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Moderate\u2010intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate\u2010intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study was conducted in China. Two hundred fifty\u2010two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self\u2010Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7\u2010item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self\u2010efficacy was significantly correlated with moderate\u2010intensity physical activity. Physical activity self\u2010efficacy mediated the relationship between moderate\u2010intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate\u2010intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self\u2010efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self\u2010efficacy played an important mediating role in predicting moderate\u2010intensity physical activity. Future studies should focus on enhancing self\u2010efficacy to improve moderate\u2010intensity physical activity for pregnant people at high risk for GDM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.13589","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T05:57:33Z","timestamp":1702101453000},"page":"403-413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Mediating Role of Physical Activity Self\u2010Efficacy in Predicting Moderate\u2010Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9719-3678","authenticated-orcid":false,"given":"Xiao","family":"Yang","sequence":"first","affiliation":[{"name":"School of Nursing Sun Yat\u2010Sen University  Guangzhou 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