A pragmatic, scalable e-health intervention for management of gestational weight gain in low-income mothers

项目总结 SARS-CoV-2(新冠肺炎)大流行正在对非 孕妇，包括体重增加和久坐行为增加，抑郁，焦虑和压力。这个 这一实用、可扩展的电子健康干预的行政补充的首要目标是 低收入母亲妊娠期体重增加的管理(R01NR017644)，是为了扩大这些 对孕期和产后人群的观察，长期目标是了解 新冠肺炎大流行对女性围产期身心健康结局的影响 在大流行期间怀孕，并确定这一影响的调解人。中心假设是，暴露于 孕期感染新冠肺炎疫情与围产期身心健康恶化有关 健康结果。具体目的是：1)检查新冠肺炎大流行对妊娠的影响 路易斯安那州孕妇体重增加，2)调查新冠肺炎大流行对 路易斯安那州大流行期间怀孕妇女不良妊娠结局的种族差异， 3)检查新冠肺炎疫情对孕妇围产期心理健康的影响 在路易斯安那州大流行期间。路易斯安那州是国家和世界的活实验室，拥有 收入和教育水平的广泛范围，以及高度的种族多样性。具体的目标将得到检验 有两个独特的研究设计。首先，对妇女医院分娩的回顾图表(巴顿 路易斯安那州鲁日)将被用来比较以下女性的妊娠体重增加和妊娠结局 在大流行期间怀孕的妇女，而在疫情爆发前刚刚怀孕的妇女 大流行(n=~23,000)；以及比较黑人和白人妇女的结果。第二，使用 序贯解释性混合方法设计我们将对最近产后的两个队列进行调查和访谈 在大流行期间怀孕的妇女对她们的心理健康以及与大流行有关的问题 困难：路易斯安那州WIC获奖者和妇女医院的患者。混合方法设计提供了严谨的 通过整合三角测量、互补、扩展和发展的组成部分。项目调查 包括经过验证的精神健康问卷和NICHD促进数据的通用数据元素 协调以加速新冠肺炎怀孕研究。潜在的调解人与大流行有关 困难，包括与世隔绝和改变政府援助、住房、就业或获得 医疗护理。在项目结束时，我们的预期结果是已经量化了新冠肺炎的影响 大流行对孕妇和产后妇女身心健康的影响及确定的影响因素 那种冲击力。

PROJECT SUMMARY The SARS-CoV-2 (COVID-19) pandemic is adversely impacting the physical and mental health of non- pregnant people, including weight gain and increased sedentary behavior, depression, anxiety, and stress. The overarching goal of this administrative supplement to A pragmatic, scalable e-health intervention for management of gestational weight gain in low-income mothers (R01NR017644), is to expand these observations into pregnant and postpartum populations with the long-term objective of understanding the impact of the COVID-19 pandemic on perinatal physical and mental health outcomes among women who were pregnant during the pandemic and to identify mediators of this impact. The central hypothesis is that exposure to the COVID-19 pandemic during pregnancy will be associated with worsened perinatal physical and mental health outcomes. The specific aims are: 1) examine the effects of the COVID-19 pandemic on gestational weight gain among pregnant women in Louisiana, 2) investigate the effects of the COVID-19 pandemic on racial disparities on adverse pregnancy outcomes among women pregnant during the pandemic in Louisiana, and 3) examine the effects of the COVID-19 pandemic on perinatal mental health among women pregnant during the pandemic in Louisiana. Louisiana is a living laboratory for the country and the world, with an expansive spectrum of income and education levels, and high racial diversity. The specific aims will be tested with two unique study designs. First, a retrospective chart review of deliveries at Woman's Hospital (Baton Rouge, Louisiana) will be used to compare gestational weight gain and pregnancy outcomes from women who were pregnant during the pandemic, compared to women who were pregnant immediately before the pandemic (n=~23,000); as well as comparing outcomes between Black and White women. Second, using a sequential explanatory mixed-methods design we will survey and interview two cohorts of recently postpartum women who were pregnant during the pandemic about their mental health as well as pandemic-related hardships: Louisiana WIC recipients and patients of Woman's Hospital. The mixed-methods design offers rigor by integrating components of triangulation, complementarity, expansion, and development. The project survey includes validated mental health questionnaires and common data elements of the NICHD Promoting Data Harmonization to Accelerate COVID-19 Pregnancy Research. Potential mediators are pandemic-related hardships, including isolation and changes to government assistance, housing, employment, or access to medical care. At the end of the project, our expected outcome is to have quantified the impact of the COVID-19 pandemic on the physical and mental health of pregnant and postpartum women and identified mediators of that impact.