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基于习惯的干预措施的制定,以支持超重或肥胖孕妇的健康饮食和身体活动行为:怀孕和产后的健康习惯(HHIPBe)。

Development of a habit-based intervention to support healthy eating and physical activity behaviours for pregnant women with overweight or obesity: Healthy Habits in Pregnancy and Beyond (HHIPBe).

机构信息

Centre for Public Health, Institute for Global Food Security, Institute of Clinical Sciences, Queen's University Belfast, Royal Victoria Hospital, Block A, Belfast, UK.

Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK.

出版信息

BMC Pregnancy Childbirth. 2024 Nov 16;24(1):760. doi: 10.1186/s12884-024-06945-7.

Abstract

BACKGROUND

The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG.

METHODS

A previous habit-based intervention 'Ten Top Tips for a Healthy Weight' (10TT) was adapted and made suitable for pregnancy in line with the Medical Research Council's (MRC) complex intervention development guidelines. It involved three key activities: (1) identifying the evidence base; (2) identifying appropriate theory; and, (3) modelling processes. A core element was integrating lived experience via personal and public involvement (PPI).

RESULTS

The original 10TTs were adapted with PPI in line with current advice on nutrition and physical activity in pregnancy. New intervention materials were devised, including a leaflet and a logbook and app for self-monitoring to be delivered alongside a brief 1:1 conversation. Behaviour change techniques (BCTs) included in the new materials were coded using a number of behavioural taxonomies. An E-learning resource was created to help standardise the approach to delivery of the intervention and avoid stigmatising conversations.

CONCLUSION

Following MRC guidance for the development of complex interventions alongside significant PPI allowed for the adaption of 10TT habit-based weight management intervention into the 'Healthy Habits in Pregnancy and Beyond' (HHIPBe) intervention. The feasibility and acceptability of implementing this intervention in the antenatal setting will be explored in a feasibility randomised controlled trial.

TRIAL REGISTRATION

This study was registered on Clinical Trials as 'Healthy Habits in Pregnancy and Beyond (HHIPBe)' ClinicalTrials.gov Identifier: NCT04336878. The study was registered on 07/04/2020.

摘要

背景

越来越多的女性在怀孕时超重或肥胖。这会增加过度妊娠体重增加(GWG)的风险,这与母婴的健康并发症有关。在产前保健环境中,鼓励健康饮食和体育活动行为并支持女性管理 GWG 的循证干预措施有限。

方法

之前的基于习惯的干预措施“健康体重的十大秘诀”(10TT)根据医学研究委员会(MRC)的复杂干预措施制定指南进行了改编和适用于怀孕。它涉及三个关键活动:(1)确定证据基础;(2)确定适当的理论;和,(3)建模过程。一个核心要素是通过个人和公众参与(PPI)整合生活经验。

结果

根据当前关于妊娠期间营养和体育活动的建议,对原始的 10TT 进行了改编,并纳入了 PPI。设计了新的干预材料,包括小册子和日志以及自我监测的应用程序,与简短的 1:1 对话一起提供。新材料中包含的行为改变技术(BCT)使用了许多行为分类法进行编码。创建了一个电子学习资源,以帮助标准化干预措施的提供方法并避免污名化对话。

结论

根据 MRC 关于复杂干预措施制定的指南以及重要的 PPI,将基于习惯的 10TT 体重管理干预措施改编为“怀孕和以后的健康习惯”(HHIPBe)干预措施。将此干预措施在产前环境中实施的可行性和可接受性将在一项可行性随机对照试验中进行探讨。

试验注册

本研究在临床试验中注册为“怀孕和以后的健康习惯(HHIPBe)”,临床试验.gov 标识符:NCT04336878。该研究于 2020 年 4 月 7 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/445c/11568677/4100f0d83d63/12884_2024_6945_Fig1_HTML.jpg

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