined whether intrinsic motivation (assessed on 5-point scales for each behavior) is associated with three lifestyle behaviors in early pregnancy: physical activity, by intensity level; healthy eating, quantified with the Alternate Healthy Eating Index for Pregnancy (AHEI-P); and weight self-monitoring, a standard weight management technique. Participants in the Northern California Pregnancy, Lifestyle and Environment Study (PETALS) population-based cohort completed validated surveys in early pregnancy (2017-18; N = 472; 22 % Asian, 6 % Black, 30 % Hispanic, 13 % multiracial, 30 % White). Cross-sectional data were analyzed in 2021-22. Overall, 40.7 % (n = 192) met United States national physical activity guidelines; the average AHEI-P score was 62.3 out of 130 (SD 11.4); and 36.9 % reported regular self-weighing (≥once/week; n = 174). In models adjusted for participant characteristics, 1-unit increases in intrinsic motivation were associated with increased likelihood of meeting physical activity guidelines (risk ratio [95 % CI]: 1.66 [1.48, 1.86], p < 0.0001); meeting sample-specific 75th percentiles for vigorous physical activity (1.70 [1.44, 1.99], p < 0.0001) and AHEI-P (1.75 [1.33, 2.31], p < 0.0001); and regular self-weighing (2.13 [1.92, 2.37], p < 0.0001). A 1-unit increase in intrinsic motivation lowered the risk of meeting the 75th percentile for sedentary behavior (0.79 [0.67, 0.92], p < 0.003). Intrinsic motivation was not associated with reaching 75th percentiles for total, light, or moderate activity. Intrinsic motivation is associated with physical activity, healthy eating, and self-weighing among diverse individuals in early pregnancy. Results can inform intervention design to promote maternal health via increased enjoyment of lifestyle behaviors.

Keywords: Behavior; Lifestyle; Motivation; Pregnancy; Primary prevention.

Abstract

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