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APPENDIX (Survey Questions) 1. What is your clinical title? a. M.D., obstetrics and gynecology b. M.D., family medicine or other field c. D.O., obstetrics and gynecology d. D.O., family medicine or other field e. Other (please specify): ______________________________ 2. For how many years has your own clinical practice included monitoring of pregnancies? a. 5 years or less b. 6-10 years c. 11-15 years d. 16-20 years e. More than 20 years 3. How familiar are you with the
|___1___|___2___|___3___|___4___|___5___|___6___|___7___| Not familiar Midpoint Very familiar 4. With what percentage of your pregnant patients do you specifically discuss exercise during pregnancy? a. 0-20% b. 21-40% c. 41-60% d. 61-80% e. 81-100% 5. In general, do you initiate a discussion about exercise with your pregnant patients, or do you discuss exercise only if your patient asks for your input? a. I initiate the discussion about exercise b. I discuss exercise with pregnant patients only if the patient asks for my input c. My staff discusses exercise with my patients 6. When you discuss exercise with your patients in their first trimester, how often do you recommend aerobic exercise such as swimming, stationary biking, stairmaster etc.?
|___1___|___2___|___3___|___4___|___5___|___6___|___7___| Never Mid-point Always 7. When you discuss exercise with your patients in their first trimester, how often do you recommend resistance exercise (strength training) such as weight machines?
|___1___|___2___|___3___|___4___|___5___|___6___|___7___| Never Mid-point Always 8. Do you recommend that patients without obstetric complications who exercise during the first and second trimesters decrease their aerobic exercise load (duration and/or intensity) during the third trimester? a. I recommend that patients reduce their aerobic exercise load in the third trimester b. I recommend that patients stop aerobic exercise during the third trimester c. I recommend no reduction in aerobic exercise load during the third trimester d. I make no specific recommendation regarding aerobic exercise in the third trimester 9. Do you recommend that patients without obstetric complications who exercise during the first and second trimesters decrease their resistance exercise load (duration and/or intensity) during the third trimester? a. I recommend that patients reduce their resistance exercise load in the third trimester b. I recommend that patients stop resistance exercise during the third trimester c. I recommend no reduction in resistance exercise load during the third trimester d. I make no specific recommendation regarding resistance exercise in the third trimester 10. When you discuss exercise with your pregnant patients, how often do you recommend that patients keep their exercise heart rate under a maximum level, such as 140 or 150 bpm? |___1___|___2___|___3___|___4___|___5___|___6___|___7___| Never Mid-point Always 11. When you discuss exercise with your pregnant patients, what duration do you usually suggest as a target or goal for aerobic exercise? a. No exercise b. 15 min or less of continuous exercise c. 16-30 min of continuous exercise d. More than 30 min of continuous exercise e. I do not make any specific recommendation regarding duration 12. When counseling pregnant patients who are not physically active but are otherwise healthy, how often do you advise the patient to begin a moderate exercise program at some point during the pregnancy? |___1___|___2___|___3___|___4___|___5___|___6___|___7___| Never Mid-point Always 13. To what extent do you think that the performance of regular aerobic exercise by a pregnant woman will reduce the probability that she will develop gestational diabetes? |___1___|___2___|___3___|___4___|___5___|___6___|___7___| Not at all Somewhat Quite a lot 14. To what extent do you think that the performance of regular aerobic exercise by a pregnant woman will reduce the probability that she will develop preeclampsia? |___1___|___2___|___3___|___4___|___5___|___6___|___7___| Not at all Somewhat Quite a lot 15*. To what extent do you think there is a need for more research and information on the effects of exercise during pregnancy on pregnancy outcomes? |___1___|___2___|___3___|___4___|___5___|___6___|___7___| No need Some need Much need * Note: There were three additional items that are not pertinent to the present report. |