Skouteris Helen, McPhie Skye, Hill Briony, McCabe Marita, Milgrom Jeannette, Kent Bridie, Bruce Lauren, Herring Sharon, Gale Janette, Mihalopoulos Cathrine, Shih Sophy, Teale Glyn, Lachal Jennifer
School of Psychology, Deakin University, Burwood, Victoria, Australia.
School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
Br J Health Psychol. 2016 Feb;21(1):31-51. doi: 10.1111/bjhp.12154. Epub 2015 Jul 31.
The objectives of this study were to evaluate the efficacy of a health coaching (HC) intervention designed to prevent excessive gestational weight gain (GWG), and promote positive psychosocial and motivational outcomes in comparison with an Education Alone (EA) group.
Randomized-controlled trial.
Two hundred and sixty-one women who were <18 weeks pregnant consented to take part. Those allocated to the HC group received a tailored HC intervention delivered by a Health Coach, whilst those in the EA group attended two education sessions. Women completed measures, including motivation, psychosocial variables, sleep quality, and knowledge, beliefs and expectations concerning GWG, at 15 weeks of gestation (Time 1) and 33 weeks of gestation (Time 2). Post-birth data were also collected at 2 months post-partum (Time 3).
There was no intervention effect in relation to weight gained during pregnancy, rate of excessive GWG or birth outcomes. The only differences between HC and EA women were higher readiness (b = 0.29, 95% CIs = 0.03-0.55, p < .05) and the importance to achieve a healthy GWG (b = 0.27, 95% CIs = 0.02-0.52, p < .05), improved sleep quality (b = -0.22, 95% CIs = -0.44 to -0.03, p < .05), and increased knowledge for an appropriate amount of GWG that would be best for their baby's health (b = -1.75, 95% CI = -3.26 to -0.24, p < .05) reported by the HC at Time 2.
Whilst the HC intervention was not successful in preventing excessive GWG, several implications for the design of future GWG interventions were identified, including the burden of the intervention commitment and the use of weight monitoring.
What is already known on the subject? Designing interventions to address gestational weight gain (GWG) continues to be a challenge. To date, health behaviour change factors have not been the focus of GWG interventions. What does this study add? Our health coaching (HC) intervention did not reduce GWG more so than education alone (EA). There was an intervention effect on readiness and importance to achieve healthy GWG. Yet there were no group differences regarding confidence to achieve healthy GWG post-intervention.
本研究的目的是评估一项旨在预防孕期体重过度增加(GWG)并促进积极心理社会和动机结果的健康指导(HC)干预措施的效果,并与单纯教育(EA)组进行比较。
随机对照试验。
261名怀孕小于18周的女性同意参与。分配到HC组的女性接受由健康指导师提供的量身定制的HC干预,而EA组的女性参加两次教育课程。女性在妊娠15周(时间1)和妊娠33周(时间2)时完成了相关测量,包括动机、心理社会变量、睡眠质量以及关于GWG的知识、信念和期望。产后2个月(时间3)也收集了产后数据。
在孕期体重增加、过度GWG率或出生结局方面没有干预效果。HC组和EA组女性之间的唯一差异在于,HC组在时间2时报告的准备度更高(b = 0.29,95%置信区间 = 0.03 - 0.55,p <.05)以及实现健康GWG的重要性更高(b = 0.27,95%置信区间 = 0.02 - 0.52,p <.05),睡眠质量有所改善(b = -0.22,95%置信区间 = -0.44至 -0.03,p <.05),并且对于适合其宝宝健康的GWG适量增加的知识有所增加(b = -1.75,95%置信区间 = -3.26至 -0.24,p <.05)。
虽然HC干预未能成功预防过度GWG,但确定了对未来GWG干预设计的若干启示,包括干预承诺的负担和体重监测的使用。
关于该主题已知的内容是什么?设计解决孕期体重增加(GWG)的干预措施仍然是一项挑战。迄今为止,健康行为改变因素尚未成为GWG干预的重点。本研究增加了什么?我们的健康指导(HC)干预在降低GWG方面并不比单纯教育(EA)更有效。在实现健康GWG的准备度和重要性方面存在干预效果。然而,干预后在实现健康GWG的信心方面没有组间差异。