Lifestyle modification intervention for overweight and obese Hispanic pregnant women: Development, implementation, lessons learned and future applications

Abstract

Objectives To describe the development, implementation and lessons learned of lifestyle intervention to promote appropriate gestational weight gain among Hispanic pregnant women. Design The intervention was informed by an empowerment oriented theoretical framework, and targeted women in the Pregnancy and Early Life Improvement Study. Methods The nutrition component consisted of recommendations for total calories, food quantity and improving carbohydrate and fat quality. We provided brown rice, omega-3 rich vegetable oil and spread, and water monthly. The physical activity focused on limiting sedentary behavior and promoting regular movement. The intervention was delivered through individual and group sessions and phone calls. Participants set their own goals, which were closely monitored. The intervention was evaluated extracting data from participant's record (attendance, goals, and challenges) and using a questionnaire. Results Participants were from underserved communities with economic, time, cultural and social barriers for engaging in lifestyle interventions. Modifications were done to facilitate participation, such as coordinating sessions with prenatal appointments and reducing group size and duration of sessions. Weekly text messages were added to reinforce the intervention. The main goal chosen by participants was reduction of sweetened beverages. The greatest challenges were replacing white rice with brown rice and improving physical activity. Participants suggested conducting sessions near their community and using social media as a motivation tool. Main outcomes results will be published elsewhere. Conclusion We identified barriers to delivering the lifestyle intervention, mainly related to group session's participation. Sessions should be conducted in the community, using text messages and social media as reinforcement.

Mobile Health Solutions for Hypertensive Disorders in Pregnancy: Scoping Literature Review (Preprint)

“…Analyzing mobile apps, 2 of them were Android apps [86,88], and other 2 iOS apps [89], [90]. Only 4 studies used sensor for physiological measurements [86,87,90,91]. We found a wide range of sensors (digital weight scales, blood pressure cuffs, context sensors, pedometers and movement sensors or phone oximeters), without any prevalence in the use of them.…”

“…A PRISMA flow diagram representing the full process described above is shown in Figure 1. Figure 2 shows the different technological solutions used, grouped in website (n=5) [69,[85][86][87], mobile apps (n=6) [84,[86][87][88][89][90] and others (n=1) [91]. The different platforms used for mobile apps (iOS vs Android) are also shown.…”

“…Regarding the type of study, we found observational studies (n=4) [69,86,88,90], qualitative research (n=1) [84], Randomized Control Trials (RCT) (n=2) [87], [91], review papers (n=1) [93] or others (n=3) [85,89,92]. Most of them involved a low number of participants.…”

“…On the other hand, RCT were only performed in the "Health promotion" category. Torres et al [91] performed a RCT to evaluate a lifestyle modification intervention for overweight and obese pregnant women. Huberty et al [87] conducted a RCT to analyze sedentary behavior over the course of pregnancy in inactive women.…”

“…Finally, "Health promotion" [87,88,91,93] category was proposed in 4 of the 11 included studies. Figure 3 shows this distribution.…”