scholarly journals Outcomes From a Hybrid Implementation-effectiveness Study of the Living Well During Pregnancy Tele-coaching Program for Women at High Risk of Excessive Gestational Weight Gain

2022 ◽  
Author(s):  
Susan de Jersey ◽  
Nina Meloncelli ◽  
Taylor Guthrie ◽  
Hilary Powlesland ◽  
Leonie Callaway ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Diet Quality ◽  
Comparison Group ◽  
Intervention Group ◽  
Implementation Effectiveness ◽  
Face To Face ◽  
Historical Comparison ◽  
Gestational Weight ◽  
Living Well

Abstract BackgroundExcess gestational weight gain (GWG) is associated with short-term perinatal complications and longer term cardiometabolic risks for mothers and their babies. Dietitian counselling and weight gain monitoring for women at risk of high pregnancy weight gain is recommended by clinical practice guidelines. However, face-to-face appointments, during a time with high appointment burden, can introduce barriers to engaging with care. Telephone counselling may offer a solution. The Living Well during Pregnancy (LWdP) program is a dietitian-delivered telephone coaching program implemented within routine antenatal care for women at risk of excess GWG. This program evaluation used a hybrid implementation-effectiveness design guided by the RE-AIM framework reports on the primary outcomes (reach, adoption, implementation, maintenance) and secondary outcomes (effectiveness) of the LWdP intervention. MethodsThe LWdP program evaluation compared data from women participating in the LWdP program with a historical comparison group (pregnant women receiving dietetic counselling for GWG in the 12 months prior to the study). The primary outcomes were described for the LWdP program. Between group comparisons were used to determine effectiveness of achieving appropriate GWG and pre and post intervention comparisons of LWdP participants was used to determine changes to dietary intake and physical activity. ResultsThe LWdP intervention group (n=142) were compared with women in the historical comparison group (n=49). Women in the LWdP intervention group attended 3.4 (95% CI 2.9 – 3.8) appointments compared with 1.9 (95% CI, 1.6 – 2.2). GWG was similar between the two groups, including the proportion of women gaining weight above the Institute of Medicine recommendations (70% vs 73%, p=0.69). Within group comparison showed that total diet quality, intake of fruit and vegetables and weekly physical activity were all significantly improved from baseline to follow-up for the women in the LWdP, while consumption of discretionary food and time spent being sedentary decreased (all p<0.05). ConclusionThe LWdP program resulted in more women accessing care and positive improvements in diet quality, intuitive eating behaviours and physical activity. It was as effective as face-to-face appointments for GWG, though more research is required to identify how to engage women earlier in pregnancy and reduce appointment burden.

scholarly journals Diet Quality Indices and Physical Activity Levels Associated with Adequacy of Gestational Weight Gain in Pregnant Women with Gestational Diabetes Mellitus

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1842
Author(s):  
Vanessa Averof Honorato de Almeida ◽  
Rafaela Alkmin da Costa ◽  
Cristiane de Freitas Paganoti ◽  
Fernanda Cristina Mikami ◽  
Ana Maria da Silva Sousa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Diet Quality ◽  
Multinomial Logistic Regression ◽  
Gestational Weight

The aim of this study was to evaluate the Diet Quality Index (DQI) and the Physical Activity (PA) levels associated with adequacy of gestational weight gain in pregnant women with gestational diabetes mellitus (GDM). A total of 172 pregnant women with a single fetus and a diagnosis of GDM participated. Food intake was self-reported on the food frequency questionnaire and DQI was quantified using the index validated and revised for Brazil (DQI-R). To assess PA, the Pregnancy Physical Activity Questionnaire was administered. Gestational weight gain was classified, following the criteria of the Institute of Medicine, into adequate (AWG), insufficient (IWG), or excessive (EWG) weight gain. A multinomial logistic regression analysis was performed, with level of significance <0.05. The participants were divided into 3 groups: AWG (33.1%), IWG (27.3%), and EWG (39.5%). The analysis indicated that if the pregnant women PA fell into tertile 1 or 2, then they had a greater chance of having IWG, whereas those with the lowest scores on the DQI-R, whose PA fell into tertile 2, and pregestational obesity women had the greatest chance of having EWG. This study has shown that low PA levels may contribute towards IWG. On the other hand, a low final DQI-R score, representing inadequate food habits, low PA levels, and pregestational obesity may increase the chance of EWG in patients with GDM.

