Graham Meredith Leigh, Strawderman Myla S, Demment Margaret, Olson Christine Marie
Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States.
Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, United States.
J Med Internet Res. 2017 Jan 9;19(1):e6. doi: 10.2196/jmir.6644.
Excessive gestational weight gain (GWG) contributes to the development of obesity in mother and child. Internet-based interventions have the potential for delivering innovative and interactive options for prevention of excessive GWG to large numbers of people.
The objective of this study was to create a novel measure of Internet-based intervention usage patterns and examine whether usage of an Internet-based intervention is associated with reduced risk of excessive GWG.
The website featured blogs, local resources, articles, frequently asked questions (FAQs), and events that were available to women in both the intervention and control arm. Weekly reminders to use the website and to highlight new content were emailed to participants in both arms. Only intervention arm participants had access to the weight gain tracker and diet and physical activity goal-setting tools. A total of 1335 (898 intervention and 437 control) relatively diverse and healthy pregnant women were randomly assigned to the intervention arm or control arm. Usage patterns were examined for both intervention and control arm participants using latent class analysis. Regression analyses were used to estimate the association between usage patterns and three GWG outcomes: excessive total GWG, excessive GWG rate, and GWG.
Five usage patterns best characterized the usage of the intervention by intervention arm participants. Three usage patterns best characterized control arm participants' usage. Control arm usage patterns were not associated with excessive GWG, whereas intervention arm usage patterns were associated with excessive GWG.
The control and intervention arm usage pattern characterization is a unique methodological contribution to process evaluations for self-directed Internet-based interventions. In the intervention arm some usage patterns were associated with GWG outcomes.
ClinicalTrials.gov; Clinical Trials Number: NCT01331564; https://clinicaltrials.gov/ct2/show/NCT01331564 (Archived by WebCite at http://www.webcitation/6nI9LuX9w).
孕期体重增加过多（GWG）会导致母亲和儿童肥胖。基于互联网的干预措施有可能为大量人群提供预防孕期体重增加过多的创新和互动选择。
本研究的目的是创建一种基于互联网干预使用模式的新测量方法，并检验基于互联网的干预措施的使用是否与降低孕期体重增加过多的风险相关。
该网站设有博客、当地资源、文章、常见问题解答（FAQs）以及干预组和对照组女性均可访问的活动。每周都会向两组参与者发送使用该网站和突出显示新内容的提醒邮件。只有干预组参与者可以使用体重增加追踪器以及饮食和身体活动目标设定工具。共有1335名（898名干预组和437名对照组）相对多样化且健康的孕妇被随机分配到干预组或对照组。使用潜在类别分析检查干预组和对照组参与者的使用模式。回归分析用于估计使用模式与三种孕期体重增加结果之间的关联：孕期总体重增加过多、孕期体重增加率过高以及孕期体重增加。
五种使用模式最能描述干预组参与者对干预措施的使用情况。三种使用模式最能描述对照组参与者的使用情况。对照组的使用模式与孕期体重增加过多无关，而干预组的使用模式与孕期体重增加过多有关。
对照组和干预组使用模式的特征描述是对基于互联网的自主干预措施过程评估的独特方法学贡献。在干预组中，一些使用模式与孕期体重增加结果相关。
ClinicalTrials.gov；临床试验编号：NCT01331564；https://clinicaltrials.gov/ct2/show/NCT01331564（由WebCite存档于http://www.webcitation/6nI9LuX9w）。
