Feasibility and acceptability of a remotely‐delivered behavioural health coaching intervention to limit gestational weight gain

Coughlin, Janelle W.; Martin, Lindsay; Henderson, Janice; Dalcin, Arlene; Fountain, Julia; Wang, Nae Yuh; Appel, Lawrence J.; Clark, Jeanne M.; Bennett, Wendy L

doi:10.1002/osp4.438

Cited by 13 publications

(23 citation statements)

References 56 publications

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“…The usability of the Mi Fit app linked to the smartband in our study was evaluated as excellent, as in the RCT Fit4two [ 42 ]. We observed that satisfaction with the messages and midwife support through the app was very high, and the acceptability of the intervention agreed with other RCTs in women who were pregnant and overweight and had obesity, such as SMARTMOMS [ 43 ], txt4two [ 44 ], or studies with women who were pregnant and had any BMI, such as RCT Interact [ 45 ] and the RCTs of Choi et al [ 46 ] and Coughlin et al [ 47 ].…”

Section: Discussionsupporting

confidence: 77%

Effectiveness of a Step Counter Smartband and Midwife Counseling Intervention on Gestational Weight Gain and Physical Activity in Pregnant Women With Obesity (Pas and Pes Study): Randomized Controlled Trial

González-Plaza¹,

Bellart²,

Arranz³

et al. 2022

JMIR Mhealth Uhealth

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Background Women who are pregnant and have obesity and excessive gestational weight gain (GWG) present a higher risk of maternal and perinatal complications. The use of mobile apps and a wristband during pregnancy may contribute to promoting healthy lifestyles and, thus, improving maternal and neonatal health. Objective This study aims to evaluate the effectiveness of a complex digital health intervention, using a smartband and app with midwife counseling, on GWG and physical activity (PA) in women who are pregnant and have obesity and analyze its impact on maternal and perinatal outcomes. In addition, we aim to study the frequency of use, usability, and satisfaction with the mobile apps used by the women in the intervention group. Methods A parallel, 2-arm, randomized controlled trial was conducted. A total of 150 women who were pregnant and had obesity were included. The intervention group received a complex combined digital intervention. The intervention was delivered with a smartband (Mi Band 2) linked to the app Mi Fit to measure PA and the Hangouts app with the midwife to provide personal health information. The control group received usual care. The validated Spanish versions of the International Physical Activity Questionnaire–Short Form and the System Usability Scale were used. Satisfaction was measured on a 1- to 5-point Likert scale. Results We analyzed 120 women, of whom 30 (25%) were withdrawn because of the COVID-19 pandemic. The median GWG in the intervention group was 7.0 (IQR 4-11) kg versus 9.3 (IQR 5.9-13.3) kg in the control group (P=.04). The adjusted mean GWG per week was 0.5 (95% CI 0.4-0.6) kg per week in the control group and 0.3 (95% CI 0.3-0.4) kg per week in the intervention group (df=0.1, 95% CI −0.2 to 0.03; P=.008). During the 35 and 37 gestational weeks, women in the intervention group had higher mean PA than women in the control group (1980 metabolic equivalents of tasks–minutes per week vs 1386 metabolic equivalents of tasks–minutes per week, respectively; P=.01). No differences were observed between the study groups in the incidence of maternal and perinatal outcomes. In the intervention group, 61% (36/59) of the women who were pregnant used the smartband daily, and 75% (44/59) evaluated the usability of the Mi Fit app as excellent. All women in the intervention group used the Hangouts app at least once a week. The mean of the satisfaction scale with the health counseling app and midwife support was 4.8/5 (SD 0.6) points. Conclusions The use of a complex mobile health intervention was associated with adequate GWG, which was lower in the intervention group than in the control group. In addition, we observed that the intervention group had increases in PA. No differences were observed in maternal perinatal complications. Trial Registration ClinicalTrials.gov NCT03706872; https://www.clinicaltrials.gov/ct2/show/NCT03706872

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Section: Discussionsupporting

confidence: 77%

Effectiveness of a Step Counter Smartband and Midwife Counseling Intervention on Gestational Weight Gain and Physical Activity in Pregnant Women With Obesity (Pas and Pes Study): Randomized Controlled Trial

González-Plaza¹,

Bellart²,

Arranz³

et al. 2022

JMIR Mhealth Uhealth

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“…Team-based postpartum care extends outside of the usual clinic setting and can be useful for implementing lifestyle interventions such as postpartum weight management [85]. Involvement of behavioral health coaches for postpartum weight reduction has been found to be feasible and well accepted [86]. In addition, a prior trial showed that an internet-based weight loss program may be feasible and effective in postpartum women of lower income as part of supplement to the WIC program [87].…”

