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. 2023 Nov 29;19(4):e1361. doi: 10.1002/cl2.1361
Methods Non‐randomized Controlled Study, public primary health care in Botucatu, Sao Paulo State, Brazil
Participants

Inclusion criteria: Aged 18 years or more and in the first gestational trimester were invited to participate in the study.

Exclusion criteria: Pregnant women who moved to antenatal care in private health services during the follow‐up, moved to another city, suffered abortion, presented conditions that classified them as having high‐risk pregnancies 21 or had any adverse condition that required rest or reduced physical activity 15 were excluded.

Age [n (%)]: ‐ Intervention, Control:

18–19: 32 (17.7), 21 (12.2)

20–30: 107 (59.1), 103 (59.9)

30–more: 42 (23.2), 48 (27.9)

Maternal skin color, White [n (%)]: ‐ Intervention, Control:

112 (62.9), 113 (65.7)

Maternal education (years) [n (%)]: ‐ Intervention, Control:

≤8: 130 (71.2), 146 (84.9)

<8: 51 (28.2), 26 (15.1)

Socioeconomic position [n (%)]: ‐ Intervention, Control: **

Class B: 14 (8.0), 20 (11.8)

Class C: 112 (63.6), 123 (72.8)

Classes D/E: 50 (28.4), 26 (15.4)

**Classified according to the Brazilian Association of Research Companies (ABEP. http://www.abep.org/, accessed on 10/May/2015)

Interventions

Intervention (n = 185)

Description: The intervention was divided into two main components:

(1) Training all of physicians and nurses responsible for antenatal care in family health units through an educational activity that lasted 16 h and consisted of an immersion course and three workshops.

(2) The systematic promotion of diet and physical activity during antenatal visits. The women were encouraged to engage in leisure‐time walking five times per week or more for 30–40 min each and at moderate intensity. According to current international guidelines, for pregnant women to be considered active and therefore experience the resulting benefits, they must engage in a minimum of 150 min of moderate or vigorous physical activity per week 15. Of note, previously inactive pregnant women were instructed to start walking for a shorter period and with lower intensity and to progressively increase their activity to reach the recommendation. Considering the ecological model adapted from Bauman et al. and Giles‐Corti, the intervention focused on intra and interpersonal factors that act on behavioral changes.

Nutrition counseling messaging: The pregnant women were counseled individually about the importance and benefits of 5 healthy dietary habits and were motivated to adopt these habits: consumption of 3 fruits daily; 2 portions of vegetables (one raw and one cooked) and 2 portions of beans (one at lunch and one at dinner) at least 5 days per week; and sporadic consumption of soft drinks and commercially prepared cookies. The selection of these 5 dietary habits was based on previous studies conducted in the same municipality 6,24,25. These recommendations were based on national guidance concerning diet during pregnancy 16 and in the national food guide.

Intervention adapted to local context: Not reported

Women empowerment approach: Partial empowerment model

Control (n = 177)

Description: These pregnant women received routine antenatal care in accordance with national recommendation

Outcomes No outcomes of interest reported.
Notes Funding: We acknowledge the staff at the Research Unit on Collective Health, Botucatu Medical School, Sao Paulo State University, the interviewers, the professionals from the Botucatu, Sao Paulo State primary health care network, and the pregnant women who made this study possible.
HHS Vulnerability Disclosure