scholarly journals Effect of a Short Message Service Intervention on Excessive Gestational Weight Gain in a Low-Income Population: A Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1428
Author(s):  
Hannah Holmes ◽  
Cristina Palacios ◽  
YanYan Wu ◽  
Jinan Banna
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Low Income ◽  
Short Message Service ◽  
Intervention Group ◽  
Control Group ◽  
Short Message ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Message Service

Objectives: The objective of this trial was to investigate the effect of educational short message service (SMS), or text messages, on excessive gestational weight gain (GWG) in a low-income, predominantly overweight/obese population. Methods: Participants (n = 83) were mostly overweight/obese women recruited at Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics on the island of O’ahu, Hawai’i at 15–20 weeks gestational age. The intervention group received SMS on nutrition and physical activity during pregnancy designed to help them meet Institute of Medicine (IOM) guidelines for GWG and American College of Obstetricians and Gynecologists guidelines for exercise, respectively. The control group received SMS about general health topics during pregnancy, excluding nutrition and physical activity. Both groups received one text message per week for eighteen weeks. GWG was defined as the difference between the last self-reported weight taken before delivery and participants’ self-reported weight before pregnancy. Differences between study groups were examined using t-tests and Chi-square tests. Linear regression models were used to examine association of GWG with study group and other factors. Results: GWG was similar (p = 0.58) in the control group (14.1 ± 11.4 kg) and the intervention group (15.5 ± 11.6 kg). The percentage of participants exceeding IOM guidelines for GWG was similar (p = 0.51) in the control group (50.0%, n = 17) and the intervention group (60.5%, n = 23). Conclusions: GWG was not significantly different between intervention and control groups. Trials that begin earlier in pregnancy or before pregnancy with longer intervention durations and varying message frequency as well as personalized or interactive messages may be needed to produce significant improvements.

scholarly journals A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Pontus Henriksson ◽  
Johanna Sandborg ◽  
Marie Blomberg ◽  
Christina Alexandrou ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Smartphone App ◽  
Healthy Weight ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Diet And Physical Activity

BACKGROUND Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. OBJECTIVE The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. METHODS HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. RESULTS Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. CONCLUSIONS This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13011

Development and Evaluation of a Theory-Based App for Managing Gestational Weight Gain for Overweight and Obese Pregnant Women: A Mixed-Method Pilot Study (Preprint)

2021 ◽  
Author(s):  
Ching-Fang Lee ◽  
Li-Kang Chi ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Mixed Method ◽  
Moderate Intensity ◽  
Obese Women ◽  
Healthy Behavior ◽  
Gestational Weight ◽  
Methodological Guidelines

BACKGROUND Overweight and obese women’s excessive gestational weight gain (GWG) may be a health risk for both the mother and the fetus; excessive GWG leads to the retention of weight postpartum and thus obesity. Given the overwhelming number of existing pregnancy-related applications (apps), we lack only a few methodological guidelines for integrating theory, evidence and previously validated apps to help overweight and obese women manage their GWG during pregnancy. OBJECTIVE This two-phase study aimed to develop the MyHealthyWeight (MHW) app based on social-cognitive theory (SCT) and evaluate its effectiveness for overweight and obese women in helping prevent excessive GWG by enhancing adherence to optimal GWG goals and healthy behavior during pregnancy. METHODS First, we constructed and developed the MHW app based on SCT theory, and we later employed a mixed-method study to evaluate the effects of the app on overweight and obese pregnant women. RESULTS All participating overweight and obese pregnant women (100%) achieved their optimal GWG through increased self-efficacy and physical activity. Their total and moderate-intensity physical activity expenditures improved, while their sedentary and light-intensity levels of physical activity decreased. CONCLUSIONS This theory-based MHW app for weight management was greatly valued by the pregnant users. Its usefulness for health-care professionals in assisting overweight and obese pregnant women in preventing excessive GWG by promoting healthy behavior, in particular through physical exercise and a healthy diet, during pregnancy was also confirmed. CLINICALTRIAL NCT04553718

