Author(s): HYVÄRINEN, M., WEGRZYK, J., DE LABRUSSE, C., VAN POPPEL, M., Institution: HESAV: HAUTE ECOLE CANTONALE VAUDOISE DE LA SANTE, Country: SWITZERLAND, Abstract-ID: 356

Introduction
Physical activity (PA) provides substantial benefits during pregnancy, yet many women reduce PA levels, making this period a key window for PA promotion. Despite clear recommendations, PA promotion remains inconsistently integrated into routine maternity care and tends to favour women with higher socio-economic status, highlighting inequities in information delivery. This study examined whether a midwife-led PA communication intervention implemented in public maternity care settings mitigates socio-educational disparities in access to PA information during pregnancy.
Methods
Using the Intervention Mapping approach, a midwife-led PA communication intervention was developed, implemented, and evaluated in Western Switzerland. Across six iterative steps, mixed-methods data—from a needs assessment (102 women, 19 midwives), a pilot intervention (15 midwives), and stakeholder engagement—informed an intervention combining midwife training, standardized communication resources, electronic medical record PA prompts, and staff meetings. Parallel community, media, and professional dissemination supported broader norm change. Women-reported outcomes derive from Lausanne University Hospital (CHUV) and were assessed using repeated cross-sectional 10-item surveys at three months (n = 108) and one-year post-implementation (n = 98), and phone interviews (n = 23). Data were analysed using chi-square tests, multivariable logistic regression, and thematic analysis.
Results
From needs assessment to one-year post-implementation, the proportion of women reporting receipt of PA information from all sources (private and public care combined) increased from 63% to 91%. Spontaneous PA communication by midwives increased substantially (30% to 71%; χ², p < 0.001), with improvements in women’s satisfaction across all domains (all χ² tests p < 0.001). Qualitative data corroborated these findings, indicating perceived content relevance and identifying areas for improvement.
In multivariable analyses including all information sources, PA information receipt was associated with survey year (2025; OR = 7.90, 95% CI [3.49–19.77]), university education (OR = 3.05, 95% CI [1.45–6.66]), and positive attitude toward PA (OR = 2.61, 95% CI [1.18–5.87]). When restricted to information delivered within CHUV, receipt was associated with survey year (OR = 5.97, 95% CI [3.04–12.24]), follow-up at CHUV (OR = 4.74, 95% CI [1.99–12.38]), and positive attitude toward PA (OR = 2.84, 95% CI [1.34–6.17]), with no association with educational level.
Discussion
These findings suggest that a system-embedded intervention improves equity in PA communication in public maternity care, with consistent information receipt across education levels, while attitude toward PA remained a determinant. Enhancing spontaneous and tailored PA communication may be key to reaching women less inclined toward PA. Future research should prioritise alternative reach indicators for these subgroups beyond PA level.