Institute of Sport Science, University of Graz, 8010 Graz, Austria.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, 1081 BT Amsterdam, The Netherlands.
Nutrients. 2019 Feb 1;11(2):311. doi: 10.3390/nu11020311.
A better understanding of what drives behaviour change in obese pregnant overweight women is needed to improve the effectiveness of lifestyle interventions in this group at risk for gestational diabetes (GDM). Therefore, we assessed which factors mediated behaviour change in the Vitamin D and Lifestyle Intervention for GDM Prevention (DALI) Lifestyle Study. A total of 436 women, with pre-pregnancy body mass index ≥29 kg/m², ≤19 + 6 weeks of gestation and without GDM, were randomised for counselling based on motivational interviewing (MI) on healthy eating and physical activity, healthy eating alone, physical activity alone, or to a usual care group. Lifestyle was measured at baseline, and at 24⁻28 and 35⁻37 weeks of gestation. Outcome expectancy, risk perception, task self-efficacy and social support were measured at those same time points and considered as possible mediators of intervention effects on lifestyle. All three interventions resulted in increased positive outcome expectancy for GDM reduction, perceived risk to the baby and increased task self-efficacy. The latter mediated intervention effects on physical activity and reduced sugared drink consumption. In conclusion, our MI intervention was successful in increasing task self-efficacy, which was related to improved health behaviours.
为了提高针对患有妊娠期糖尿病（GDM）风险的肥胖超重孕妇的生活方式干预措施的有效性，需要更好地了解哪些因素可以促使肥胖孕妇超重女性改变行为。因此，我们评估了维生素 D 和生活方式干预预防 GDM（DALI）生活方式研究中哪些因素可以调节行为变化。共有 436 名女性，其孕前体重指数≥29kg/m²，妊娠≤19+6 周，且无 GDM，随机分为基于动机访谈（MI）的健康饮食和身体活动咨询组、单纯健康饮食组、单纯身体活动组或常规护理组。在基线时、妊娠 24-28 周和 35-37 周时测量生活方式。在同一时间点测量结果预期、风险感知、任务自我效能和社会支持，并将其视为干预措施对生活方式影响的可能中介因素。所有三种干预措施都导致了对 GDM 减少的积极结果预期、对婴儿的风险感知增加和任务自我效能的提高。后者调节了对身体活动的干预效果，并减少了含糖饮料的摄入。总之，我们的 MI 干预成功地提高了任务自我效能，这与改善健康行为有关。