Associations of the Neighborhood Built Environment with Gestational Weight Gain

2021 ◽  
Author(s):  
William A. Grobman ◽  
Emma G. Crenshaw ◽  
Derek J. Marsh ◽  
Rebecca B. McNeil ◽  
Victoria L. Pemberton ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Built Environment ◽  
Gestational Weight Gain ◽  
Grocery Stores ◽  
Multinomial Regression ◽  
Lower Odds ◽  
Residential Address ◽  
Gestational Weight ◽  
Nulliparous Women

Objective This study aimed to determine whether specific factors of the built environment related to physical activity and diet are associated with inadequate and excessive gestational weight gain (GWG). Study Design This analysis is based on data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be, a prospective cohort of nulliparous women who were followed from the beginning of their pregnancies through delivery. At each study visit, home addresses were recorded and geocoded. Locations were linked to several built-environment characteristics such as the census tract National Walkability Score (the 2010 Walkability Index) and the number of gyms, parks, and grocery stores within a 3-km radius of residential address. The primary outcome of GWG (calculated as the difference between prepregnancy weight and weight at delivery) was categorized as inadequate, appropriate, or excessive based on weight gained per week of gestation. Multinomial regression (generalized logit) models evaluated the relationship between each factor in the built environment and excessive or inadequate GWG. Results Of the 8,182 women in the analytic sample, 5,819 (71.1%) had excessive GWG, 1,426 (17.4%) had appropriate GWG, and 937 (11.5%) had inadequate GWG. For the majority of variables examined, built environments more conducive to physical activity and healthful food availability were associated with a lower odds of excessive or inadequate GWG category. For example, a higher number of gyms or parks within 3 km of a participant's residential address was associated with lower odds of having excessive (gyms: adjusted odds ratio [aOR] = 0.93 [0.89–0.96], parks: 0.94 [0.90–0.98]) or inadequate GWG (gyms: 0.91 [0.86–0.96]; parks: 0.91 [0.86–0.97]). Similarly, a higher number of grocery stores was associated with lower odds of having excessive GWG (0.94 [0.91–0.97]). Conclusion Among a diverse population of nulliparous women, multiple aspects of the built environment are associated with excessive and inadequate GWG. Key Points

Effect of an mHealth-Based Intervention on Excessive Gestational Weight Gain Prevention among Overweight and Obese Women: A Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Hung Hui Chen ◽  
Ching-Fang Lee ◽  
Jian-Pei Huang ◽  
Li-Kang Chi ◽  
Yvonne Hsiung
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Obese Women ◽  
Third Trimester ◽  
Overweight Women ◽  
Mhealth Intervention ◽  
Excessive Gestational Weight Gain

BACKGROUND Excessive gestational weight gain (GWG) is a public health concern since it can lead to adverse consequences and health problems for expecting mothers and their unborn infants. There is a need to evaluate the effects of a GWG management intervention to reduce the burden and risk among overweight and obese women during pregnancy. OBJECTIVE To explore the efficacy of a mobile health (mHealth) intervention to prevent excessive GWG, overweight and obese pregnant women were invited to use an app and wearable activity tracker (WAT). METHODS A randomized controlled trial with an experimental study design. Ninety-two pregnant women were recruited, and all overweight and obese participants from the two prenatal outpatient clinics in northern Taiwan had, at less than 17 weeks gestation, a prepregnancy body mass index (BMI) ≥ 25 kg/m2. These participants were randomly assigned (1:1) by a random number table; the experimental group received an mHealth-based program using the MyHealthyWeight (MHW) app and a WAT to wear during pregnancy. The control group received standard antenatal treatments without any mHealth-based elements. Two hospital follow-up visits were scheduled at 24-26 weeks in the second trimester and 34-36 weeks in the third trimester. Sociodemographic characteristics, pregnancy physical activity questionnaire (PPAQ), a self-efficacy questionnaire and body weight were measures of interest. A generalized estimating equation (GEE) was used to examine the trajectories and the intervention effect on GWG. RESULTS No difference in GWG was found between the intervention and control groups at baseline. The weight gain trajectory in the entire cohort of women with obesity exhibited a quadratic pattern; compared with the control group, a slight increase in the intervention group was found in the second trimester. Throughout the whole pregnancy, the mHealth intervention group had a significantly lower proportion of excessive GWG in total and weekly weight gain. In particular, obese women in the intervention group, compared with obese women in the control group, gained less weight (average difference of 8.76 kg) in the third trimester. The GEE model indicated that obese women who were aged 35 years, had prepregnancy exercise habits, had perceived self-efficacy of diet, and had more physical activity had lower GWG (p<.05). CONCLUSIONS The mHealth program has shown positive results in significantly managing GWG among obese and overweight women. Among obese women, the second semester trajectory of weight gain and the lower proportion of excessive GWG were more notable than those of overweight women. Although the intervention seems to be more effective among women with obesity, our results show the potential to prevent excessive GWG during pregnancy in both overweight and obese women. Guidance may be provided to health-care professionals who wish to promote healthy diet and physical activity behaviors. CLINICALTRIAL The protocol of the study was registered in ClinicalTrials. gov (NCT04553731).

