Opportunities of mHealth in Preconception Care: Preferences and Experiences of Patients and Health Care Providers and Other Involved Professionals

Dijk, Matthijs R. van; Koster, Maria P. H.; Rosman, Ageeth N.; Steegers‐Theunissen, Régine P.M.

doi:10.2196/mhealth.7834

Cited by 31 publications

(19 citation statements)

References 32 publications

(26 reference statements)

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“…Each woman will be provided with a free subscription to the mHealth coaching programme ‘Smarter Pregnancy’ (Erasmus MC, University Medical Centre, Rotterdam, the Netherlands) that has been shown to improve nutrition and other lifestyle behaviours in this target population before 45–48. The programme offers personal coaching for 26 weeks, which is based on current personal circumstances, pregnancy, nutrition and lifestyle status.…”

Section: Methods and Analysismentioning

confidence: 99%

Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands

et al. 2019

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IntroductionPericonception obesity is associated with a higher risk for adverse perinatal outcomes such as gestational diabetes mellitus, preeclampsia, large for gestational age, operative delivery and preterm birth. Lifestyle interventions during pregnancy have resulted in insufficient effects on reducing these perinatal complications. A few reasons for this disappointing effect can be suggested: (1) the time period during pregnancy for improvement of developmental circumstances is too short; (2) the periconception period in which complications originate is not included; and (3) lifestyle interventions may not have been sufficiently multidisciplinary and customised. A preconception lifestyle intervention might be more effective to reduce perinatal complications. Therefore, the aim of the Towards Prepared mums study is to evaluate the effect of a lifestyle intervention starting prior to conception on lifestyle behaviour change.Methods and analysisThis protocol outlines a non-blinded, randomised controlled trial. One hundred and twelve women (18–40 years of age) with overweight or obesity (body mass index≥25.0 kg/m2) who plan to conceive within 1 year will be randomised to either the intervention or care as usual group. The intervention group will receive a multidisciplinary, customised lifestyle intervention stimulating physical activity, a healthy diet and smoking cessation, if applicable. The lifestyle intervention and monitoring will take place until 12 months postpartum. The primary outcome is difference in weight in kg from baseline to 6 weeks postpartum. Secondary outcomes are gestational weight gain, postpartum weight retention, smoking cessation, dietary and physical activity habits. Furthermore, exploratory outcomes include body composition, cardiometabolic alterations, time to pregnancy, need for assisted reproductive technologies, perinatal complications of mother and child, and lung function of the child. Vaginal and oral swabs, samples of faeces, breast milk, placenta and cord blood will be stored for evaluation of microbial flora, epigenetic markers and breast milk composition. Furthermore, a cost-effectiveness analysis will take place.Ethics and disseminationEthical approval was obtained from the Medical Ethical Committee of Maastricht University Medical Centre+ (NL52452.068.15/METC152026). Knowledge derived from this study will be made available by publications in international peer-reviewed scientific journals and will be presented at (inter)national scientific conferences. A dissemination plan for regional and national implementation of the intervention is developed.Trial registration numberClinicalTrials.gov NCT02703753.

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Section: Methods and Analysismentioning

confidence: 99%

Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands

et al. 2019

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“…Besides, they mentioned to find the program to simple and therefore quitted before finishing the 24 weeks of coaching. [39] Conclusions and future perspectives Overall, we can conclude that the ''Smarter Pregnancy'' mHealth coaching program is able to motivate women from more and less deprived neighborhoods to improve their nutrition and lifestyle behaviors. Women who live in more deprived neighborhoods, however, seem to improve their nutrition and lifestyle behaviors more compared to women from less deprived neighborhoods.…”

Section: Comparison With Prior Workmentioning

confidence: 97%

Neighborhood Deprivation and the Effectiveness of Mobile Health Coaching to Improve Periconceptional Nutrition and Lifestyle in Women: Survey in a Large Urban Municipality in the Netherlands (Preprint)

