Targeting Pregnancy-Related Weight Gain To Reduce Disparities In Obesity: A Randomized Controlled Trial
AbstractThe obesity epidemic in the United States has affected Black women more than any other racial/ethnic group. The childbearing period represents a critical life stage of heightened vulnerability for new or persistent obesity, especially among Black women, who retain 2-3 times more weight after pregnancy than White women. Gestational weight gain is the strongest identified risk factor for retaining a substantial amount of weight postpartum, yet few published interventions have been effective in reducing excessive weight gain in pregnancy, particularly among low-income Black mothers. Traditional high-intensity, in-person weight control programs are costly, have limited scalability, and are unlikely to meet the needs of these at-risk mothers, whose competing demands (e.g., childcare, work, school) pose a significant challenge to intervention adherence and efficacy. We propose a novel, technology-based intervention (using text messaging and Facebook) to minimize excessive gestational weight gain that overcomes many of these barriers. Preliminary data from our research team support the utility of technology platforms for the delivery of weight control interventions; however, adequately powered randomized controlled trials are needed to prove efficacy of these platforms for controlling gestational weight gain. In the proposed study, 262 overweight or moderately obese low-income Black women seen at Temple University's obstetric clinics will be enrolled and randomized to either: 1) usual care or 2) technology-based intervention, which includes daily skills and monitoring text messages with personalized feedback, individual web-based weight gain graphs, health coach counseling calls, and a Facebook support group. The primary outcome is prevalence of excessive gestational weight gain; cardiometabolic risk factors, mode of delivery, and infant birth weight are secondary outcomes. Research questions concerning mediators and moderators of intervention effects will also be addressed. Findings from this study have the potential to provide obstetric practices around the nation with efficacy-based weight control treatment in pregnancy that can be easily disseminated to Black mothers. The proposed project addresses goals of MCHB's Strategic Research Issues #2 and #4 that focus on health disparities and maternal and child health populations. In addition, this study tackles two critical Healthy People 2020 objectives: 1) Increase the proportion of mothers who achieve a recommended weight gain during their pregnancies (Objective MICH-13); and 2) Reduce the proportion of adults who are obese (Objective NWS-9). As more than 50% of Black women overgain in pregnancy, interventions to prevent excessive gestational weight gain are of critical importance to reduce disparities in obesity prevalence, and improve maternal and child health.
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Herring SJ, Cruice JF, Bennett GG, Darden N, Wallen JJ, Rose MZ, Davey A, Foster GD. Intervening during and after pregnancy to prevent weight retention among African American women. Prev Med Rep. 7:119-123.
Herring SJ, Cruice JF, Bennett GG, Rose MZ, Davey A, Foster GD. Preventing excessive gestational weight gain among African American women: a randomized clinical trial. Obesity. 24(1):30-6.
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