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Dikgale B, Dlakavu F, Masenge A, De Gouveia S, Adam S. Pregnant women's dietary patterns and knowledge of gestational weight gain: A cross-sectional study. Int J Gynaecol Obstet 2024; 166:871-878. [PMID: 38523434 DOI: 10.1002/ijgo.15462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 12/18/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE Excess gestational weight gain (GWG) is a risk factor for various unfavorable maternal and neonatal outcomes that may be preventable. Maintaining a healthy lifestyle while pregnant can help prevent uncontrollable weight gain. The aim of this study was to assess pregnant women's knowledge on weight, GWG, diet, and knowledge of obesity-related complications among women who seek care at our semi-urban, regional setting. METHODS A prospective observational study was conducted at the prenatal clinic at Kalafong Academic Hospital. Prospective participants completed a questionnaire on their perception of GWG, attitudes toward GWG, knowledge of GWG, associated complications of obesity, and food choices. Data analysis was performed using SAS version 9.4. RESULTS The majority of the 500 individuals were overweight or obese prior to pregnancy. By the end of the third trimester, this increased by 10.1% (n = 420; 86.1%). Nearly half (n = 240; 48.78%) of the overweight and obese women underestimated their weight. Only 26.53% (n = 26) of women who checked their body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) gained weight according to recommendations. However, less than half (n = 96; 30.5%) gained weight within the recommended range, despite the fact that the majority of them (n = 315; 64%) were aware of the harmful effects of obesity on the cardiovascular system and the effects of high calories on weight gain (n = 321; 65%). CONCLUSION Despite basic knowledge of the impact of high-caloric intake on weight gain and cardiovascular complications, less than half of the study population gained weight within the recommended range.
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Affiliation(s)
- Busisiwe Dikgale
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Fuziwe Dlakavu
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Pretoria, South Africa
| | | | - Sumaiya Adam
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
- Diabetes Research Centre, University of Pretoria, Pretoria, South Africa
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Banafshe E, Javadifar N, Abbaspoor Z, Karandish M, Ghanbari S. Factors Influencing Weight Management in Pregnant Women with Overweight or Obesity: A Meta-Synthesis of Qualitative Studies. J Acad Nutr Diet 2024; 124:964-994.e1. [PMID: 38648889 DOI: 10.1016/j.jand.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Overweight and obesity have multiple negative consequences for the health of both the mother and the child. Interventions to prevent excessive weight gain during pregnancy have had varying success, and the proportion of pregnant women who exceed national guidelines for weight gain continues to increase. OBJECTIVE To investigate the influence of factors on weight management among pregnant women with overweight or obesity. METHODS This meta-synthesis of qualitative studies involved searching databases PubMed, Embase, Cochrane, Scopus, and Web of Science. The databases were searched on October 4, 2022, and the search was updated on April 21, 2023. The screening of titles, abstracts, and full texts was conducted utilizing Covidence software. The quality assessment of the articles was performed using the Critical Appraisal Skills Programme checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement was used to enhance transparency in reporting. A meta-aggregation approach was used to guide the data extraction and synthesis. RESULTS A total of 46 studies with appropriate Critical Appraisal Skills Programme scores were included for qualitative synthesis. Findings were extracted and integrated into 4 themes: psychological factors (personally driven negative emotions and society-driven negative emotions), social factors (societal attitudes and beliefs and social support resources), factors related to education and counseling (information provision and communication), and factors associated with effective care (provided care components and the method of providing effective care). CONCLUSIONS To improve weight management during pregnancy, health care providers should provide tailored and individualized recommendations that take into consideration the factors influencing these women.
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Affiliation(s)
- Elahe Banafshe
- Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Javadifar
- Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zahra Abbaspoor
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Ghanbari
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Raju S, Cowdell F, Dyson J. Barriers and facilitators to healthy gestational weight gain amongst pregnant women from ethnic minority groups: A systematic search and narrative synthesis. Midwifery 2024; 135:104051. [PMID: 38870776 DOI: 10.1016/j.midw.2024.104051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/02/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Excessive weight gain can be detrimental to the health and wellbeing of both mother and child. There is evidence that women from ethnic minority groups are more likely to gain excessive weight during pregnancy. For the purpose of this review, ethnic minority women are defined as those with different national or cultural traditions from the main population. AIM Our aim was to identify barriers and facilitators to healthy gestational weight gain in pregnant women in ethnic minority groups. METHODS Databases searched were MEDLINE, CINAHL, PsycInfo and PsycArticles between 2011 and 2022. Inclusion criteria were empirical studies of any method considering gestational weight gain in ethnic minority women published in English. Data were extracted according to aim, participants, methods, and findings in relation to barriers and facilitators. Included papers were assessed for quality according to relevant Joanna Briggs Institute checklists. FINDINGS Twenty-six studies were identified. Five themes were revealed: (1) knowledge and beliefs, (2) cultural and social influences, (3) confidence, (4) physical experiences, and (5) personal and environmental factors. DISCUSSION Some barriers and facilitators were relevant to all groups and others were more specific to ethnic minority groups. The latter included social and cultural influences, which were reported extensively. Our search was comprehensive, although it is possible we may not have captured all relevant papers. CONCLUSION We recommend that the barriers and facilitators identified here are considered in designing future, or adjusting current, health care practitioner mediated interventions to support healthy gestational weight gain in ethnic minority women.