Gootjes¹,

Dijk²,

Köster³

et al. 2018

Preprint

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Background: Living in a deprived neighborhood is associated with several adverse pregnancy outcomes. This can be explained by the accumulation of risk factors, such as inadequate nutrition and lifestyle behaviors, in residents who live in those deprived neighborhoods. In 2011, we launched the ''Smarter Pregnancy'' mHealth coaching program, which has proven to be effective to improve inadequate nutrition and lifestyle behaviors in women before and during pregnancy. We did not investigate before, whether this mHealth program is equally effective in women who live in deprived neighborhoods.Objective: To study the associations between neighborhood deprivation and improvement of inadequate nutrition and lifestyle behaviors of women before and during pregnancy who subscribed to the ''Smarter Pregnancy'' program. Methods:We analyzed data from women who were contemplating pregnancy or already had been pregnant and used the ''Smarter Pregnancy'' program between 2011-2016. The program consisted of 24 weeks of coaching on five nutrition and lifestyle behaviors of which adequate daily intakes or lifestyle behaviors were defined as an intake of ≥200 grams of vegetables, two pieces of fruit, daily folic acid supplement use of 400 µg per day, and no smoking or alcohol consumption. Neighborhood deprivation was determined according to the status scores of the Netherlands Institute for Social Research. Logistic regression analyses and generalized estimating equation models were used to assess the associations between the neighborhood status score (NSS) and the improvement of inadequate nutrition and lifestyle behaviors, adjusted for maternal age, body mass index, geographic origin, pregnancy status and participation as a couple.Results: A total of 2,554 women were included of whom 521 participated with their male partner. Overall, daily vegetable intake was most frequently inadequate at the start of the program (n=1,985; 77.7%). Women with a higher NSS (i.e. no deprived neighborhood) less often smoked (adjusted OR 0.85, 95%CI 0.77;0.93), more often consumed alcohol (adjusted OR 1.14, 95%CI 1.04;1.24) and were less likely to complete the 24 weeks of coaching (OR 0.91, 95%CI 0.88;0.95) compared to women who live in a neighborhood with a low NSS.In the total study group, the relative improvement of inadequate nutrition and lifestyle behaviors after 24 weeks of coaching was between 26% and 64%. NSS was negatively associated with this improvement, 2 indicating that women with a higher NSS were less likely to improve inadequate nutrition and lifestyle behaviors, especially vegetable intake (adjusted OR 0.89, 95%CI 0.82 ; 0.97). Conclusions:The ''Smarter Pregnancy'' mHealth coaching program empowers women to improve inadequate nutrition and lifestyle behaviors. Unexpectedly, the program seemed more effective in women who live in deprived neighborhoods. It is important to unravel differences in needs and behaviors of specific target groups in order to further tailor the mHealth program based on demographic characteristics, such a...

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“…89 National studies outside of VA report that only 15 to 33% of women interviewed in the postpartum period had discussed preconception health with their clinicians before their pregnancies. [90][91][92][93] Qualitative data suggest that providers in the VA system rarely ask about or initiate conversations regarding their patients' reproductive goals or plans, 28 which are often important precursors to a discussion of preconception health. Data from a recent national survey of over 2,300 women Veterans indicated that fewer than half (49%) who were currently pregnant or considering pregnancy in the future reported discussions of preconception health risks in the past year.…”

Section: Preconception Care In Vamentioning

confidence: 99%

Preconception Care in the Veterans Health Administration

et al. 2018

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Preconception care (PCC), defined as a set of interventions to help women optimize their health and well-being prior to pregnancy, can improve pregnancy outcomes and is recommended by national organizations including the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists. Women Veterans who use the Department of Veterans Affairs (VA) health care system may face elevated risks of adverse pregnancy and birth outcomes due to a high prevalence of chronic medical and mental health conditions as well as psychosocial stressors including sexual trauma history and intimate partner violence. Many women Veterans of childbearing age experience poverty and homelessness, which are key social determinants of poor reproductive health outcomes. Furthermore, racial/ethnic disparities in maternal and neonatal outcomes are well documented, and nearly half of women Veterans of reproductive age are minority race/ethnicity. High-quality, equitable, patient-centered PCC services to address modifiable risks in this population are therefore a priority for VA. In this article, we provide a brief background of PCC, discuss the health risks of Veterans associated with adverse pregnancy outcomes, and highlight VA initiatives related to PCC. Lastly, we discuss implications and future directions for PCC research and policy within VA and across other health systems.

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Opportunities of mHealth in Preconception Care: Preferences and Experiences of Patients and Health Care Providers and Other Involved Professionals

Cited by 31 publications

References 32 publications

Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands

Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands

Neighborhood Deprivation and the Effectiveness of Mobile Health Coaching to Improve Periconceptional Nutrition and Lifestyle in Women: Survey in a Large Urban Municipality in the Netherlands (Preprint)

Preconception Care in the Veterans Health Administration

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