Nutrition, Behavior Change and Physical Activity Outcomes From the PEARS RCT—An mHealth-Supported, Lifestyle Intervention Among Pregnant Women With Overweight and Obesity

Abstract Background Prevalence of overweight and obesity during childhood is still elevated in high-income countries. GiochiAMO is a health promotion program that uses knowledge-based education and games to teach healthy nutrition and physical activity among children (6–8 years old). Methods This study was a single arm field trial. Second and third grade classes of primary school attended an oral presentation about nutrition and physical activity and then were involved in three game sessions. Two multiple-choice questionnaires were administered at the beginning and at the end of the trail. The following scores were measured: nutrition behavior score (NTs), physical activity behavior score (PAs) and delta score (Ds). Wilcoxon, T-test and Mann Whitney were used to perform the univariate analysis. Results A total number of 74 and 76 children participated in the physical activity and nutrition interventions. NTs was 4.17 (SD: 2.23) before and 5.03 (SD: 2.79) after the intervention (P = 0.005). PAs was 27.4 (SD: 9.6) before and 30.5 (SD: 10.7) after the intervention (P = 0.003). No significant differences were obtained comparing males and females for all scores. Ds was 0.86 for nutrition and 3.1 for physical activity. Univariate analysis of Delta scores obtained no significant differences. Conclusions The present results confirm the effectiveness of ‘GiochiAMO’ to change nutrition and physical activity behavior.

Download Full-text

Champ4life Study Protocol: A One-Year Randomized Controlled Trial of a Lifestyle Intervention for Inactive Former Elite Athletes with Overweight/Obesity

Nutrients ◽

10.3390/nu12020286 ◽

2020 ◽

Vol 12 (2) ◽

pp. 286

Author(s):

Analiza M. Silva ◽

Catarina L. Nunes ◽

Catarina N. Matias ◽

Filipe Jesus ◽

Rúben Francisco ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Lifestyle Intervention ◽

Elite Athletes ◽

Resting Energy Expenditure ◽

Overweight And Obesity ◽

Metabolic Markers ◽

Health Related ◽

Former Elite Athletes

Preventive and educational programs directed to former elite athletes in the areas of healthy living are required. This is particularly relevant as obesity and health-related problems are observed in retired athletes, especially in those whose current levels of physical activity are below the recommendations. During their sports career, elite athletes are supported by a multidisciplinary team; upon retirement, no support is provided for the transition to a different lifestyle. So far, no program has been implemented to promote sustained healthy lifestyle behaviors in the post-career transition and evidence is lacking for such an intervention. Firstly, we aim to determine if Champ4life, a 1-year lifestyle intervention targeting inactive former athletes with overweight and obesity, is effective for reducing total and abdominal fat. Secondly, our purpose is to assess the effectiveness of the intervention on the levels of physical activity and sedentary behavior, resting energy expenditure, cardio-metabolic markers, physical fitness, energy balance components, eating self-regulation markers, and quality of life over 12 months. Champ4life is an evidence- and theory-based program using a randomized control trial design (intervention vs. control group) that will be conducted on 94 inactive former elite athletes with overweight and obesity. The first four months of the Champ4Life program include a nutritional appointment and 12 weekly, 90-min sessions. Classroom sessions seek to provide participants with key information and a toolbox of behavior change techniques to initiate and sustain long-term lifestyle changes. Participants will undergo baseline, 4-month, and 12-month measurements of body composition (primary outcomes), resting energy expenditure, physical fitness, metabolic markers, energy balance related-markers, and quality of life (secondary outcome). This trial will provide evidence on the effectiveness of the Champ4life program, a pioneer lifestyle intervention for retired athletes, offering tools for sustained changes in physical activity, sedentary behavior and diet, aiming to improve body composition and overall health-related markers.

Download Full-text

Correlates of Physical Activity Engagement among Pregnant Women with Overweight and Obesity

Women s Health Issues ◽

10.1016/j.whi.2020.06.001 ◽

2020 ◽

Vol 30 (5) ◽

pp. 393-400

Author(s):

Shannon D. Donofry ◽

Lisa J. Germeroth ◽

Rachel P. Kolko Conlon ◽

Elizabeth M. Venditti ◽

Michele D. Levine

Keyword(s):

Physical Activity ◽

Pregnant Women ◽

Overweight And Obesity ◽

Activity Engagement

Download Full-text

Effect of A Community-Based Lifestyle Intervention on Physical Activity and Diet in Pregnant Women

Canadian Journal of Diabetes ◽

10.1016/s1499-2671(08)24086-4 ◽

2008 ◽

Vol 32 (4) ◽

pp. 319

Author(s):

Amy Hui ◽

Sora Ludwig ◽

Phillip Gardiner ◽

Gustaaf Sevenhuysen ◽

Heather Dean ◽

...