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Affiliation(s)
- Sereena Raju
- Birmingham City University, Faculty of Health, Education and Life Sciences, Westbourne Road, Birmingham B15 3TN, England, UK.
| | - Fiona Cowdell
- Birmingham City University, Faculty of Health, Education and Life Sciences, Westbourne Road, Birmingham B15 3TN, England, UK
| | - Judith Dyson
- Birmingham City University, Faculty of Health, Education and Life Sciences, Westbourne Road, Birmingham B15 3TN, England, UK
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Li Q, Piaseu N, Phumonsakul S, Thadakant S. Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy. Nutrients 2024; 16:217. [PMID: 38257110 PMCID: PMC10820561 DOI: 10.3390/nu16020217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
In urban Chinese women with normal body weight during pregnancy, we implemented a comprehensive dietary intervention program aimed at enhancing nutrition literacy, dietary quality, and gestational weight gain. The methods included both online and offline health education on prenatal nutrition, weekly weight monitoring, family back education practices, and real-time dietary guidance. The intervention was delivered to randomly assigned control and intervention group participants from gestational week 12 to week 24. The intervention group (n = 44; 100% complete data) showed significant differences (mean (SD)) compared to the control group (n = 42; 95.5% complete data) in nutrition literacy (53.39 ± 6.60 vs. 43.55 ± 9.58, p < 0.001), restrained eating (31.61 ± 7.28 vs. 28.79 ± 7.96, p < 0.001), Diet Quality Distance (29.11 ± 8.52 vs. 40.71 ± 7.39, p < 0.001), and weight gain within the first 12 weeks of intervention (4.97 ± 1.33 vs. 5.98 ± 2.78, p = 0.029). However, there was no significant difference in the incidence of gestational diabetes (2 (4.5%) vs. 4 (9.5%), p = 0.629). Participants in the intervention group reported an overall satisfaction score of 4.70 ± 0.46 for the intervention strategy. These results emphasize the positive role of comprehensive dietary intervention in promoting a healthy diet during pregnancy.
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Affiliation(s)
- Qian Li
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
- Ph.D. Candidate in the Doctor of Philosophy Program in Nursing Science (International Program), Faculty of Medicine Ramathibodi Hospital, Faculty of Nursing, Mahidol University, Salaya 73170, Thailand
| | - Noppawan Piaseu
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| | - Srisamorn Phumonsakul
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| | - Streerut Thadakant
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
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You H, Wang YY, Zhang C, Walker AN, Ge JJ, Zhao SQ, Peng XQ. Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention. BMC Public Health 2023; 23:130. [PMID: 36653762 PMCID: PMC9848710 DOI: 10.1186/s12889-023-15067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Unhealthy gestational weight gain is a modifiable risk factor for adverse maternal and child health. Appropriate and effective intervention strategies that focus on behavioral change or maintenance are critical in weight management during pregnancy. Our aim was to uncover the influencing factors and psychosocial mechanisms of gestational weight control behavior, and to construct a behavioral model suitable for intervention based on Information-Motivation-Behavioral skills (IMB) model. METHODS A sample of 559 pregnant women from a municipal maternal and child healthcare facility in Jiangsu Province, China was enrolled in this cross-sectional empirical study. Partial least square structural equation modelling was used to verify the hypothesized model, and post hoc analyses was used to test the effect of parity and pre-pregnancy BMI on the model. RESULTS The IMB model elements can predict gestational weight management (GWM) behavior well, with information being the most influential factor. As predicted, information affects GWM directly (β = 0.325, p < 0.05) and indirectly (β = 0.054, p < 0.05) through behavioral skills. Likewise, motivation has direct (β = 0.461, p < 0.05) effects on GWM, and has indirect (β = 0.071, p < 0.05) effects through behavioral skills. Behavioral skills have a direct impact (β = 0.154, p < 0.05). The model had a goodness of fit (GOF = 0.421) and was robust when tested in subgroups of different parity or pre-pregnancy BMI. CONCLUSION Findings from this study supported the predictions of the IMB model for GWM behavior, and identified its modifiable determinants. The tested behavior model for GWM can serve as a new validated intervention strategy in weight management among pregnant women.
