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Table 1 Lessons learnt and implications for future interventions: physical activity for smoking cessation during pregnancy

From: Lessons learned from the London Exercise and Pregnant (LEAP) Smokers randomised controlled trial process evaluation: implications for the design of physical activity for smoking cessation interventions during pregnancy

Lesson learnt Evidence from LEAP trial Implication for future research and practice
1) Text messaging Effective form of communicating, convenient and cost-effective. Include text messaging as a means of communicating with participants.
2) Pedometers Women enjoyed wearing them particularly because they could see the immediate results. Use ‘gadgets’ that are simple to use yet effective and empowering for participants.
3) Financial incentives Facilitated intervention attendance particularly amongst women from deprived backgrounds. Identify a way of easing financial burden (i.e. travel costs) on women to enable them to attend sessions. Conduct further research on financial incentives for smoking cessation.
4) Intensity of exercise Researchers were hesitant to encourage women to exercise at higher intensities and not certain how to adapt exercise for different stages of pregnancy. Current guidelines suggest there is no need to adapt exercise for pregnant women with no medical or obstetric complications; consider revising guidelines.
5) Frequency of visits is too high Face-to-face support may need to be combined with self-help strategies. Research is needed to determine how effective this self-help support is for promoting exercise in pregnancy.
6) Training needs Targeted training would have been beneficial. Include more and specific information on (i) how to talk to teenagers about smoking, (ii) how to deal with deprivation related issues drug/alcohol abuse, (iii) family/friend/partner presence in session, (iv) stage of pregnancy, (v) preventing postpartum return to smoking.