Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial

Abstract

Background Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight. Methods Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain. Results Treatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain. Conclusions The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy. Trial registration This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518

Enhancing Quality of Life through a Supervised Cardiac Rehabilitation Program along with a conventional conditioning exercise program at home in Cardiovascular Disease Patients

“…[13] Improving QOL can help patients to manage their symptoms better, adhere to their treatment plans, and enjoy a more fulfilling life. [13,14] Cardiac rehabilitation programs can play a key role in improving QOL in CVD patients. These programs typically include exercise training, education on CVD risk factors and lifestyle modifications, and psychological support.…”

“…[3][4][5][6][7] By improving QOL, cardiac rehabilitation can help to reduce morbidity and mortality in patients with CVD. [1,9,14] The growing body of evidence supports cardiac rehabilitation programs' beneficial effects on cardiovascular disease patients' quality of life. [7][8][9][10][11][12] Cardiac rehabilitation programs are designed to help patients with cardiovascular disease improve their physical and psychological well-being through exercise, education, and counseling.…”