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Affiliation(s)
- Hua You
- School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yuan-Yuan Wang
- Jiangsu Health Development Research Center, Nanjing, China
| | - Chi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | | | - Jin-Jin Ge
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shi-Qi Zhao
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xue-Qing Peng
- School of Public Health, Nanjing Medical University, Nanjing, China.
- Chengdu Center for Disease Control and Prevention, 4 Longxiang Road, Wuhou District, Chengdu, 610041, China.
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Physical Activity Beliefs and Behaviors during Pregnancy and their Association with Provider Counseling among Women in the Southern United States. PHYSICAL ACTIVITY AND HEALTH 2022. [DOI: 10.5334/paah.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Ge J, Zhao S, Peng X, Walker AN, Yang N, Zhou H, Wang L, Zhang C, Zhou M, You H. Analysis of the Weight Management Behavior of Chinese Pregnant Women: An Integration of the Protection Motivation Theory and the Information-Motivation-Behavioral Skills Model. Front Public Health 2022; 10:759946. [PMID: 35186832 PMCID: PMC8855928 DOI: 10.3389/fpubh.2022.759946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Inappropriate gestational weight gain has become a public health concern that threatens maternal and child health. Pregnant women's ability to manage their weight during pregnancy directly impacts their weight gain. In this study, we integrated the protection motivation theory and the information-motivation-behavioral skills model to develop an integrative theoretical model suitable for pregnancy weight management and reveal significant explainable factors of weight management behaviors during pregnancy. Based on a cross-sectional survey of 550 pregnant women from Jiangsu province, we came up with our findings. The results showed that several factors influenced pregnancy weight management behavior. According to the research, information, self-efficacy, response costs, and behavioral skills were significantly associated with weight management behaviors during pregnancy, while behavioral skills were also significant mediators of information, self-efficacy, and behavior. Furthermore, the information related to pregnancy weight management had the biggest impact on weight management behavior during pregnancy. The results of the model fit were acceptable and the integrative model could explain 30.6% of the variance of weight management behavior during pregnancy, which implies that the integrative theoretical model can effectively explain and predict weight management behaviors during pregnancy. Our study provides practical implications for the integrative model in improving pregnancy weight management behavior and offers a theoretical base for the weight management of pregnant women.
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Affiliation(s)
- Jinjin Ge
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shiqi Zhao
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xueqing Peng
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Anita Nyarkoa Walker
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ni Yang
- Department of Gynecology and Obstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Hua Zhou
- Department of Gynecology and Obstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Li Wang
- Department of Gynecology and Obstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Chi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Meng Zhou
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Hua You
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
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Groth SW, Meng Y, Yeh KL, Fernandez ID. Influence of Appetite and Perceived Ability to Control Cravings on Excessive Gestational Weight Gain. J Obstet Gynecol Neonatal Nurs 2021; 50:669-678. [PMID: 34474006 PMCID: PMC8594632 DOI: 10.1016/j.jogn.2021.08.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To explore whether appetite is associated with gestational weight gain (GWG) and to assess the effect of perceived ability to control cravings on excessive GWG. DESIGN Secondary data analysis. SETTING Rochester, New York, United States. PARTICIPANTS Women who were pregnant (N = 1,005) and participated in a randomized controlled trial to test the effect of electronically mediated interventions to prevent excessive GWG and postpartum weight retention. METHODS We used two questions to assess appetite and perceived ability to control cravings before 28 weeks gestation: "How would you describe your appetite now compared to times when you are not pregnant?" and "How sure are you that you will be able to avoid overeating when you have cravings?" We conducted logistic regression to assess the relationships between appetite, perceived ability to control cravings, and excessive GWG. RESULTS More than 47% of participants gained excessive weight during pregnancy. Approximately 62% of participants reported being hungrier, and more than 42% indicated that they were unsure they could avoid overeating with cravings. Participants who reported similar/less appetite than before pregnancy were less likely to gain excessive weight (p < .05). Participants who were sure they could control cravings were less likely to gain excessive weight (p = .02). CONCLUSION Our results show that appetite and perceived ability to control cravings may affect GWG. Additional research is needed to assess if interventions targeting appetite and craving control could limit GWG.