Effect of a 12-week workplace interview intervention on physical activity and low back pain: a single-center, randomized controlled study

2020 ◽  
Author(s):  
Kazuhiro Shimo ◽  
Mami Hasegawa ◽  
Seiko Mizutani ◽  
Tomomi Hasegawa ◽  
Takahiro Ushida
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapist ◽  
Intervention Group ◽  
Office Workers ◽  
Controlled Study ◽  
Control Group ◽  
Low Back ◽  
Face To Face

Abstract Background Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear if workplace PA interventions can improve LBP. This study aimed to investigate the effects of workplace interview intervention on increasing PA and improving LBP among office workers. Methods We recruited 37 workers of a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention group (n=20) or control group (n=17). We affixed waist-worn accelerometers to monitor PA in all participants, and provided face-to-face counseling with a physical therapist or nurse once a week for 12 weeks as workplace PA program to reassurance and encourage participants to keep high levels of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. Results Baseline characteristics were similar in both groups, but PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, was PA significantly increased at 3 and 6 months from baseline and LBP severity improved significantly at 6 months from baseline. We calculated the effect size of the interview intervention, and found that workplace interview intervention had a medium to large effect on PA and LBP severity. Conclusions Our data suggests that workplace PA intervention can increase PA and improve LBP among office workers. Trial registration UMIN-CTR Clinical Trial UMIN000038864 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044321). Registered 12 December 2019, retrospectively registered.

scholarly journals High physical activity and high sedentary behavior increased the risk of gestational diabetes mellitus among women with excessive gestational weight gain: a prospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Heng Yaw Yong ◽  
Zalilah Mohd Shariff ◽  
Barakatun Nisak Mohd Yusof ◽  
Zulida Rejali ◽  
Jacques Bindels ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Sedentary Behavior ◽  
Logistic Models ◽  
Second Trimester ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Group 2

Abstract Background Although physical activity (PA) in pregnancy benefits most women, not much is known about pregnancy-related changes in PA and its association with gestational diabetes mellitus (GDM) risk. The aim of this study was to identify the trajectory of PA during pregnancy and possible associations with the risk of GDM. Methods This was a prospective cohort study of 452 pregnant women recruited from 3 health clinics in a southern state of Peninsular Malaysia. PA levels at the first, second, and third trimester were assessed using the Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24–28 weeks of gestation following the Ministry of Health Malaysia criteria. Group-based trajectory modeling was used to identify PA trajectories. Three multivariate logistic models were used to estimate the odds of trajectory group membership and GDM. Results Two distinct PA trajectories were identified: low PA levels in all intensity of PA and sedentary behavior (Group 1: 61.1%, n = 276) and high PA levels in all intensity of PA as well as sedentary behavior (Group 2: 38.9%, n = 176). Moderate and high intensity PA decreased over the course of pregnancy in both groups. Women in group 2 had significantly higher risk of GDM in two of the estimated logistic models. In all models, significant associations between PA trajectories and GDM were only observed among women with excessive gestational weight gain in the second trimester. Conclusions Women with high sedentary behavior were significantly at higher risk of GDM despite high PA levels by intensity and this association was significant only among women with excessive GWG in the second trimester. Participation in high sedentary behavior may outweigh the benefit of engaging in high PA to mitigate the risk of GDM.

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