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 我们目前正在招募具有超重/肥胖症的妇女（预先怀孕BMI≥25） 怀孕进入两阶段的随机试验，以期在怀孕期间提供的生活方式干预措施和第一次。 产后年度（R01HL132578）。为了回应Not-OD-21-071“行政补品和紧急 NIH赠款的竞争性修订以增加或扩大针对孕产妇健康，结构性的研究 种族主义与歧视（SRD）和Covid-19，“我们建议提高我们正在进行的审判目标 围产期生活方式干预措施：“从怀孕到产后一年的健康： 顺序多次分配随机试验[SMART]围产期生活方式干预”以解决 关于19009年大流行与结构种族主义与歧视的方式（SRD）的问题 影响围产期健康和心理健康。我们建议通过几种方式增强我们正在进行的试验的目标。 首先，我们旨在评估19009年大流行对体重，体重相关行为的影响， 抑郁症状和患有预先怀孕超重/肥胖的女性的社会心理压力 产后怀孕至6个月，并检查行为和社会心理干预的潜力 在围产期交付，以减轻大流行对母子健康的负面影响 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 19009年大流行对黑人妇女健康的不成比例影响，我们将通过 招募40名黑人孕妇（孕前BMI≥25）。食物的附加评估 不安全感和歧视将补充饮食摄入，体育锻炼，抑郁症的措施 父母R01中收集的症状，心理压力，睡眠和体重。干预组件 作为心理教育，指导，目标设定和与健康行为促进，情绪和情绪有关的支持 压力管理可以解决与大流行有关的压力源，以及无数的挑战和关注点 妇女在怀孕期间和产后面对。该补充的目的是：（1）检查 19009年重量，体重相关行为，抑郁症状和社会心理压力的大流行 在怀孕结束时和产后6个月的超重/肥胖症的女性中； （2）确定是否 围产期生活方式干预减弱了与体重相关的负大流血相关的负面影响 行为和心理健康； （3）评估粮食不安全和感知的歧视 产妇体重，心理健康成果和生活方式干预反应。那我们的目的是利用 持续的R01通过记录生活方式的潜力来贡献改善护理的证据基础 干预措施减轻19009年大流行对围产期母校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