Psychological predictors of dietary intentions in pregnancy

Gardner, Benjamin; Croker, Helen; Barr, Suzanne; Briley, Annette; Poston, Lucilla; Wardle, Jane

doi:10.1111/j.1365-277x.2012.01239.x

Cited by 42 publications

(33 citation statements)

References 34 publications

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“…Attitudinal data relating to diet were comparable to a population sample of pregnant women [12]. The intervention did not achieve any reduction in perceived barriers, but despite this, important dietary changes were achieved which may infer low levels of self efficacy.…”

Section: Discussionmentioning

confidence: 82%

“…Prior to embarking on a large randomised controlled trial (RCT) and in accordance with UK Medical Research Council Guidance for development of a complex intervention [10], we first explored the theoretical basis for an intervention in obese pregnant women [5,6,11,12], leading to development of a novel intervention (Phase 1). We now report on Phase 2, an exploratory trial to determine whether this intervention achieved the changes in dietary and physical activity behaviours anticipated, and to undertake a process evaluation of every aspect of fidelity of the intervention and the protocol.…”

Section: Introductionmentioning

confidence: 99%

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Developing a complex intervention for diet and activity behaviour change in obese pregnant women (the UPBEAT trial); assessment of behavioural change and process evaluation in a pilot randomised controlled trial

Poston

Briley

Barr

et al. 2013

BMC Pregnancy Childbirth

113

138

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BackgroundComplex interventions in obese pregnant women should be theoretically based, feasible and shown to demonstrate anticipated behavioural change prior to inception of large randomised controlled trials (RCTs). The aim was to determine if a) a complex intervention in obese pregnant women leads to anticipated changes in diet and physical activity behaviours, and b) to refine the intervention protocol through process evaluation of intervention fidelity.MethodsWe undertook a pilot RCT of a complex intervention in obese pregnant women, comparing routine antenatal care with an intervention to reduce dietary glycaemic load and saturated fat intake, and increase physical activity. Subjects included 183 obese pregnant women (mean BMI 36.3 kg/m2).Diet was assessed by repeated triple pass 24-hour dietary recall and physical activity by accelerometry and questionnaire, at 16+0 to 18+6 and at 27+0 to 28+6 weeks’ gestation in women in control and intervention arms. Attitudes to behaviour change and quality of life were assessed and a process evaluation undertaken. The full RCT protocol was undertaken to assess feasibility.ResultsCompared to women in the control arm, women in the intervention arm had a significant reduction in dietary glycaemic load (33 points, 95% CI −47 to −20), (p < 0.001) and saturated fat intake (−1.6% energy, 95% CI −2.8 to −0. 3) at 28 weeks’ gestation. Objectively measured physical activity did not change. Physical discomfort and sustained barriers to physical activity were common at 28 weeks’ gestation. Process evaluation identified barriers to recruitment, group attendance and compliance, leading to modification of intervention delivery.ConclusionsThis pilot trial of a complex intervention in obese pregnant women suggests greater potential for change in dietary intake than for change in physical activity, and through process evaluation illustrates the considerable advantage of performing an exploratory trial of a complex intervention in obese pregnant women before undertaking a large RCT.Trial registrationTrial Registration Number: ISRCTN89971375

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Developing a complex intervention for diet and activity behaviour change in obese pregnant women (the UPBEAT trial); assessment of behavioural change and process evaluation in a pilot randomised controlled trial

Poston

Briley

Barr

et al. 2013

BMC Pregnancy Childbirth

113

138

View full text Add to dashboard Cite

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“…Perhaps older mothers did not perceive that they needed to decrease their sugar consumption, despite receiving education and setting goals to reduce added sugar consumption. Gardner et al found that pregnant women who perceived their current intake to be excessive were significantly more likely to intend to eat less high-sugar foods than those who believed their intake to be adequate (Gardner et al, 2012). Further research in similar populations is needed to better understand how age might influence effectiveness of interventions aimed at dietary change in this population.…”

Section: Discussionmentioning

confidence: 99%

Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women

et al. 2015

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Background Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers (CHWs). A community-partnered randomized controlled trial (RCT) with pregnant Latina women resulted in significantly improved vegetable, fiber, added sugar, and total fat consumption compared to a minimal intervention (MI) group. However, studying RCT intervention effects alone does not explain the mechanisms by which the intervention was successful or help identify which participants may have benefitted most. Purpose To improve the development and targeting of future CHW interventions for high-risk pregnant women, we examined baseline characteristics (moderators) and potential mechanisms (mediators) associated with these dietary changes. Methods Secondary analysis of data for 220 Latina RCT participants was conducted. A linear regression with effects for intervention group, moderator, and interaction between intervention group and moderator was used to test each hypothesized moderator of dietary changes. Sobel-Goodman mediation test was used to assess mediating effects on dietary outcomes. Results Results varied by dietary outcome. Improvements in vegetable consumption were greatest for women who reported high spousal support at baseline. Women younger than age 30 were more likely to reduce added sugar consumption than older women. Participants who reported higher baseline perceived control were more likely to reduce fat consumption. No examined mediators were significantly associated with intervention effects. Conclusion Future interventions with pregnant Latinas may benefit from tailoring dietary goals, to consider age, level of spousal support, and perceived control to eat healthy.

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“…Pregnant women who already consume a diet with excess fat and sugar content are also more likely to intend to lower the intake of these foods. 9 A recent review of 10 studies that tried to define the most effective components of successful interventions for limiting gestational weight gain found no evidence to favour one behavioural technique over another, but there was some suggestion that interventions were more likely to succeed in non-smokers and if started early in pregnancy. 10 The lack of detail and standardised reporting of the psychological theory underpinning the behavioural change or the specific techniques used in the interventions were notable.…”

Section: Editorialsmentioning

confidence: 99%