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促进妊娠期体重适当增加的行为干预的可行性和效果。

The Feasibility and Efficacy of a Behavioral Intervention to Promote Appropriate Gestational Weight Gain.

机构信息

Saginaw Valley State University, 7400 Bay Road, University Center, MI, 48710, USA.

Michigan State University, East Lansing, MI, USA.

出版信息

Matern Child Health J. 2019 Dec;23(12):1604-1612. doi: 10.1007/s10995-019-02812-6.

Abstract

INTRODUCTION

Nearly half of all women gain above gestational weight gain (GWG) recommendations. This study assessed the feasibility and efficacy of a pilot behavioral intervention on GWG and physical activity behaviors.

METHODS

Women (n = 45) 14-20 weeks gestation enrolled in a behavioral intervention. Physicians 'prescribed' the intervention to low risk patients. The intervention included self-monitoring, support, and optional walking groups. Process evaluation measures regarding usage and acceptability of study components were obtained. Physical activity was objectively measured at baseline and 35 weeks. The percentage of participants with appropriate GWG was calculated. Control data was obtained from the same clinic where participants were recruited.

RESULTS

Overall, the intervention was acceptable to participants; attrition was low (6.7%), weekly contact was high (87%), and self-monitoring was high (Fitbit worn on 82% of intervention weeks; weekly weighing on 81%). Facebook (40% of weeks) and study website use (19%) was low, as was walking group attendance (7% attended a single group). Participants reported a lack of discussions about the study with their physician. Results showed no significant difference between intervention and control participants in the percentage who gained excess weight (p = 0.37). There was a significant decrease in moderate-to-vigorous physical activity in intervention participants (p < 0.0001).

DISCUSSION

Continued efforts for promoting physical activity and appropriate GWG are needed. Although acceptable, the intervention was not efficacious. Trainings for, or input from prenatal healthcare providers on how to best encourage and support patients' engagement in healthy behaviors, such as PA, are warranted.

摘要

简介

近一半的女性体重增加超过妊娠体重增加(GWG)建议。本研究评估了一项针对 GWG 和身体活动行为的试点行为干预的可行性和效果。

方法

妊娠 14-20 周的女性(n=45)参加了行为干预。医生向低危患者“开”出干预处方。干预包括自我监测、支持和可选的步行小组。获得了关于研究组件使用情况和可接受性的过程评估措施。在基线和 35 周时对身体活动进行了客观测量。计算了具有适当 GWG 的参与者的百分比。控制数据来自参与者招募的同一诊所。

结果

总的来说,干预措施对参与者是可接受的;流失率低(6.7%),每周接触率高(87%),自我监测率高(Fitbit 在 82%的干预周佩戴;每周称重 81%)。Facebook(40%的周)和研究网站的使用(19%)较低,步行小组的出勤率(7%参加了一个小组)也较低。参与者报告说,他们与医生就该研究没有进行讨论。结果显示,干预组和对照组参与者体重增加过多的百分比没有显著差异(p=0.37)。干预组参与者的中等到剧烈的身体活动显著减少(p<0.0001)。

讨论

需要继续努力促进身体活动和适当的 GWG。尽管可以接受,但干预措施没有效果。需要对产前保健提供者进行培训,或征求他们的意见,了解如何最好地鼓励和支持患者参与健康行为,如 PA。

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