Design of a novel digital intervention to promote healthy weight management among postpartum African American women

Abstract

BackgroundExcess weight retention among postpartum women is a risk factor for long term obesity, and African American women are at heightened risk. New solutions, including digital technologies and community-based approaches are needed. Digital platforms, like social media, provide opportunity for participant co-creation (i.e., content co-generated by users and investigators) of health messages and may allow for adaptation of evidence-based weight management interventions to reduce participant burden. The BeFAB intervention, a branded, digital weight management program, tests this hypothesis.MethodsBeFAB content comprises culturally-specific nutrition, physical activity, stress management, health information seeking and related weight management messages and content designed for African American women. The intervention is 12 weeks in duration, delivered through a mobile phone app, and is designed to target specific behavioral predictor beliefs and attitudinal measures (e.g., self-efficacy to achieve weight management goals) based on the culturally-specific content. Use of personal, culturally-specific video-based narratives in the app, and through a secret Facebook group, are included to help model HEAL behaviors and brand BeFAB. Intervention development consisted of iterative formative research steps to engage African American women. The program will be evaluated in a small randomized trial among patients recruited at a clinical facility.ConclusionsBeFAB applies evidence-based content using a promising digital approach. It is novel in its use of branding, culturally-tailored content, and digital technology for behavior change.Evaluation of BeFAB will contribute to the growing literature on digital health behavior change interventions for weight management.

Feasibility of a Digital Intervention to Promote Healthy Weight Management among Postpartum African American/Black Women

“…This study was a 3 month feasibility study to examine the implementation of a digital healthy body weight program for postpartum AA/Black women ( n = 136). The sample size was determined based on detecting a mean weight loss difference of 4.45 kg between the groups, and assumed an attrition rate of 20% [ 27 ]. This study was approved by the Institutional Review Board at The George Washington University (#091732), with an Interagency Agreement with MedStar Hospital Center.…”

“…Lesson topics were tailored to the social and familial context of having a new baby along with formative work identifying key social, cultural and environmental factors. A community advisory board was convened providing additional input and feedback on the lessons and proposed focus (for more detail, see Evans et al [ 27 ]). Sample content topics included “Tip the Calorie Balance”, “Being Active with Family”, and “Stress, Family, and Weight”.…”

“…In-app messages were delivered five days per week on topics such as making over meals, managing cravings, and tips on how to be creative and fit in physical activity. Participants could track their weight and receive feedback ( Figure 2 ), and also had the ability to choose one of six nutrition goals weekly (e.g., “Limit sugary drinks like juice and soda to no more than 1 per day, Limit junk and high fat foods to no more than 1 per day”) and one of six physical activity goals weekly (e.g., “Do 30 min of physical activity like walking or working around the house, Watch less than 2 h of TV per day”) and monitor their progress on those goals (see Figure 3 ; for more detail, see Evans et al [ 27 ]). Participants received virtual “badges” such as the “Healthy Me” badge for meeting self-monitoring milestones (see Figure 4 ).…”

“…This article describes the feasibility of implementing a digital healthy body weight intervention designed for postpartum AA/Black women: BeFAB (Be Fabulous After Baby, with a dual meaning of Be Fit After Baby) [ 27 ]. Feasibility metrics include recruitment, retention and engagement, and acceptability.…”

Building Strong Futures: The Feasibility of Using a Targeted Digital Media Campaign to Improve Knowledge About Pregnancy and Low Birthweight Among Black Women

“…With the COVID-19 pandemic shifting many in-person programs to offer virtual options, digitally-based interventions offer an enticing way to achieve positive pregnancy-related behavior changes on a larger scale. Digital interventions have shown promise in promoting breastfeeding, blood pressure monitoring, and healthy weight management among pregnant and postpartum women (Evans et al 2019 ; Rivera-Romero et al 2018 ; Dauphin 2020 ). Digitally-based interventions also take into account the fact that women report frequently using the internet to look for health information during pregnancy (Graham et al 2019 ; Lupton 2016 ).…”