Keyword(s):

Physical Activity ◽

Pregnant Women ◽

Lifestyle Intervention ◽

Community Based

Download Full-text

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial (Preprint)

10.2196/preprints.17494 ◽

2019 ◽

Author(s):

Alline Beleigoli ◽

Andre Q Andrade ◽

Maria De Fatima Diniz ◽

Antonio Luiz Ribeiro

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Behavior Change ◽

Dietary Habits ◽

Overweight And Obesity ◽

Waiting List ◽

Personalized Feedback ◽

Small Magnitude ◽

Web Based ◽

Behavior Change Program

BACKGROUND The effect of computer- or human-delivered personalized feedback on the effectivess of web-based behavior change platforms for weight loss is unclear. OBJECTIVE We aimed to compare the effectiveness of a web-based behavior change intervention personalized through either computerized or human-delivered feedback with a nonpersonalized intervention in promoting weight loss in community-based adults with overweight or obesity. METHODS This pragmatic, 3-group, parallel-arm, randomized trial recruited students and staff in a Brazilian public university who were aged 18 to 60 years, had a BMI of ≥25 kg/m<sup>2</sup>, and were not pregnant. Participants were allocated to one of 3 groups: platform only (24-week behavior change program delivered using a web platform with personalized computer-delivered feedback), platform plus coaching (same 24-week web-based behavior change program plus 12 weeks of personalized feedback delivered online by a dietitian), or waiting list (nonpersonalized dietary and physical activity recommendations delivered through an e-booklet and videos). Self-reported weight at 24 weeks was the primary outcome. Changes in dietary and physical activity habits within 24 weeks were secondary outcomes. RESULTS Among the 1298 participants, 375 (28.89%) were lost to follow-up. In the intention-to-treat analysis, the platform-only and platform plus coaching groups had greater mean weight loss than the waiting-list group at 24 weeks (–1.08 kg, 95% CI –1.41 to –0.75 vs –1.57 kg, 95% CI –1.92 to –1.22 vs –0.66 kg, 95% CI –0.98 to –0.34, respectively). The platform-only and platform plus coaching groups, compared with the waiting list group, had a greater increase in the consumption of vegetables (3%, 95% CI 1% to 6% vs 5%, 95% CI 2% to 8% vs –3%, 95% CI –5% to 0%) and fruits (9%, 95% CI 6% to 12% vs 6%, 95% CI 2% to 9% vs 2%, 95% CI 0% to 6%) and a larger reduction in ultraprocessed food intake (–18%, 95% CI –23% to –13% vs –25%, 95% CI –30% to –20% vs –12%, 95% CI –16% to –8%). Changes in physical activity did not differ across the groups. Engagement was higher in the platform plus coaching group than in the platform-only group (7.6 vs 5.2 completed sessions; <i>P</i>=.007). Longer usage of the platform was associated with clinically meaningful (≥5%) weight loss (odds ratio 1.02, 95% CI 1.01 to 1.04). CONCLUSIONS The web-based behavior change programs with computer- and human-delivered personalized feedback led to greater, albeit small-magnitude, weight loss within 24 weeks. Improvement in multiple dietary habits, but not physical activity, were also greater in the personalized programs compared with the nonpersonalized one. The human-delivered personalized feedback by the online dietitian coach increased user engagement with the program and was associated with a significantly higher chance of clinically meaningful weight loss. CLINICALTRIAL ClinicalTrials.gov NCT03435445; https://clinicaltrials.gov/ct2/show/NCT03435445 INTERNATIONAL REGISTERED REPORT RR2-10.2196/10.1186/s12889-018-5882-y

Download Full-text

Effect of Lifestyle Intervention Program for Overweight and Obesity Pregnant Women

Journal of Korean Academy of Nursing ◽

10.4040/jkan.19228 ◽

2020 ◽

Vol 50 (3) ◽

pp. 459

Author(s):

