Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity

Research

Jihong Liu¹  Gabrielle M. Turner-McGrievy²  Ellen Wingard³  Sara Wilcox⁴  Alycia K. Boutté⁵ 

[1] Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 29208, Columbia, SC, USA;Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 29208, Columbia, SC, USA;Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 29208, Columbia, SC, USA;Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;

关键词: Pregnancy;    Maternal health;    Health behaviors;    Behavior change;    Physical activity;    Nutrition;    Diet quality;   

DOI  :  10.1186/s12966-022-01387-w

 received in 2022-06-27, accepted in 2022-11-26,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPhysical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight.MethodsHealth In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain.ResultsTreatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain.ConclusionsThe intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy.Trial registrationThis trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518

【 授权许可】

CC BY   
© The Author(s) 2022

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