Acceptability of a mobile-health intervention to increase physical activity among pregnant patients with overweight or obesity: A feasibility randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Tainayah Thomas ◽  
Fei Xu ◽  
Sneha Sridhar ◽  
Tali Sedgwick ◽  
Linda Nkemere ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Moderate Intensity ◽  
Moderate Intensity Physical Activity ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Intensity Physical Activity ◽  
Overweight Or Obesity

BACKGROUND Pregnant patients with overweight or obesity are at high risk of perinatal complications. Excess gestational weight gain further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior change to reduce excess gestational weight gain, reduce intervention costs, and increase scalability by improving access. OBJECTIVE To test the acceptability and feasibility of a pilot mHealth lifestyle intervention for pregnant patients with overweight or obesity to promote moderate-intensity physical activity, encourage guideline-concordant gestational weight gain, and inform the design of a larger pragmatic cluster randomized controlled trial. METHODS We conducted a mixed-methods acceptability and feasibility randomized controlled trial among pregnant patients with a pre-pregnancy body mass index 25.0-40.0 kg/m2. Patients with singletons at 8–15 weeks’ gestation, and aged 21 years or older with Wi-Fi access were randomly assigned (1:1) to receive usual prenatal care or an mHealth lifestyle intervention. Participants in the intervention arm received wireless scales, access to an intervention website, activity trackers to receive automated feedback on weight gain and activity goals, and a monthly call from a lifestyle coach. Surveys and focus groups with intervention participants assessed intervention satisfaction and ways to improve the intervention. Physical activity outcomes were assessed using the Pregnancy Physical Activity Questionnaire and gestational weight gain was assessed using electronic health record data in both arms. RESULTS Thirty-three patients were randomly assigned to the intervention arm and 35 patients to the usual care arm. 100% of participants in the intervention arm weighed themselves at least once a week compared with 20% of participants in the usual care arm. Participants in the intervention arm wore the activity tracker 6.4 days/week, weighed themselves 5.3 times/week, and 87.9% rated the program “good to excellent.” Focus groups found participants desired more support related to nutrition to help them manage gestational weight gain and would have preferred an app instead of a website. Participants in the intervention arm had a 23.46 MET-hours greater change in total physical activity per week (95% CI:1.13, 45.8) and a 247.2-minute greater change in moderate intensity physical activity per week (95% CI: 36.2, 530.6) in unadjusted models, but these effects were attenuated in adjusted models (change in total physical activity: 15.55 MET-hours per week; 95% CI: -6.32, 37.42; change in moderate intensity physical activity: 199.6 minutes per week; 95% CI: -43.7, 442.9). We found no difference in total gestational weight gain (mean difference: 1.14 kg; 95% CI: -0.71, 3.00) compared to usual care. CONCLUSIONS A pilot mHealth lifestyle intervention was feasible, highly acceptable, and promoted self-monitoring. Refined interventions are needed to effectively impact physical activity and gestational weight gain among pregnant patients with overweight or obesity. CLINICALTRIAL ClinicalTrials.gov NCT03936283

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

Rationale, design, and challenges with implementing a clinical intervention to teach appropriate gestational weight gain (TAGG): Protocol of a Randomized controlled trial (Preprint)

2019 ◽  
Author(s):  
Awathif Mackeen ◽  
Danielle Downs ◽  
Vonda Hetherington ◽  
Shawnee Lutcher ◽  
Jacob Mowery ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Usual Care ◽  
Gestational Weight Gain ◽  
Perceived Stress ◽  
Controlled Trial ◽  
Household Food Security ◽  
Gestational Weight ◽  
Randomized Controlled

BACKGROUND Excessive gestational weight gain (GWG) has public health implications including preterm birth, preeclampsia, gestational diabetes, and cesarean delivery. In an effort to mitigate adverse consequences of excessive GWG, this study tests a health intervention that includes enhancements to improve knowledge and awareness of appropriate GWG, and patient-centered nutritional counseling to promote appropriate GWG. OBJECTIVE The primary objective of the study was to increase the proportion of women who are managing their GWG as recommended by the IOM.4,5 METHODS This randomized controlled trial was conducted at Geisinger in Pennsylvania where excessive GWG is common among women with pre-conception obesity. Eligible, consenting participants with pre-pregnancy body mass index >30.0 kg/m2 were randomized (1:1) to: 1) Usual Care: usual written educational materials and counseling by an obstetric care provider or 2) Enhanced Care: Usual Care plus a) a personalized letter from a physician detailing appropriate GWG, b) exposure to individualized GWG chart in the electronic health record via the patient portal, and c) a consult with a Registered Dietitian Nutritionist and follow-up via tele-health counseling (10-20 mins/1-2 weeks) for the duration of the pregnancy. RESULTS The primary outcome was the proportion of women that gain less than 20 pounds over the course of the pregnancy. Secondary outcomes include knowledge, expectations, and attitude about pregnancy weight gain; increased self-efficacy for ability to eat healthy and being physically active to manage weight; and eating behavior. Potential moderators that will be explored include sleep, perceived stress, perceived involvement in care, and household food security. Data collection has been completed as of November 2019. CONCLUSIONS As GWG care was initiated for mothers with pre-pregnancy BMI >30 kg/m2 within the first and second trimesters, the intervention may have the additional benefit of reducing other adverse pregnancy outcomes including the incidence of gestational diabetes due to healthier rates of GWG. In addition to assessing appropriate GWG, this project will assess eating habits, physical activity, GWG attitudes, sleep quality, and psychological measures, all of which are associated with GWG. Exploratory mediators including perceived stress and food insecurity will also be evaluated. CLINICALTRIAL ClinicalTrials.gov NCT02963428