Hye Kyung Choi ◽

Hyeon Ok Kim

Keyword(s):

Pregnant Women ◽

Lifestyle Intervention ◽

Intervention Program ◽

Overweight And Obesity ◽

Lifestyle Intervention Program

Download Full-text

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/17494 ◽

2020 ◽

Vol 22 (11) ◽

pp. e17494

Author(s):

Alline Beleigoli ◽

Andre Q Andrade ◽

Maria De Fatima Diniz ◽

Antonio Luiz Ribeiro

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Behavior Change ◽

Dietary Habits ◽

Overweight And Obesity ◽

Waiting List ◽

Personalized Feedback ◽

Small Magnitude ◽

Web Based ◽

Behavior Change Program

Background The effect of computer- or human-delivered personalized feedback on the effectivess of web-based behavior change platforms for weight loss is unclear. Objective We aimed to compare the effectiveness of a web-based behavior change intervention personalized through either computerized or human-delivered feedback with a nonpersonalized intervention in promoting weight loss in community-based adults with overweight or obesity. Methods This pragmatic, 3-group, parallel-arm, randomized trial recruited students and staff in a Brazilian public university who were aged 18 to 60 years, had a BMI of ≥25 kg/m2, and were not pregnant. Participants were allocated to one of 3 groups: platform only (24-week behavior change program delivered using a web platform with personalized computer-delivered feedback), platform plus coaching (same 24-week web-based behavior change program plus 12 weeks of personalized feedback delivered online by a dietitian), or waiting list (nonpersonalized dietary and physical activity recommendations delivered through an e-booklet and videos). Self-reported weight at 24 weeks was the primary outcome. Changes in dietary and physical activity habits within 24 weeks were secondary outcomes. Results Among the 1298 participants, 375 (28.89%) were lost to follow-up. In the intention-to-treat analysis, the platform-only and platform plus coaching groups had greater mean weight loss than the waiting-list group at 24 weeks (–1.08 kg, 95% CI –1.41 to –0.75 vs –1.57 kg, 95% CI –1.92 to –1.22 vs –0.66 kg, 95% CI –0.98 to –0.34, respectively). The platform-only and platform plus coaching groups, compared with the waiting list group, had a greater increase in the consumption of vegetables (3%, 95% CI 1% to 6% vs 5%, 95% CI 2% to 8% vs –3%, 95% CI –5% to 0%) and fruits (9%, 95% CI 6% to 12% vs 6%, 95% CI 2% to 9% vs 2%, 95% CI 0% to 6%) and a larger reduction in ultraprocessed food intake (–18%, 95% CI –23% to –13% vs –25%, 95% CI –30% to –20% vs –12%, 95% CI –16% to –8%). Changes in physical activity did not differ across the groups. Engagement was higher in the platform plus coaching group than in the platform-only group (7.6 vs 5.2 completed sessions; P=.007). Longer usage of the platform was associated with clinically meaningful (≥5%) weight loss (odds ratio 1.02, 95% CI 1.01 to 1.04). Conclusions The web-based behavior change programs with computer- and human-delivered personalized feedback led to greater, albeit small-magnitude, weight loss within 24 weeks. Improvement in multiple dietary habits, but not physical activity, were also greater in the personalized programs compared with the nonpersonalized one. The human-delivered personalized feedback by the online dietitian coach increased user engagement with the program and was associated with a significantly higher chance of clinically meaningful weight loss. Trial Registration ClinicalTrials.gov NCT03435445; https://clinicaltrials.gov/ct2/show/NCT03435445 International Registered Report Identifier (IRRID) RR2-10.2196/10.1186/s12889-018-5882-y

Download Full-text

Implementation and Outcomes of Lay Health Worker–Led Self-Management Interventions for Long-Term Conditions and Prevention: A Systematic Review

Health Education & Behavior ◽

10.1177/1090198119863842 ◽

2019 ◽

Vol 46 (6) ◽

pp. 1045-1072 ◽

Cited By ~ 1

Author(s):

Mari Punna ◽

Tarja Kettunen ◽

Anne-Marie Bagnall ◽

Kirsti Kasila

Keyword(s):

