Encouraging brisk walking with the free Active10 app in postnatal women who had a hypertensive pregnancy: “Just Walk It” feasibility study

Objective To explore the feasibility of a future trial to investigate whether encouraging use of the free NHS smartphone app Active10 increases brisk walking and reduces blood pressure (BP) in postnatal mothers who had hypertensive disorders of pregnancy (HDP). Design 3-month feasibility study. Setting London maternity unit. Population 21 women with HDP. Methods At recruitment we recorded initial (booking) clinic BP and asked participants to complete a questionnaire. Two months after delivery all participants were sent (by post/email/WhatsApp) a “Just Walk It” leaflet encouraging them to download the Active10 app and walk briskly for at least 10 minutes/day. This was backed by a telephone call after 2-weeks. Assessments were repeated 3-months later, and included telephone interviews about the acceptability and use of Active10. Main outcome measures Were recruitment rate, follow-up rate and acceptability/use of Active10. Results Of 28 women approached, 21 (75%, 95% CI 55.1–89.3%) agreed to participate. Age range was 21–46 years and five (24%) self-identified as black ethnicity. One woman dropped out of the study, and one became ill. The remaining participants (90%, 19/21, 95% CI 69.6–98.8%) were followed up after 3-months. Ninety-five percent (18/19) downloaded the Active10 app and 74% (14/19) continued using it at 3-months, averaging 27-minutes brisk walking/day according to Active10 weekly screenshots. Comments included: “Brilliant app”, “Really motivates me”. Mean BP was 130/81mmHg at booking and 124/80mmHg at 3-months follow-up. Conclusions The Active10 app was acceptable to postnatal women after HDP and may have increased minutes of brisk walking. A future trial could explore whether this simple, low-cost intervention could reduce long-term BP in this vulnerable group.

[1]  Chanam Lee,et al.  Impact of COVID-19 on physical activity: A rapid review , 2022, Journal of global health.

[2]  R. T. Larsen,et al.  Effectiveness of physical activity monitors in adults: systematic review and meta-analysis , 2022, BMJ.

[3]  K. Evenson,et al.  Evaluating Evidence-Based Content, Features of Exercise Instruction, and Expert Involvement in Physical Activity Apps for Pregnant Women: Systematic Search and Content Analysis , 2022, JMIR mHealth and uHealth.

[4]  Gareth Iacobucci Sixty seconds on . . . pregnancy and exercise , 2021, British medical journal.

[5]  M. Sinclair,et al.  The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes , 2021, PloS one.

[6]  K. Evenson,et al.  How APPropriate are physical activity apps for pregnant women appropriate: A systematic search and content analysis of evidence-based content, features of exercise instruction, and expert involvement (Preprint) , 2021, JMIR mHealth and uHealth.

[7]  M. Razai,et al.  The Importance of Community and Patient Involvement in the Design of Physical Activity Programs , 2020, Journal of primary care & community health.

[8]  S. Galea,et al.  Mitigating the psychological effects of social isolation during the covid-19 pandemic , 2020, BMJ.

[9]  P. Oakeshott,et al.  Re: Evaluation of a simple risk score to predict preterm pre‐eclampsia using maternal characteristics: a prospective cohort study , 2019, BJOG: an International Journal of Obstetrics and Gynaecology.

[10]  U. Sovio,et al.  Evaluation of a simple risk score to predict preterm pre‐eclampsia using maternal characteristics: a prospective cohort study , 2019, BJOG : an international journal of obstetrics and gynaecology.

[11]  L. Magee,et al.  Impact of ethnicity on adverse perinatal outcome in women with chronic hypertension: a cohort study , 2019, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[12]  W. Kraus,et al.  Physical Activity to Prevent and Treat Hypertension: A Systematic Review , 2019, Medicine and science in sports and exercise.

[13]  Jie Gao,et al.  Active 10: Brisk Walking to Support Regular Physical Activity , 2019, PervasiveHealth.

[14]  M. Murphy,et al.  Active 10 - A new approach to increase physical activity in inactive people in England. , 2019, Progress in cardiovascular diseases.

[15]  A. Khalil,et al.  Labetalol Versus Nifedipine as Antihypertensive Treatment for Chronic Hypertension in Pregnancy: A Randomized Controlled Trial , 2017, Hypertension.

[16]  H. Bundgaard,et al.  Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study , 2017, British Medical Journal.

[17]  E. Rimm,et al.  Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses’ Health Study II: observational cohort study , 2017, British Medical Journal.

[18]  C. Chew‐Graham,et al.  Preeclampsia and Future Cardiovascular Health: A Systematic Review and Meta-Analysis , 2017, Circulation. Cardiovascular quality and outcomes.

[19]  M. Teare,et al.  Sample size requirements to estimate key design parameters from external pilot randomised controlled trials: a simulation study , 2014, Trials.

[20]  Julia d. Robinson Sixty Seconds with… , 2012, Psych-Talk.

[21]  Rachel A. Tinius,et al.  An Assessment of Mobile Applications Designed to Address Physical Activity During Pregnancy and Postpartum. , 2021, International journal of exercise science.

[22]  Carmelo Velardo,et al.  Self-Management of Postnatal Hypertension: The SNAP-HT Trial , 2018, Hypertension.