Abstract:
Background: Physical exercise is a key preventive measure for chronic diseases across the
lifespan, including during pregnancy, where it promotes maternal and fetal health. Despite its
benefits, evidence on the intention to perform physical exercise during pregnancy and its
predictors remains limited in low-income settings, particularly in Sub-Saharan Africa and
Ethiopia.
Objective: This study aimed to assess the intention to do physical exercise and its associated
factors among pregnant women attending antenatal care services in public hospitals of Harari
Regional State, Eastern Ethiopia, from February 1 to March 30, 2024.
Methods: An Institution-based cross-sectional study among 405 pregnant women attending
Antenatal Care follow-up at Hiwot Fana Specialized University Hospital and Jugel General
Hospital. Participants were selected using systematic random sampling technique. Data were
collected through interviewer-administered structured questionnaires, entered using Epi Data
version 4.6, and analyzed with STATA version 17. The results of the descriptive statistics were
summarized using mean, standard deviation, percentages, frequency tables and graphs.
Standardized β and R2 values were used to interpret outcome variable.Simple and multiple linear
regression analysis were performed. In multiple linear regression analysis, Statistical significance
was declared at a p-value of <0.05 with 95% confidence interval.
Results: Of the 411 women approached, 405 completed the study (98.5% response rate). The
mean intention score was 16.15 (SD ± 5.82), with 58.3% (n = 236) scoring above the mean. The
TPB model explained 36% of the variance in exercise intention. Significant predictors included:
direct attitude [β = 0.230, p < 0.001, 95% CI (0.187, 0.458)], direct perceived behavioral control
[β = 0.259, p < 0.001, 95% CI (1.920, 5.855)], knowledge of exercise benefits [β = 0.248, p =
0.001, 95% CI (0.194, 0.786)], high school education [β = 0.169, p = 0.005, 95% CI (0.297,
1.621)], college or university education [β = 0.192, p = 0.004, 95% CI (0.413, 2.135)], and being
in the second trimester of pregnancy [β = 0.190, p = 0.017, 95% CI (0.247, 2.504)]
Conclusion: More than half of the pregnant women reported a high intention to engage in
physical exercise. Intention was significantly influenced by perceived behavioral control,
positive direct attitude, higher educational attainment, knowledge of exercise benefits, and
second-trimester pregnancy, were significant associated factors.Therefore, study aimed at
promoting physical exercise during pregnancy should strengthen perceived control and positive
attitudes, particularly among less-educated women and those in earlier stages of pregnancy.
