Effect of a Short Message Service Intervention on Excessive Gestational Weight Gain in a Low-Income Population: A Randomized Controlled Trial

Abstract

Objectives: The objective of this trial was to investigate the effect of educational short message service (SMS), or text messages, on excessive gestational weight gain (GWG) in a low-income, predominantly overweight/obese population. Methods: Participants (n = 83) were mostly overweight/obese women recruited at Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics on the island of O’ahu, Hawai’i at 15–20 weeks gestational age. The intervention group received SMS on nutrition and physical activity during pregnancy designed to help them meet Institute of Medicine (IOM) guidelines for GWG and American College of Obstetricians and Gynecologists guidelines for exercise, respectively. The control group received SMS about general health topics during pregnancy, excluding nutrition and physical activity. Both groups received one text message per week for eighteen weeks. GWG was defined as the difference between the last self-reported weight taken before delivery and participants’ self-reported weight before pregnancy. Differences between study groups were examined using t-tests and Chi-square tests. Linear regression models were used to examine association of GWG with study group and other factors. Results: GWG was similar (p = 0.58) in the control group (14.1 ± 11.4 kg) and the intervention group (15.5 ± 11.6 kg). The percentage of participants exceeding IOM guidelines for GWG was similar (p = 0.51) in the control group (50.0%, n = 17) and the intervention group (60.5%, n = 23). Conclusions: GWG was not significantly different between intervention and control groups. Trials that begin earlier in pregnancy or before pregnancy with longer intervention durations and varying message frequency as well as personalized or interactive messages may be needed to produce significant improvements.

Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy

“…This is in contrast to previous studies that have shown ineffective outcomes, particularly those focusing on online dietary interventions [ 10 , 11 , 12 , 13 , 14 ], which mainly provide static text or video information with limited incorporation of interactive information consultations or regular text responses. However, the acquisition of dietary information does not inherently impart healthy dietary knowledge and skills.…”

“…Therefore, promoting dietary behaviors during pregnancy becomes crucial for enhancing the health of pregnant women. However, over time, many studies on dietary interventions during pregnancy have yielded mixed results, particularly a significant portion of online dietary intervention studies show no effect [ 10 , 11 , 12 , 13 , 14 ]. This may be related to insufficient key components in the intervention design, which may not have effectively addressed the critical barriers in pregnant women’s health dietary practices [ 15 ].…”

Telehealth for healthy gestational weight gain among overweight pregnant women: A systematic review

“…Only three of the 15 included articles were qualitative studies Tinius et al, 2021). Among the quantitative papers, 11 were RCTs (Ainscough et al, 2020;Dodd et al, 2018;Ferrara et al, 2020;Gonzalez-Plaza et al, 2022;Henriksson et al, 2022;Holmes et al, 2020;Mackeen et al, 2022;Olson et al, 2018;Van Horn et al, 2018;Zhou et al, 2020). Our review revealed a cohort study assessing an intervention promoting healthy nutrition, physical activity, and gestational weight gain (GWG).…”

A Review of the Clinician’s Role in Women’s Weight Management and Implications for Women’s Health and Pregnancy Outcomes

“…Women who received this behavioral therapy intervention gained less weight than women who did not (8.7 kg vs 12.3 kg; adjusted mean difference, −3.1 kg; 95% CI, −6.2 to −0.1), and the number of women who gained excessive weight in the intervention group was lower than that of women in the control group (37% vs 66%, P = 0.033) 47 . In contrast, a study of mostly overweight and obese women in Hawaii in which the intervention group received text messages concerning diet quality and quantity and exercise recommendations found no significant difference in GWG or the proportion with excess GWG, suggesting that the use of text messages may not be an effective intervention treatment, or the frequency of text messages may need to increase to be more effective 62 . Another Internet/smart phone–based intervention using a weight gain tracker and dietary and exercise tools to set and monitor goals found no effect 63 .…”

“…47 In contrast, a study of mostly overweight and obese women in Hawaii in which the intervention group received text messages concerning diet quality and quantity and exercise recommendations found no significant difference in GWG or the proportion with excess GWG, suggesting that the use of text messages may not be an effective intervention treatment, or the frequency of text messages may need to increase to be more effective. 62 Another Internet/smart phone-based intervention using a weight gain tracker and dietary and exercise tools to set and monitor goals found no effect. 63 A small study (n = 54) tested in-person versus Internet/smart phone counseling and reported that both equally lowered the proportion of women with excess GWG compared with the control group.…”