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Leonard KS, Oravecz Z, Symons Downs D. Low Resting Energy Expenditure Is Associated with High Gestational Weight Gain Only When Resting Energy Expenditure Fluctuates. Reprod Sci 2021; 28:2582-2591. [PMID: 33730361 PMCID: PMC10489300 DOI: 10.1007/s43032-021-00544-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/09/2021] [Indexed: 11/28/2022]
Abstract
Resting energy expenditure (REE) may be useful for individualizing energy intake (EI) and physical activity (PA) goals, and in turn, regulating gestational weight gain (GWG). Limited research, however, has examined the association between REE and GWG. This study examined (1) change in REE from 14 to 28 gestation, (2) time-varying associations between REE and GWG, and (3) EI and PA patterns during the weeks when REE and GWG were significantly associated. Pregnant women with overweight/obesity (N = 27) participating in the Healthy Mom Zone study completed weekly point estimates of EI (back-calculation), PA (wrist-worn activity monitor), REE (mobile metabolism device), and weight (Wi-Fi scale) from 14 to 28 weeks gestation. Analyses included descriptives and time-varying effect modeling. REE fluctuated, increasing on average from 14 to 28 weeks gestation, but decreased at gestational weeks 17, 20, 21, 23, 26, and 28. Most women increased in REE; however there was large between-person variability in the amount of change. Associations between REE and GWG were small but time-varying; low REE was associated with high GWG between gestational weeks 25 to 28 when there was observably larger fluctuation in REE. Moreover, over half of the women were categorized as having excessive EI and most as low active during this time. EI needs may be overestimated and PA needs may be underestimated when REE is fluctuating, which may increase the risk for high second trimester GWG. Researchers should consider the role of REE to inform EI and PA goals to regulate GWG.
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Affiliation(s)
- Krista S Leonard
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Zita Oravecz
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University & Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, USA.
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McCloud MB, Barosso J. Experiences of Pregnant Women With Obesity. Nurs Womens Health 2021; 25:179-186. [PMID: 33895114 DOI: 10.1016/j.nwh.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/27/2021] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore how pregnant women with obesity feel about their bodies before and during pregnancy. DESIGN Qualitative descriptive design. SETTING Obstetric and gynecologic offices in a rural setting in Maryland that employed physicians and midwives as prenatal care providers. PARTICIPANTS A purposive sampling technique was used to recruit a sample of 20 women. Inclusion criteria were pregnant women ages 18 to 35 years with a prepregnancy body mass index of greater than 30 kg/m2, in the third trimester of the pregnancy (28-40 weeks gestation), and receiving regular prenatal care from a licensed provider. INTERVENTION/MEASUREMENT A typology analysis chart was used to group participants' responses from their interviews in the areas of positive or negative feelings regarding their prepregnancy body and weight, and positive or negative feelings regarding their pregnant body. RESULTS Data were analyzed using a four-square matrix by identifying those participants who felt positive regarding their prepregnancy body/weight and pregnant body (n = 6), felt negative regarding their prepregnancy body/weight and pregnant body (n = 3), felt negative regarding their prepregnant body but positive regarding their pregnant body (n = 8), and felt positive regarding their prepregnant body but negative about their pregnant body (n = 3). CONCLUSION Pregnancy had allowed many of the women to gain a sense of achievement, where the growth of the fetus and subsequent weight gain were seen as positive attributes, and they embraced the functionality of their bodies.
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Adaptive, behavioral intervention impact on weight gain, physical activity, energy intake, and motivational determinants: results of a feasibility trial in pregnant women with overweight/obesity. J Behav Med 2021; 44:605-621. [PMID: 33954853 DOI: 10.1007/s10865-021-00227-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Interventions have modest impact on reducing excessive gestational weight gain (GWG) in pregnant women with overweight/obesity. This two-arm feasibility randomized control trial tested delivery of and compliance with an intervention using adapted dosages to regulate GWG, and examined pre-post change in GWG and secondary outcomes (physical activity: PA, energy intake: EI, theories of planned behavior/self-regulation constructs) compared to a usual care group. Pregnant women with overweight/obesity (N = 31) were randomized to a usual care control group or usual care + intervention group from 8 to 2 weeks gestation and completed the intervention through 36 weeks gestation. Intervention women received weekly evidence-based education/counseling (e.g., GWG, PA, EI) delivered by a registered dietitian in a 60-min face-to-face session. GWG was monitored weekly; women within weight goals continued with education while women exceeding goals received more intensive dosages (e.g., additional hands-on EI/PA sessions). All participants used mHealth tools to complete daily measures of weight (Wi-Fi scale) and PA (activity monitor), weekly evaluation of diet quality (MyFitnessPal app), and weekly/monthly online surveys of motivational determinants/self-regulation. Daily EI was estimated with a validated back-calculation method as a function of maternal weight, PA, and resting metabolic rate. Sixty-five percent of eligible women were randomized; study completion was 87%; 10% partially completed the study and drop-out was 3%. Compliance with using the mHealth tools for intensive data collection ranged from 77 to 97%; intervention women attended > 90% education/counseling sessions, and 68-93% dosage step-up sessions. The intervention group (6.9 kg) had 21% lower GWG than controls (8.8 kg) although this difference was not significant. Exploratory analyses also showed the intervention group had significantly lower EI kcals at post-intervention than controls. A theoretical, adaptive intervention with varied dosages to regulate GWG is feasible to deliver to pregnant women with overweight/obesity.
