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一项专门的健康指导干预预防孕妇体重过度增加和产后体重滞留的随机对照试验方案:HIPP 研究。

Protocol for a randomized controlled trial of a specialized health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women: the HIPP study.

机构信息

School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia.

出版信息

BMC Public Health. 2012 Jan 25;12:78. doi: 10.1186/1471-2458-12-78.

Abstract

BACKGROUND

Pregnancy is a time of significant physiological and physical change for women. In particular, it is a time at which many women are at risk of gaining excessive weight. We describe the rationale and methods of the Health in Pregnancy and Post-birth (HIPP) Study, a study which aims primarily to determine the effectiveness of a specialized health coaching (HC) intervention during pregnancy, compared to education alone, in preventing excessive gestational weight gain and postpartum weight retention 12 months post birth. A secondary aim of this study is to evaluate the mechanisms by which our HC intervention impacts on weight management both during pregnancy and post birth.

METHODS/DESIGN: The randomized controlled trial will be conducted with 220 women who have a BMI > 18.5 (American IOM cut-off for normal weight), are 18 years of age or older, English speaking, no history of disordered eating or diabetes and are less than 18 weeks gestation at recruitment. Women will be randomly allocated to either a specialized HC intervention group or an Education Alone group. Our specialized HC intervention has two components: (1) one-on-one sessions with a Health Coach, and (2) two by two hour educational group sessions led by a Health Coach. Women in the Education Alone group will receive two by two hour educational group sessions with no HC components. Body Mass Index, waist circumference, and psychological factors including motivation, readiness to change, symptoms of depression and anxiety, and body dissatisfaction will be assessed at baseline (14-16 weeks gestation), and again at follow-up: 32 weeks gestation, 6 weeks, 6 months and 12 months postpartum.

DISCUSSION

Our study responds to the urgent need to design effective interventions in pregnancy to prevent excessive gestational weight gain and postpartum weight retention. Our pregnancy HC intervention is novel and innovative and has been designed to be easily adopted by health professionals who work with pregnant women, such as obstetricians, midwives, allied health professionals and health psychologists.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12611000331932.

摘要

背景

妊娠是女性生理和身体发生重大变化的时期。特别是,许多女性在此期间面临体重过度增加的风险。我们描述了健康妊娠和产后(HIPP)研究的基本原理和方法,该研究旨在主要确定在妊娠期间,与单独教育相比,专门的健康指导(HC)干预在预防过度妊娠体重增加和产后 12 个月体重滞留方面的有效性。该研究的次要目的是评估我们的 HC 干预通过哪些机制在妊娠和产后期间对体重管理产生影响。

方法/设计:这项随机对照试验将对 220 名 BMI 大于 18.5(美国 IOM 正常体重的截止值)的女性进行,这些女性年龄在 18 岁以上,讲英语,没有饮食失调或糖尿病病史,招募时妊娠不足 18 周。女性将被随机分配到专门的 HC 干预组或单独教育组。我们的专门 HC 干预有两个组成部分:(1)与健康教练进行一对一的会议,(2)由健康教练领导的两个两小时的教育小组会议。单独教育组的女性将接受两个两小时的教育小组会议,不包括 HC 部分。体重指数、腰围以及包括动机、改变准备、抑郁和焦虑症状以及身体不满在内的心理因素,将在基线(妊娠 14-16 周)时进行评估,并在随访时再次评估:妊娠 32 周、6 周、6 个月和 12 个月产后。

讨论

我们的研究响应了在妊娠期间设计有效干预措施以防止过度妊娠体重增加和产后体重滞留的迫切需要。我们的妊娠 HC 干预是新颖且创新的,旨在为与孕妇合作的健康专业人员(如产科医生、助产士、联合健康专业人员和健康心理学家)轻松采用。

试验注册

澳大利亚新西兰临床试验注册中心 ACTRN12611000331932。

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