Effects of theory-guided unsupervised exercise on depression, sleep quality, and sense of control in pregnant women: A randomized controlled trial.

Background: Unsupervised exercise is beneficial for pregnant women, and ongoing exercise may affect the course of pregnancy. Therefore, promoting continued exercise among women is critical.

Aims: To implement a home-based exercise program, guided by the COM-B model theory, and assess its effects on depression, sleep quality, and sense of control among pregnant women.

Methods: Pregnant women (N = 100) were selected and randomly assigned in a 1:1 ratio to either the intervention or the control group. Both groups received exercise instruction. The intervention group received an additional intervention based on the COM-B model theory. Depression and sleep quality were evaluated at 28 and 35 weeks of gestation, while women's sense of control was assessed at 35 weeks of gestation.

Results: In total, 91 participants completed the study, with 100 included in the intention-to-treat analysis. The intervention group showed improvement in depression at 28 and 35 weeks of gestation and in sleep quality at 35 weeks. Although there was no significant difference in the sense of control between the groups, the intervention group demonstrated better emotional control.

Linking evidence to action: A theory-guided exercise intervention shows benefits in improving third-trimester depression, sleep quality, and emotional control. Therefore, exercise programs during pregnancy should consider to encompass capacities, opportunities, and motivations to encourage exercise behavior.