Physical Activity ◽

Cardiovascular Diseases ◽

Behavior Change ◽

Health Worker ◽

Self Management ◽

Long Term Conditions ◽

Lay Health Worker ◽

Management Interventions ◽

Nutrition Behavior

The aim of this study was to systematically review lay health worker (LHW)–led self-management interventions for adults with long-term conditions to see how the interventions have been implemented and to compose a synthesis of research findings, taking into consideration the intervention components that have been applied. We conducted systematic searches for articles published between January 2010 and December 2015 in five databases: Cochrane, MEDLINE, CINAHL, PsycINFO, and Web of Science. Forty original studies were found that met the inclusion criteria: self-management with diabetes ( n = 29), cardiovascular diseases ( n = 8), and those at risk of cardiovascular diseases ( n = 3). These consisted of 22 randomized controlled trials and 18 other trials, with durations of 1 day to 24 months. The findings showed that the training of LHWs and the implementation of interventions varied widely. A synthesis of the implementation methods covers the background of the LHWs and the interventions as well as the components applied in each. Eight interventions had effects on physical activity and eight on nutrition behavior. The review also includes preliminary findings on intervention components effective in improving physical activity and nutrition behavior, including self-monitoring as a behavior change technique and group meetings as an intervention format. The same components and behavior change techniques were applied in effective and noneffective interventions. The review found that LHW-led interventions have potential in promoting self-management in long-term condition. In the future, a qualified and evidence-based structure for LHW-led interventions is suggested in order to improve the systematization of interventions and their effects.

Download Full-text

Individually Tailored, Adaptive Intervention to Manage Gestational Weight Gain: Protocol for a Randomized Controlled Trial in Women With Overweight and Obesity (Preprint)

10.2196/preprints.9220 ◽

2017 ◽

Author(s):

Danielle Symons Downs ◽

Jennifer S Savage ◽

Daniel E Rivera ◽

Joshua M Smyth ◽

Barbara J Rolls ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Weight Gain ◽

Pregnant Women ◽

Healthy Eating ◽

Controlled Trial ◽

Overweight And Obesity ◽

Adaptive Intervention ◽

Gestational Weight ◽

Randomized Controlled

BACKGROUND High gestational weight gain is a major public health concern as it independently predicts adverse maternal and infant outcomes. Past interventions have had only limited success in effectively managing pregnancy weight gain, especially among women with overweight and obesity. Well-designed interventions are needed that take an individualized approach and target unique barriers to promote healthy weight gain. OBJECTIVE The primary aim of the study is to describe the study protocol for Healthy Mom Zone, an individually tailored, adaptive intervention for managing weight in pregnant women with overweight and obesity. METHODS The Healthy Mom Zone Intervention, based on theories of planned behavior and self-regulation and a model of energy balance, includes components (eg, education, self-monitoring, physical activity/healthy eating behaviors) that are adapted over the intervention (ie, increase in intensity) to better regulate weight gain. Decision rules inform when to adapt the intervention. In this randomized controlled trial, women are randomized to the intervention or standard care control group. The intervention is delivered from approximately 8-36 weeks gestation and includes step-ups in dosages (ie, Step-up 1 = education + physical activity + healthy eating active learning [cooking/recipes]; Step-up 2 = Step-up 1 + portion size, physical activity; Step-up 3 = Step-up 1 + 2 + grocery store feedback, physical activity); 5 maximum adaptations. Study measures are obtained at pre- and postintervention as well as daily (eg, weight), weekly (eg, energy intake/expenditure), and monthly (eg, psychological) over the study period. Analyses will include linear mixed-effects models, generalized estimating equations, and dynamical modeling to understand between-group and within-individual effects of the intervention on weight gain. RESULTS Recruitment of 31 pregnant women with overweight and obesity has occurred from January 2016 through July 2017. Baseline data have been collected for all participants. To date, 24 participants have completed the intervention and postintervention follow-up assessments, 3 are currently in progress, 1 dropped out, and 3 women had early miscarriages and are no longer active in the study. Of the 24 participants, 13 women have completed the intervention to date, of which 1 (8%, 1/13) received only the baseline intervention, 3 (23%, 3/13) received baseline + step-up 1, 6 (46%, 6/13) received baseline + step-up 1 + step-up 2, and 3 (23%, 3/13) received baseline + step-up 1 + step-up 2 +step-up 3. Data analysis is still ongoing through spring 2018. CONCLUSIONS This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy. Results from this study will be useful in designing a larger randomized trial to examine efficacy of this intervention and developing strategies for clinical application. REGISTERED REPORT IDENTIFIER RR1-10.2196/9220

Download Full-text