Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity

Brown, Susan D.; Hedderson, Monique M.; Ehrlich, Samantha F.; Galarce, Maren; Tsai, Ai‐Lin; Quesenberry, Charles P.; Ferrara, Assiamira

doi:10.1186/s12884-019-2293-8

Cited by 16 publications

(19 citation statements)

References 61 publications

(63 reference statements)

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“…underweight) may have been too small to detect differences. A variety of relevant variables were controlled for in analyses; however, some important social and lifestyle factors, such as such as sleep quality [57], stress, depression, social support [58,59], and built environment [60], were not assessed in IFPS II and therefore, were not controlled for in analyses.…”

Section: Discussionmentioning

confidence: 99%

Associations between pre-pregnancy BMI, gestational weight gain, and prenatal diet quality in a national sample

et al. 2019

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This secondary analysis explored the association between gestational weight gain, pre-pregnancy body mass index (BMI), and prenatal diet quality in a United States national sample. The sample comprised 1322 pregnant women in the longitudinal Infant Feeding Practices Study II with Diet History Questionnaire data. Diet quality in the third trimester was assessed using the Alternative Healthy Eating Index for Pregnancy. Self-reported pre-pregnancy BMI (categorized as underweight<18.5, normal weight 18.5–24.9, overweight 25.0–29.9, and obese≥30.0) and total gestational weight gain were used to categorize adherence to the Institute of Medicine’s recommendations as inadequate, adequate, or excessive weight gain. Diet quality in pre-pregnancy BMI and gestational weight gain groups were compared using Tukey-adjusted generalized linear models adjusted for sociodemographic factors, Women, Infants, and Children participation, parity, and energy intake. Due to missing gestational weight gain data, sensitivity analyses with multiply imputed data were conducted. Women were on average 28.9 years old and of higher socioeconomic status (40% college graduates) and mostly non-Hispanic White (84%), and the mean Alternative Healthy Eating Index for Pregnancy score was 61.2 (of 130). Both pre-pregnancy BMI and gestational weight gain were inversely associated with diet quality scores (p<0.01). The interaction between pre-pregnancy BMI and gestational weight gain was significant (p = 0.04), therefore gestational weight gain models were stratified by BMI group. In stratified adjusted models, gestational weight gain was differently associated with diet quality scores (p<0.05) among women with underweight, normal weight, overweight, and obesity. The relationship between gestational weight gain and prenatal diet quality depended on pre-pregnancy BMI. For example, within women with normal weight, higher diet quality was observed in the adequate gestational weight gain group. Interventions to broadly improve prenatal diet quality are needed, however, resources can be used to target women with higher pre-pregnancy BMIs and women with inadequate or excessive gestational weight gain.

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Section: Discussionmentioning

confidence: 99%

Associations between pre-pregnancy BMI, gestational weight gain, and prenatal diet quality in a national sample

et al. 2019

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“…Previous successful lifestyle interventions for weight management (i.e., PA and diet) targeting pregnant and postpartum women [ 8 – 10 ] set in the health care system utilize behavior change techniques [ 28 ] including, but not limited to, self-monitoring of and feedback on behavior (e.g., daily self-monitoring of minutes walking or number of steps); goal setting; review of behavior goals (e.g., reviewing behavior logs and modifying behavior goals accordingly); and problem solving (e.g., when to fit walking or stepping into a typical day). Components of these behavior change techniques are already incorporated into standard clinical care for women with GDM, for example, the provision of an individualized daily carbohydrate gram goal (i.e., medical nutrition therapy) and/or caloric intake goal (i.e., weight management), reviewing behavior progress with a diabetes educator, and modifying the goals accordingly [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

Using a consumer-based wearable activity tracker for physical activity goal setting and measuring steps in pregnant women with gestational diabetes mellitus: exploring acceptance and validity

Ehrlich

Maples

Barroso

et al. 2021

BMC Pregnancy Childbirth

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Background Activity monitoring devices may be used to facilitate goal-setting, self-monitoring, and feedback towards a step-based physical activity (PA) goal. This study examined the performance of the wrist-worn Fitbit Charge 3™ (FC3) and sought opinions on walking and stepping-in-place from women with gestational diabetes (GDM). Methods Participants completed six 2-min metronome-assisted over ground bouts that varied by cadence (67, 84, or 100 steps per minute) and mode (walking or stepping-in-place; N = 15), with the sequence randomized. Steps were estimated by FC3 and measured, in duplicate, by direct observation (hand-tally device, criterion). Equivalence testing by the two one-sided tests (TOST) method assessed agreement within ± 15%. Mean absolute percent error (MAPE) of steps were compared to 10%, the accuracy standard of the Consumer Technology Association (CTA)™. A subset (n = 10) completed a timed, 200-m self-paced walk to assess natural walking pace and cadence. All participants completed semi-structured interviews, which were transcribed and analyzed using descriptive and interpretive coding. Results Mean age was 27.0 years (SD 4.2), prepregnancy BMI 29.4 kg/m2 (8.3), and gestational age 32.8 weeks (SD 2.6). The FC3 was equivalent to hand-tally for bouts of metronome-assisted walking and stepping-in-place at 84 and 100 steps per minute (i.e., P < .05), although walking at 100 steps per minute (P = .01) was no longer equivalent upon adjustment for multiple comparisons (i.e., at P < .007). The FC3 was equivalent to hand-tally during the 200-m walk (i.e., P < .001), in which mean pace was 68.2 m per minute (SD 10.7), or 2.5 miles per hour, and mean cadence 108.5 steps per minute (SD 6.5). For walking at 84 and 100 steps per minute, stepping-in-place at 100 steps per minute, and the 200-m walk, MAPE was within 10%, the accuracy standard of the CTA™. Interviews revealed motivation for PA, that stepping-in-place was an acceptable alternative to walking, and competing responsibilities made it difficult to find time for PA. Conclusions The FC3 appears to be a valid step counter during the third trimester, particularly when walking or stepping-in-place at or close to women’s preferred cadence.

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“…The third trial, GestationaL Weight Gain and Optimal Wellness (GLOW), was an efficacy trial of a 13-session lifestyle program primarily delivered by telephone to prevent excessive gestational weight gain (Getting in Balance), which was compared with usual medical care (data collected in 2014 −2018, n=389). 19,20 Pregnant women were randomized into the trial at 8−15 weeks of gestation, with follow-up assessments at 32 weeks of gestation, 6 months postpartum, and 12 months postpartum. In this study, the GLOW sample excluded 9 women who experienced a pregnancy loss before the first follow-up assessment and thus were ineligible for the remaining assessments.…”

Section: Trial Characteristicsmentioning

confidence: 99%

Methods-Motivational Interviewing Approach for Enhanced Retention and Attendance

Jake‐Schoffman

Brown

Baiocchi

et al. 2021

American Journal of Preventive Medicine

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Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity

Cited by 16 publications

References 61 publications

Associations between pre-pregnancy BMI, gestational weight gain, and prenatal diet quality in a national sample

Associations between pre-pregnancy BMI, gestational weight gain, and prenatal diet quality in a national sample

Using a consumer-based wearable activity tracker for physical activity goal setting and measuring steps in pregnant women with gestational diabetes mellitus: exploring acceptance and validity

Methods-Motivational Interviewing Approach for Enhanced Retention and Attendance

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