Effects of health promotion behavior education in pregnancy on sleep quality and physical activity: a randomized controlled trial

This randomized controlled trial was conducted to evaluate the effect of health promotion behavior education for pregnant women on sleep quality and physical activity levels. This randomized controlled trial was conducted with 57 third-trimester pregnant women recruited from a Family Health Center in Türkiye. Participants were randomly assigned to intervention and control groups. The intervention group received six weekly 30-minute face-to-face health promotion education sessions, whereas the control group received routine prenatal care. Data were analyzed using descriptive statistics, chi-square tests, independent samples t-tests, Mann–Whitney U tests, Wilcoxon signed-rank tests, and mixed repeated-measures ANOVA. Because baseline PPAQ total scores differed significantly between groups, additional baseline-adjusted ANCOVA analyses were performed for the post-intervention and one-month follow-up PPAQ total scores. The groups were generally comparable at baseline, although significant differences were observed in pregnancy planning status and baseline PPAQ total scores. No significant difference was found in the household chores and caregiving activities subscale after the intervention and during follow-up. Mixed repeated-measures ANOVA showed no significant group, time, or group × time effect for household/caregiving activities. A significant group and time effect was observed for occupational activity, whereas the group × time interaction approached significance. For sports/exercise activity, the group × time interaction was significant, indicating a more favorable change over time in the intervention group. The education program was found effective in improving exercise/physical behaviors among pregnant women, but showed limited effects on other subdimensions of physical activity. No significant improvement in sleep quality was achieved. Longer-term and multi-component interventions may be more effective in supporting behavioral change among pregnant women. The study was retrospectively registered in ClinicalTrials.gov (NCT07315971 first posted 20 November 2025).