Optimizing health from pregnancy through one year postpartum: A sequential multiple assignment randomized trial (SMART) of perinatal lifestyle intervention

优化从怀孕到产后一年的健康：围产期生活方式干预的序贯多重分配随机试验 (SMART)

• 批准号: 10392312
• 负责人: MICHELE D LEVINE
• 金额: $ 36.84万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-13 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10392312
• 关键词: Address; Administrative Supplement; Affect; Area; Attenuated; Behavior; Behavioral; Behavioral trial; Body mass index; COVID-19; COVID-19 pandemic; Caring; Data Collection; Dietary intake; Discrimination; Exposure to; Face; Food; Goals; Grant; Health; Health behavior; Intervention; Maternal Health; Measures; Mental Health; Modeling; Moods; Mothers; Obesity; Outcome; Overweight; Parents; Pennsylvania; Perinatal; Personal Satisfaction; Physical activity; Postpartum Period; Pregnancy; Pregnant Women; Psychosocial Stress; Reporting; Research; Risk; Role; Sampling; Sequential Multiple Assignment Randomized Trial; Sleep; Social Environment; Stress; Structural Racism; United States National Institutes of Health; Weight; Woman; Women' s Health; adverse maternal outcomes; biopsychosocial; black women; comparison intervention; depressive symptoms; evidence base; food insecurity; improved; lifestyle intervention; maternal weight; neonatal outcome; novel; pandemic disease; perinatal health; perinatal intervention; perinatal period; pregnant; prepregnancy; psychoeducation; psychosocial; racial discrimination; racial health disparity; racism; randomized trial; recruit; response; stress management; stressor; treatment as usual

ABSTRACT We are currently recruiting women with overweight/obesity (prepregnancy BMI ≥ 25) at the beginning of pregnancy into a two-stage randomized trial of lifestyle interventions delivered across pregnancy and the first year postpartum (R01HL132578). In response to NOT-OD-21-071 “Administrative Supplements and Urgent Competitive Revisions for NIH Grants to Add or Expand Research Focused on Maternal Health, Structural Racism and Discrimination (SRD), and COVID-19,” we propose to enhance the aims of our ongoing trial of perinatal lifestyle interventions, “Optimizing Health from Pregnancy through One Year Postpartum: A Sequential Multiple Assignment Randomized Trial [SMART] of Perinatal Lifestyle Intervention” to address questions about the ways in which the COVID-19 pandemic and structural racism and discrimination (SRD) affect perinatal health and mental health. We propose to enhance the aims of our ongoing trial in several ways. First, we aim to evaluate the effects of the COVID-19 pandemic on weight, weight-related behaviors, depressive symptoms, and psychosocial stress among women with prepregnancy overweight/obesity from pregnancy to 6 months postpartum and examine the potential for behavioral and psychosocial intervention delivered during the perinatal period to attenuate negative effects of the pandemic on maternal health and mental health. Second, we propose to add assessments of food insecurity and racial discrimination. Given the disproportionate effects of the COVID-19 pandemic on Black women’s health, we will enhance our sample by recruiting 40 additional Black pregnant women (prepregnancy BMI ≥ 25). The added assessments of food insecurity and discrimination will supplement measures of dietary intake, physical activity, depressive symptoms, psychosocial stress, sleep, and weight collected in the parent R01. Intervention components such as psychoeducation, coaching, goal-setting, and support related to health behavior promotion, mood and stress management can address stressors related to the pandemic, and the myriad challenges and concerns women face during pregnancy and postpartum. The aims of this supplement are to: (1) Examine the impact of the COVID-19 pandemic on weight, weight-related behaviors, depressive symptoms, and psychosocial stress in women with overweight/obesity at the end of pregnancy and 6 months postpartum; (2) Determine whether perinatal lifestyle intervention attenuates negative pandemic-related effects on weight, weight-related behaviors and mental health; and (3) Evaluate food insecurity and perceived discrimination in relation to maternal weight, mental health outcomes, and lifestyle intervention response. Thus, we aim to leverage the ongoing R01 to contribute an evidence base to improve care by documenting the potential for lifestyle intervention to attenuate negative impacts of the COVID-19 pandemic on perinatal maternal health and mental health.

抽象的 我们目前正在招募超重/肥胖（孕前BMI≥25）的女性。 怀孕期间进行的生活方式干预的两阶段随机试验 产后一年 (R01HL132578)。回应 NOT-OD-21-071“行政补充和紧急 对 NIH 拨款进行竞争性修订，以增加或扩大以孕产妇健康、结构性研究为重点的研究 种族主义和歧视 (SRD) 以及 COVID-19”，我们建议加强我们正在进行的试验的目标 围产期生活方式干预，“优化从怀孕到产后一年的健康：A 围产期生活方式干预的序贯多重分配随机试验 [SMART]”，以解决 关于 COVID-19 大流行和结构性种族主义和歧视 (SRD) 的方式的问题 影响围产期健康和心理健康。我们建议通过多种方式加强我们正在进行的试验的目标。 首先，我们的目标是评估 COVID-19 大流行对体重、体重相关行为的影响， 孕前超重/肥胖女性的抑郁症状和社会心理压力 怀孕至产后 6 个月，并检查行为和心理社会干预的潜力 在围产期分娩，以减轻大流行对孕产妇健康的负面影响 心理健康。其次，我们建议增加对粮食不安全和种族歧视的评估。鉴于 鉴于 COVID-19 大流行对黑人女性健康造成的不成比例的影响，我们将通过以下方式增强我们的样本 另外招募 40 名黑人孕妇（孕前 BMI ≥ 25）。对食品的附加评估 不安全感和歧视将补充饮食摄入、体力活动、抑郁等措施 父母 R01 中收集的症状、社会心理压力、睡眠和体重。干预组件如 作为与健康行为促进、情绪和健康相关的心理教育、指导、目标设定和支持 压力管理可以解决与大流行相关的压力源以及无数的挑战和担忧 女性在怀孕期间和产后的脸部。本补充的目的是： (1) 检查 COVID-19 大流行对体重、体重相关行为、抑郁症状和社会心理压力的影响 妊娠末期和产后 6 个月超重/肥胖的女性； (2) 判断是否 围产期生活方式干预可减轻流行病相关对体重的负面影响 行为和心理健康； (3) 评估粮食不安全和与以下方面相关的歧视 母亲体重、心理健康结果和生活方式干预反应。因此，我们的目标是利用 正在进行的 R01 通过记录生活方式的潜力，为改善护理提供证据基础 采取干预措施，减轻 COVID-19 大流行对围产期孕产妇健康和心理的负面影响 健康。

项目成果

Taste manipulation during a food cue-reactivity task: Effects on cue-elicited food craving and subsequent food intake among individuals with overweight and obesity.

食物提示反应任务期间的味觉操纵：对超重和肥胖个体中提示引起的食物渴望和随后的食物摄入的影响。

• DOI: 10.1016/j.eatbeh.2019.03.005
• 发表时间: 2019
• 期刊: Eating behaviors
• 影响因子: 2.8
• 作者: Germeroth,LisaJ;Wallace,MeredithL;Levine,MicheleD
• 通讯作者: Levine,MicheleD