Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Jennifer Fricas


Jodilyn Owen


Studies show that physical inactivity in pregnancy is attributed to pregnant people receiving inadequate and incomplete prenatal physical activity and exercise (PAE) counseling from healthcare professionals (HCPs). There is a gap in the knowledge translation of prenatal PAE guidelines and pregnant people are uncertain how to safely engage in PAE. The purpose of this quality improvement project was to evaluate the effect of an online brief in-service training integrating the 6 Rs Framework on Rainier Valley Birth & Health Center HCPs’ (i.e., Certified Nurse-Midwives and Licensed Midwives) attitudes, beliefs, knowledge, and practices pertaining to antenatal PAE. Quantitative data was collected using Likert-scale and multiple-choice questions that were modified with permission from a tool developed and published by Leiferman and colleagues. The primary investigator assessed provider knowledge of physical activity guidelines in pregnancy and the 6 Rs Framework which was used with permission of Donnelly and colleagues. Open-ended questions assessed provider confidence in PAE prescription. All respondents on the postsurvey agreed that it is important to discuss PAE with pregnant patients, and 86 percent felt confident in doing so. Interestingly however, when respondents were asked to provide an example of how to safely prescribe PAE to a pregnant patient using the principles of frequency, intensity, time, and type, only one respondent addressed all components of the question completely. Despite having access to clinical tools and suitable resources and recommendations to facilitate exercise prescription, most HCPs could not cite specific and consistent PAE guidance. It is unclear whether providing clinics with in-service training on antenatal PAE will reduce the prevalence of physical inactivity in pregnancy, but it is likely to be effective in improving the understanding of barriers at both the provider and patient levels which can translate to benefit gains for patients and the community.