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.
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.
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DOI：
10.1186/s12966-022-01387-w
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发表时间：
2022-12-09
影响因子：
8.7
通讯作者：
Wingard, Ellen
中科院分区：
文献类型：
--
作者：
Wilcox, Sara;Liu, Jihong;Turner-McGrievy, Gabrielle M.;Boutte, Alycia K.;Wingard, Ellen
身体活动（PA），饮食和健康相关的生活质量（HRQOL）与孕产妇和婴儿健康有关，但需要采取干预措施来改善体重升高的不同孕妇的这些结果。妊娠和产后健康（HIPP）是一项随机对照试验。超重或肥胖但其他健康的孕妇（N=219，44%为非洲裔美国人，56%为白色人）被随机分配至基于社会认知理论的行为干预组（n=112）或标准护理组（n=107）。干预组接受了一次深入的咨询会议，一个私人Facebook小组，以及10个基于内容的咨询电话，伴随着行为播客，然后每周或每两周一次的咨询电话，直到分娩。标准护理组每月收到邮件和10个专注于健康怀孕的播客。PA（SenseWear臂章）、饮食（ASA 24）和HRQOL（SF-12）测量值在基线（<16周）和妊娠晚期（32周）从盲法评估者处获得。混合模型重复测量回归模型检验了治疗（组x时间）和组内效应。我们假设干预参与者比标准护理参与者具有更高水平的PA，更优质的饮食和更高的HRQOL。探索性分析检查了结果随时间的变化是否根据参与者是否推荐，过度或不充分的体重增加而有所不同。蔬菜摄入量（d=0.40，p<0.05）和全谷物百分比（d=0.60，p<0.01）的治疗效果有利于干预参与者。两组HRQOL的心理成分均有所改善，但干预组的改善程度低于标准治疗组（d=-0.33，p<0.05）。时间效应表明，总PA，步/天，和HRQOL身体成分在两组中显着下降。组内效应表明，干预参与者的饮食质量显着改善。在标准护理参与者中，中等强度PA显著下降，而在干预参与者中，轻度PA下降，久坐行为显著增加。最后，探索性分析表明，总PA和轻PA增加，而久坐行为减少的那些会议指南的体重增加，与相反的模式中看到那些过度或不足的体重增加。干预改善了几种饮食结果，但对PA和HRQOL的影响不大，强调了怀孕期间行为改变的挑战。本试验于2014年9月10日在ClinicalTrials.gov上注册。NCT 02260518在线版本包含补充材料，可通过10.1186/s12966-022-01387-w获得。
Physical 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. Health 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. Treatment 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. The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy. This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518 The online version contains supplementary material available at 10.1186/s12966-022-01387-w.
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影响因子：
5
作者：
Deierlein AL;Ghassabian A;Kahn LG;Afanasyeva Y;Mehta-Lee SS;Brubaker SG;Trasande L
通讯作者：
Trasande L
影响因子：
7.2
作者：
通讯作者：
--
影响因子：
7.2
作者：
通讯作者：
--
限制超重和肥胖孕妇妊娠期体重增加的行为生活方式干预。
DOI：
10.1002/oby.23119
发表时间：
2021-04
期刊：
Obesity (Silver Spring, Md.)
影响因子：
--
作者：
通讯作者：
--
DOI：
10.1089/whr.2020.0089
发表时间：
2020
期刊：
Women's health reports (New Rochelle, N.Y.)
影响因子：
--
作者：
Liu J;Wilcox S;Wingard E;Burgis J;Schneider L;Dahl A
通讯作者：
Dahl A