Section: Lifestyle Interventionsmentioning

confidence: 99%

The Fourth Trimester: a Time for Enhancing Transitions in Cardiovascular Care

Choi

Timlin

Varma

et al. 2022

Curr Cardiovasc Risk Rep

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Purpose of Review The “fourth trimester” concept, defined as the first 12 weeks after delivery (and beyond), is a critical window of time for clinicians to intervene to optimize women’s cardiovascular health after pregnancy. A timely and comprehensive postpartum cardiovascular assessment should be performed in all women following delivery in order to (1) follow up medical conditions present prior to conception, (2) evaluate symptoms and signs of common postpartum complications, and (3) identify risk factors and prevent future adverse cardiovascular outcomes. In this review, we aim to discuss major maternal cardiovascular risk factors such as hypertensive disorders of pregnancy, gestational diabetes mellitus, postpartum weight retention, and postpartum depression, as well as lactation as a potential protective risk modifying factor. Additionally, we will review effectiveness of outpatient interventions to enhance transitions in cardiovascular care during the fourth trimester. Recent Findings A seamless hand-off from obstetric to primary care, and potentially cardiology, is needed for early detection and management of hypertension, weight, glycemic control, stress and mood, and long-term cardiovascular risk. Additionally, the use of telemedicine, blood pressure self-monitoring, remote activity monitoring, and behavioral health coaches are potentially feasible modalities to augment clinic-based care for cardiovascular risk factors and weight management, but additional studies are needed to study their long-term effectiveness. Summary Development of a comprehensive postpartum care plan with careful consideration of each patient’s risk profile and access to resources is critical to improve maternal morbidity and mortality, reduce health disparities, and achieve long-term cardiovascular health for women. Supporting postpartum well-being of women during this transition period requires a multidisciplinary approach, especially primary care engagement, and planning should start before delivery.

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“…Bislang wurden einige Studien, vor allem Pilot-Projekte, auf den Weg gebracht. Ein Wirksamkeitsnachweis Appgestützter Lebensstilinterventionen steht aus, wobei erste Ergebnisse durchaus positiv zu bewerten sind [55,57,60]…”

Section: Digital-gestützte Lebensstilinterventionenunclassified

“…Methoden der Verhaltensänderung lassen sich sehr gut innerhalb von Smartphone-Apps anwenden. Selbstbeobachtung von Gesundheitsdaten in Verbindung mit Zielsetzungen und automatisiertem Feedback werden in einigen der laufenden und geplanten App-gestützten Interventionsstudien integriert 55 56 57 58 . Sogenannte „smarte Sensorik“, darunter Fitnesstracker und Bluetooth-Waagen, sind häufig mit den Apps verknüpft und erleichtern das Aufzeichnen von Gesundheitsdaten, wie Gewicht, Bewegung und Blutdruck.…”

Section: Lebensstilinterventiosstudien In Der Schwangerschaftunclassified

“…Bislang wurden einige Studien, vor allem Pilot-Projekte, auf den Weg gebracht. Ein Wirksamkeitsnachweis App-gestützter Lebensstilinterventionen steht aus, wobei erste Ergebnisse durchaus positiv zu bewerten sind 55 57 60 . In Deutschland bietet das neue digitale Versorgungsgesetz und die damit verbundene Möglichkeit für Ärzte digitale Gesundheitsanwendungen (DiGAs) als „Apps auf Rezept“ zu verschreiben, sowie die Einführung der elektronischen Patientenakte sinnvolle Rahmenbedingungen für zukünftige digitale Lösungen.…”

Section: Lebensstilinterventiosstudien In Der Schwangerschaftunclassified

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Adipositasprävention in den ersten 1000 Tagen

Raab

Geyer

Hauner

2022

Adipositas - Ursachen, Folgeerkrankungen, Therapie

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ZusammenfassungIn den ersten 1000 Tagen werden die Weichen für die langfristige Gesundheit von Mutter und Kind gestellt. Übergewicht, eine exzessive Gewichtzunahme in der Schwangerschaft sowie ein ungünstiger Lebensstil wirken sich kurz- und langfristig negativ auf die Gesundheit von Mutter und Kind aus. Die hohe Prävalenz von Übergewicht und Adipositas bei Frauen im gebärfähigen Alter sowie die steigende Zahl von Kindern und Jugendlichen mit Übergewicht oder Adipositas stellen ein wachsendes Gesundheitsproblem dar. Die Prädisposition für die spätere Gewichtsentwicklung beginnt bereits im Mutterleib. Primärpräventive Maßnahmen sind daher besonders sinnvoll. Bisherige Studien zu Lebensstilinterventionen in der Schwangerschaft zeigten moderat positive Effekte auf Gewichts- und Gesundheitsparameter der Mutter, wirkten sich jedoch nicht auf die Gewichtsentwicklung der Kinder aus. Es sind daher neue Präventionskonzepte erforderlich, die früher beginnen, risikoadaptiert sind und sich flächendeckend in die Praxis implementieren lassen. Digitale Maßnahmen wie Smartphone-Applikationen (Apps) könnten hierbei eine sinnvolle Unterstützung bieten. Die Zahl an aussagekräftigen Studien zur Erprobung App-gestützter Interventionen ist noch dürftig, erste Ergebnisse deuten jedoch auf positive Effekte hin. Die Herausforderung für die kommenden Jahre wird sein, solche Ansätze zur Unterstützung einer gesunden Lebensweise rund um die Schwangerschaft zu entwickeln, zu evaluieren und zu implementieren, um die langfristige Gesundheit von Mutter und Kind wirksamer zu schützen.

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Feasibility and acceptability of a remotely‐delivered behavioural health coaching intervention to limit gestational weight gain

Cited by 13 publications

References 56 publications

Effectiveness of a Step Counter Smartband and Midwife Counseling Intervention on Gestational Weight Gain and Physical Activity in Pregnant Women With Obesity (Pas and Pes Study): Randomized Controlled Trial

Effectiveness of a Step Counter Smartband and Midwife Counseling Intervention on Gestational Weight Gain and Physical Activity in Pregnant Women With Obesity (Pas and Pes Study): Randomized Controlled Trial

The Fourth Trimester: a Time for Enhancing Transitions in Cardiovascular Care

Adipositasprävention in den ersten 1000 Tagen

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