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

Greater energy demand of exercise during pregnancy does not impact mechanical efficiency

2020 ◽  
Vol 45 (5) ◽  
pp. 493-499 ◽  
Author(s):  
Kathryn M. Denize ◽  
Pegah Akbari ◽  
Danilo Fernandes da Silva ◽  
Francois Haman ◽  
Kristi B. Adamo
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Energy Demand ◽  
Movement Pattern ◽  
Late Pregnancy ◽  
Mechanical Efficiency ◽  
Moderate Intensity ◽  
Gestational Weight

Pregnant women are recommended to engage in 150 min of moderate-intensity physical activity per week to reduce pregnancy complications. Many women struggle to remain physically active throughout pregnancy, and there is no consensus about whether women adopt a less efficient movement pattern as they progress through pregnancy and experience gestational weight gain. This study assessed the change in energy expenditure and mechanical efficiency in pregnant women (PREG; n = 10) when performing a walking treadmill task in early, mid, and late pregnancy and also compared with an age- and body mass index-matched, nonpregnant (CON; n = 10) group. On average, the PREG group gained within the Institute of Medicine’s gestational weight gain guidelines (11.6 ± 3.6 kg) and were all inactive (measured using accelerometry), except for 1 participant, by the third trimester, as per the 2019 Canadian physical activity guidelines for pregnant women. Energy expended to complete the walking task increased throughout pregnancy and was higher than the controls (111.5 ± 24.6 kcal) in mid and late pregnancy (139.0 ± 22.2 kcal, p = 0.02, and 147.3 ± 24.6 kcal, p = 0.005, respectively), but not early pregnancy (129.9 ± 18.9 kcal, p = 0.08). Walking mechanical efficiency was similar within pregnant women at each time point and compared to nonpregnant controls. Our findings add to the growing body of evidence demonstrating that pregnant women can safely perform physical activity by showing that walking mechanical efficiency is unchanged at low to moderate intensities. Novelty Energy demand during exercise increases proportionally to weight gain across pregnancy trimesters. However, mechanical efficiency remains unchanged during low- to moderate-intensity walking.

scholarly journals The Behavioral Wellness in Pregnancy study: a randomized controlled trial of a multi-component intervention to promote appropriate weight gain

2019 ◽  
Vol 109 (4) ◽  
pp. 1071-1079
Author(s):  
Lyndi M Buckingham-Schutt ◽  
Laura D Ellingson ◽  
Spyridoula Vazou ◽  
Christina G Campbell
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Behavioral Intervention ◽  
Controlled Trial ◽  
Institute Of Medicine ◽  
Weight Retention ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Prepregnancy Weight ◽  
The Face

ABSTRACT Background Adequate weight gain during pregnancy is important to both maternal and fetal outcomes. To date, randomized controlled trials have not been effective at increasing the proportion of women meeting gestational weight-gain guidelines. Objectives The aim of this study was to determine whether a multi-component behavioral intervention with a Registered Dietitian Nutritionist significantly improves the proportion of women who adhere to the 2009 Institute of Medicine weight-gain guidelines. Methods Participants were randomly assigned to usual care (UC; n = 24) or intervention (n = 23) between 8 and 14 weeks of gestation. The intervention included a minimum of 6 one-on-one counseling sessions over ∼30 wk focusing on healthy diet and physical activity (PA) goals. In addition to the face-to-face visits, weekly communication via email supported healthy eating, PA, and appropriate weight gain. Gestational weight gain, PA, and diet were assessed at 8–14, 26–28, and 34–36 weeks of gestation; weight retention was measured 2 mo postpartum. Results The proportion of women meeting the guidelines was significantly greater in those receiving the intervention than UC (60.8% compared with 25.0%, OR: 4.7; 95% CI: 1.3, 16.2; P = 0.019). Furthermore, 36.4% of the intervention women were at or below their prepregnancy weight at 2 mo postpartum compared with 12.5% in the UC group (P = 0.05). Conclusions A multi-component behavioral intervention improved adherence to the 2009 Institute of Medicine weight-gain guidelines. This trial was registered with clinicaltrials.gov as NCT02168647.

scholarly journals Role of physical activity in preventing and treating obesity

2005 ◽  
Vol 99 (2) ◽  
pp. 765-770 ◽  
Author(s):  
James O. Hill ◽  
Holly R. Wyatt
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Weight Gain ◽  
Optimal Level ◽  
Additional Research ◽  
Moderate Intensity ◽  
Moderate Intensity Physical Activity ◽  
Intensity Physical Activity ◽  
Prevalence Of Obesity ◽  
Maintain Weight Loss

There is an inverse relationship between physical activity and weight gain. However, additional research is needed to quantify the amount of physical activity required to prevent weight gain in different populations, improve the way we convey physical activity recommendations to the public, and help the individuals increase their physical activity. Although physical activity does not appear to contribute significantly to weight loss, it is critical for maintenance of weight loss. Available data are consistent in that 60–90 min/day of moderate-intensity physical activity is required to maintain a significant weight loss. Although there is agreement about the need for high levels of physical activity to maintain weight loss, there is a need for more research to understand why physical activity is critical for weight loss maintenance. Finally, additional research is needed to determine whether there is an optimal level of physical activity below which it is difficult for most people to achieve a balance between energy intake and expenditure at a healthy body weight. The increasing prevalence of obesity may reflect the fact that the majority of the population has fallen below such a level of physical activity.

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