Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial

Abstract

BackgroundApproximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy.ObjectiveThe primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention.MethodsThis randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women’s weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care.ResultsRecruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign.ConclusionFeasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo)Registered Report IdentifierRR1-10.2196/9920

Nutrition, Behavior Change and Physical Activity Outcomes From the PEARS RCT—An mHealth-Supported, Lifestyle Intervention Among Pregnant Women With Overweight and Obesity

“…Mobile-Health (mHealth) technologies offer the potential to support traditional lifestyle interventions without increasing contact hours with clinicians (12). Smartphone apps have been proposed as a novel method to provide antenatal education, for example in improving glycaemic control (13), gestational weight gain (14,15) and maternal self-efficacy and mental wellbeing (16). A recent meta-analysis demonstrated the increasing prevalence of mHealth-supported randomized controlled trials for weight management in pregnancy (17).…”

Patient engagement practice within perinatal eHealth: A scoping review

“…Perinatal eHealth programs change the face of connectivity and coaching for new or expectant parents. Tailored alerts and information sharing directed to the personal handheld devices of patients changes their capacity to interact as members of the care teams (Choi et al, 2015; Danbjørg et al, 2015; Davis et al, 2018; Frize et al, 2013; Herring et al, 2019). eHealth patients have a chance to view information and their own personal health data and trends on demand (Abbass‐Dick et al, 2017; Isetta et al, 2013; Valencia et al, 2020; van der Wulp et al, 2014).…”

“…Commitment is practised in programs through integration of behavioural change and self-efficacy theories during the development and design (See Supplement Material S3: Table S2). eHealth modalities mediated new opportunities for patients to become meaningfully changes their capacity to interact as members of the care teams (Choi et al, 2015;Danbjørg et al, 2015;Davis et al, 2018;Frize et al, 2013;Herring et al, 2019). eHealth patients have a chance to view information and their own personal health data and trends on demand (Abbass-Dick et al, 2017;Isetta et al, 2013;Valencia et al, 2020;van der Wulp et al, 2014).…”

Adipositasprävention in den ersten 1000 Tagen

“…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.…”