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Cited by 51Gestational Diabetes Research and ManagementMobile Health and mHealth ApplicationsObesity, Physical Activity, Diet

Adaptive, behavioral intervention impact on weight gain, physical activity, energy intake, and motivational determinants: results of a feasibility trial in pregnant women with overweight/obesity

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Downs, Danielle Symons, Savage, Jennifer S., Rivera, Daniel E., Pauley, Abigail M., Leonard, Krista S., Hohman, Emily E., Guo, Penghong, McNitt, Katherine M. +2 more·2021·Journal of Behavioral Medicine
DOI 10.1007/s10865-021-00227-9PMC PMC9764232
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Abstract

Interventions have modest impact on reducing excessive gestational weight gain (GWG) in pregnant women with overweight/obesity. This two-arm feasibility randomized control trial tested delivery of and compliance with an intervention using adapted dosages to regulate GWG, and examined pre-post change in GWG and secondary outcomes (physical activity: PA, energy intake: EI, theories of planned behavior/self-regulation constructs) compared to a usual care group. Pregnant women with overweight/obesity (N = 31) were randomized to a usual care control group or usual care + intervention group from 8 to 2 weeks gestation and completed the intervention through 36 weeks gestation. Intervention women received weekly evidence-based education/counseling (e.g., GWG, PA, EI) delivered by a registered dietitian in a 60-min face-to-face session. GWG was monitored weekly; women within weight goals continued with education while women exceeding goals received more intensive dosages (e.g., additional hands-on EI/PA sessions). All participants used mHealth tools to complete daily measures of weight (Wi-Fi scale) and PA (activity monitor), weekly evaluation of diet quality (MyFitnessPal app), and weekly/monthly online surveys of motivational determinants/self-regulation. Daily EI was estimated with a validated back-calculation method as a function of maternal weight, PA, and resting metabolic rate. Sixty-five percent of eligible women were randomized; study completion was 87%; 10% partially completed the study and drop-out was 3%. Compliance with using the mHealth tools for intensive data collection ranged from 77 to 97%; intervention women attended > 90% education/counseling sessions, and 68-93% dosage step-up sessions. The intervention group (6.9 kg) had 21% lower GWG than controls (8.8 kg) although this difference was not significant. Exploratory analyses also showed the intervention group had significantly lower EI kcals at post-intervention than controls. A theoretical, adaptive intervention with varied dosages to regulate GWG is feasible to deliver to pregnant women with overweight/obesity.

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Cited by

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Authors
Downs, D. S., Savage, J. S., Rivera, D. E., Pauley, A. M., Leonard, K. S., Hohman, E. E., Guo, P., McNitt, K. M., Stetter, C., & Kunselman, A.
Affiliations
  • Pennsylvania State University (US)
  • Arizona State University (US)
Corresponding author
Downs, Danielle Symons
ORCID
Venue
Journal of Behavioral Medicine
Publisher
Springer Science and Business Media LLC
Published
2021-05-05
Volume
44
Issue
5
Pages
605-621
ISSN
  • 0160-7715 (ISSN-L)
  • 1573-3521
DOI
10.1007/s10865-021-00227-9
PMC
PMC9764232
OpenAlex
W3157249336
Cited by
51
References
9
Citations by year
2026: 6 · 2025: 11 · 2024: 10 · 2023: 9 · 2022: 10 · 2021: 4 · 2020: 1
FWCI
7.48
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Behavioral Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Heart, Lung, and Blood Institute (1 R01 HL119245-01)
  • National Center for Advancing Translational Sciences (UL1 TR000127 and TR002014)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
gestational weight gain, maternal obesity, overweight in pregnancy, adaptive interventions, behavioral interventions, physical activity, energy intake, self-regulation, motivational factors, mobile health, dietitian counseling, intervention feasibility
MeSH terms
Energy Intake, Feasibility Studies, Female, Humans, Obesity, Pregnancy, Pregnancy Complications, Weight Gain, Exercise, Pregnant People, Pregnant Women, Overweight

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