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Moore AP, Flynn AC, Adegboye ARA, Goff LM, Rivas CA. Factors Influencing Pregnancy and Postpartum Weight Management in Women of African and Caribbean Ancestry Living in High Income Countries: Systematic Review and Evidence Synthesis Using a Behavioral Change Theoretical Model. Front Public Health 2021; 9:637800. [PMID: 33681136 PMCID: PMC7925838 DOI: 10.3389/fpubh.2021.637800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Women of black African heritage living in high income countries (HIC) are at risk of obesity and weight-related complications in pregnancy. This review aimed to synthesize evidence concerning attitudes to weight management-related health behaviors in pregnancy and postpartum, in women of black African ancestry, living in high-income countries. Methods: A systematic review of the literature and thematic evidence synthesis using the Capability-Opportunity-Motivation Behavioral change theoretical model (COM-B). Databases searched included MEDLINE, EMBASE, Web of Science, and Scopus. The CASP tool was used to assess quality. Results: Twenty-four papers met the selection criteria, most of which were from the US. Motivational factors were most commonly described as influencers on behavior. Normative beliefs about "eating for two," weight gain being good for the baby, the baby itself driving food choice, as well as safety concerns about exercising in pregnancy, were evident and were perpetuated by significant others. These and other social norms, including a cultural acceptance of larger body shapes, and daily fast food, created a challenge for healthy behavior change. Women also had low confidence in their ability to lose weight in the postpartum period. Behavior change techniques, such as provision of social support, use of credible sources, and demonstration may be useful to support change. Conclusions: The women face a range of barriers to engagement in weight-related health behaviors at this life-stage. Using a theoretical behavior change framework can help identify contextual factors that may limit or support behavior change.
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Affiliation(s)
- Amanda P. Moore
- Department of Nutrition, Kings College London, London, United Kingdom
| | - Angela C. Flynn
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | | | - Louise M. Goff
- Department of Nutrition, Kings College London, London, United Kingdom
| | - Carol A. Rivas
- UCL Social Research Institute, University College London (UCL), London, United Kingdom
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Hebert-Beirne J, Camenga DR, James AS, Brady SS, Newman DK, Burgio KL, Kane Low L, Hardacker CT, Gahagan S, Williams BR. Social Processes Informing Toileting Behavior Among Adolescent and Adult Women: Social Cognitive Theory as an Interpretative Lens. QUALITATIVE HEALTH RESEARCH 2021; 31:430-442. [PMID: 33427071 PMCID: PMC8053251 DOI: 10.1177/1049732320979168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Little is known about social processes shaping adolescent and adult women's toileting behaviors. The "Study of Habits, Attitudes, Realities, and Experiences" (SHARE) examines adolescent and adult women's experiences related to bladder health across the life course. Forty-four focus groups with 360 participants organized by six age groups were conducted across seven sites. A transdisciplinary team used social cognitive theory as an interpretive lens across a five-stage analysis. The act of observing was identified as the overarching social process informing women's toileting behaviors in three ways: (a) observing others' toileting behavior, (b) being aware that one's own toileting behaviors are monitored by others, and (c) observing oneself relative to others. We found that underlying processes of toileting behaviors, seemingly private are, in fact, highly social. We suggest, given this social embeddedness that health promotion efforts should leverage interpersonal networks for "social norming" interventions and policies to promote healthy toileting behaviors.
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Affiliation(s)
| | | | | | - Sonya S Brady
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Diane K Newman
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathryn L Burgio
- University of Alabama, Birmingham, Alabama, USA
- Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Birmingham, Alabama, USA
| | | | | | - Sheila Gahagan
- University of California San Diego, La Jolla, California, USA
| | - Beverly Rosa Williams
- University of Alabama, Birmingham, Alabama, USA
- Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Birmingham, Alabama, USA
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