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Effectiveness of a Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Randomized Controlled Trial

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Sandborg, Johanna, Söderström, Emmie, Henriksson, Pontus, Bendtsen, Marcus, Henström, Maria, Leppänen, Marja H, Maddison, Ralph, Migueles, Jairo H +2 more·2021·JMIR mHealth and uHealth
DOI 10.2196/26091PMC PMC7995071

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Abstract

Background: Excessive gestational weight gain (GWG) during pregnancy is a major public health concern associated with negative health outcomes for both mother and child. Scalable interventions are needed, and digital interventions have the potential to reach many women and promote healthy GWG. Most previous studies of digital interventions have been small pilot studies or have not included women from all BMI categories. We therefore examined the effectiveness of a smartphone app in a large sample (n=305) covering all BMI categories. Objective: To investigate the effectiveness of a 6-month intervention (the HealthyMoms app) on GWG, body fatness, dietary habits, moderate-to-vigorous physical activity (MVPA), glycemia, and insulin resistance in comparison to standard maternity care. Methods: A 2-arm parallel randomized controlled trial was conducted. Women in early pregnancy at maternity clinics in Östergötland, Sweden, were recruited. Eligible women who provided written informed consent completed baseline measures, before being randomized in a 1:1 ratio to either an intervention (n=152) or control group (n=153). The control group received standard maternity care while the intervention group received the HealthyMoms smartphone app for 6 months (which includes multiple features, eg, information; push notifications; self-monitoring; and feedback features for GWG, diet, and physical activity) in addition to standard care. Outcome measures were assessed at Linköping University Hospital at baseline (mean 13.9 [SD 0.7] gestational weeks) and follow-up (mean 36.4 [SD 0.4] gestational weeks). The primary outcome was GWG and secondary outcomes were body fatness (Bod Pod), dietary habits (Swedish Healthy Eating Index) using the web-based 3-day dietary record Riksmaten FLEX, MVPA using the ActiGraph wGT3x-BT accelerometer, glycemia, and insulin resistance. Results: Overall, we found no statistically significant effect on GWG (P=.62); however, the data indicate that the effect of the intervention differed by pre-pregnancy BMI, as women with overweight and obesity before pregnancy gained less weight in the intervention group as compared with the control group in the imputed analyses (–1.33 kg; 95% CI –2.92 to 0.26; P=.10) and completers-only analyses (–1.67 kg; 95% CI –3.26 to –0.09; P=.031]). Bayesian analyses showed that there was a 99% probability of any intervention effect on GWG among women with overweight and obesity, and an 81% probability that this effect was over 1 kg. The intervention group had higher scores for the Swedish Healthy Eating Index at follow-up than the control group (0.27; 95% CI 0.05-0.50; P=.017). We observed no statistically significant differences in body fatness, MVPA, glycemia, and insulin resistance between the intervention and control group at follow up (P≥.21). Conclusions: Although we found no overall effect on GWG, our results demonstrate the potential of a smartphone app (HealthyMoms) to promote healthy dietary behaviors as well as to decrease weight gain during pregnancy in women with overweight and obesity. Trial Registration: ClinicalTrials.gov NCT03298555; https://clinicaltrials.gov/ct2/show/NCT03298555 International Registered Report Identifier (IRRID): RR2-10.2196/13011

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Authors
Sandborg, J., Söderström, E., Henriksson, P., Bendtsen, M., Henström, M., Leppänen, M. H., Maddison, R., Migueles, J. H., Blomberg, M., & Löf, M.
Affiliations
  • Linköping University (SE)
  • Karolinska Institutet (SE)
  • University of Helsinki (FI)
  • Deakin University (AU)
Corresponding author
Sandborg, Johanna
ORCID
Venue
JMIR mHealth and uHealth
Publisher
JMIR Publications Inc.
Published
2021-03-11
Volume
9
Issue
3
Pages
e26091
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/26091
PMC
PMC7995071
OpenAlex
W3133957422
Cited by
139
References
7
Citations by year
2026: 29 · 2025: 21 · 2024: 38 · 2023: 28 · 2022: 20 · 2021: 3
FWCI
25.00
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DiVA (Linkoping University) (submittedVersion, other-oa)
  • Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Työväentutkimus Vuosikirja (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
gestational weight gain, mobile application, digital health interventions, pregnancy, maternal obesity, pre-pregnancy body mass index, dietary habits, physical activity, glycemia, insulin resistance, adiposity, self-monitoring, push notifications, obstetric care, maternal health promotion, accelerometer-measured activity, glycemic control
MeSH terms
Smartphone, Bayes Theorem, Child, Diet, Female, Humans, Maternal Health Services, Pregnancy, Sweden, Weight Gain, Exercise, Mobile Applications

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