Coughlin J W, Martin L M, Henderson J, Dalcin A T, Fountain J, Wang N-Y, Appel L J, Clark J M, Bennett W
Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA.
Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA.
Obes Sci Pract. 2020 Jul 16;6(5):484-493. doi: 10.1002/osp4.438. eCollection 2020 Oct.
Gestational weight gain (GWG) and postpartum weight retention (PPWR) are significant, potentially modifiable, contributors to women's future weight and health trajectories. There is a need for feasible and patient-centered (i.e., convenient, remotely-delivered, technology-enhanced, and accessible through the prenatal care setting) behavioural interventions that limit GWG and PPWR. This study tests the feasibility and acceptability of a remotely-delivered behavioural health coaching intervention to limit gestational weight gain and postpartum weight retention.
Pregnant women (11-16 weeks gestation) were recruited from two prenatal clinics and randomized to the active intervention or health education comparison group. Completion of the program was monitored and perceived helpfulness was rated (0-100).
Twenty-six women were randomized ( = 13 per arm; mean age = 31.6 years, SD = 3.6; mean BMI = 26.7 kg/m, SD = 7.4). Participants completed a median of 18 coaching calls and 16/19 learning activities during pregnancy, and a median of 6 calls and 5/6 learning activities postpartum. They logged weights at least once/week for a median of 36/38 expected weeks and tracked daily calories and exercise for a median of 154/266 days and 72/266 days, respectively. Median (Q1, Q3) helpfulness ratings of the program during pregnancy were 80 (64, 91) and 62 (50, 81) postpartum; helpfulness ratings of coaching calls were 85 (58, 98). At 37 weeks gestation, 77% of participants achieved IOM weight gain recommendations compared to 54% in the comparison group.
This study provides evidence for the feasibility and acceptability of a remotely-delivered behavioural weight control intervention in pregnancy and postpartum.
孕期体重增加（GWG）和产后体重滞留（PPWR）是影响女性未来体重和健康轨迹的重要因素，且具有潜在的可调节性。需要可行的、以患者为中心（即方便、远程提供、技术增强且可通过产前护理机构获得）的行为干预措施来限制GWG和PPWR。本研究测试了一种远程提供的行为健康指导干预措施在限制孕期体重增加和产后体重滞留方面的可行性和可接受性。
从两家产前诊所招募怀孕11至16周的孕妇，并随机分为积极干预组或健康教育对照组。对项目完成情况进行监测，并对感知到的帮助程度进行评分（0至100）。
26名女性被随机分组（每组13人；平均年龄 = 31.6岁，标准差 = 3.6；平均体重指数 = 26.7kg/m，标准差 = 7.4）。参与者在孕期完成了中位数为18次指导通话和16/19次学习活动，产后完成了中位数为6次通话和5/6次学习活动。她们至少每周记录一次体重，中位数为预期的36/38周，分别跟踪每日卡路里摄入量和运动量，中位数为154/266天和72/266天。孕期该项目的中位数（四分位距1，四分位距3）帮助评分分别为80（64，91）和产后62（50，81）；指导通话的帮助评分为85（58，98）。在妊娠37周时，77%的参与者达到了美国医学研究所（IOM）的体重增加建议，而对照组为54%。
本研究为孕期和产后远程提供的行为体重控制干预措施的可行性和可接受性提供了证据。
