Goals for Reaching Optimal Wellness: GROWell

达到最佳健康的目标：GROWell

• 批准号: 10437737
• 负责人: Leigh Ann Simmons
• 金额: $ 36.49万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-26 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10437737
• 关键词: Address; Adherence; Adult; Age; Algorithms; Anxiety; Behavior monitoring; Behavioral; Birth; Blinded; Body Weight decreased; Body mass index; Breast Feeding; Categories; Cellular Phone; Cesarean section; Child; Childbirth; Clinic; Diet; Education; Energy Intake; Enrollment; Feedback; Female; Fetal Growth; Food; Frequencies; Gestational Age; Gestational Diabetes; Goals; Guidelines; Health; Human; Individual; Infant; Informal Social Control; Institute of Medicine (U.S.); Internet; Intervention; Link; Maternal and Child Health; Measures; Mental Depression; Methodology; Monitor; Mothers; Nutrient; Obesity; Occupations; Overweight; Participant; Physical activity; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Birth; Problem Solving; Public Health; Race; Randomized; Randomized Controlled Trials; Recipe; Recommendation; Reporting; Research; Resources; Risk; Self Care; Small for Gestational Age Infant; Technology; Testing; Text; Text Messaging; Time; Weight; Weight Gain; Weight maintenance regimen; Woman; Women' s Health; Work; arm; attentional control; base; clinical care; clinical practice; clinical research site; comparative efficacy; demographics; design; dietary; efficacy testing; evidence base; gestational weight gain; improved; infancy; innovation; mHealth; maternal outcome; meetings; member; mother nutrition; neonatal outcome; obesity treatment; obstetric outcomes; parity; postpartum weight; prenatal; prepregnancy; prepregnancy obesity; prevent; recruit; retention rate; skills; social media; theories; tool; weight maintenance; young adult

Research attempts to prevent excess gestational weight gain, defined as gaining more weight during pregnancy than Institute of Medicine (IOM) guidelines for prepregnancy body mass index (BMI), have largely been unsuccessful. Roughly 62% of overweight and 45% of obese women still gain more weight than recommended, increasing risk for postpartum weight retention. Few mobile health (mHealth) interventions have been trialed to address pregnancy-associated weight gain, which is a missed opportunity. Adult women are high users of technology for general and pregnancy-specific health information seeking and sharing. To fill this gap, our long-term goal is to disseminate into clinical practice a standalone mHealth tool that is effective for overweight and obese pregnant women to achieve gestational weight gain within IOM recommendations and return to prepregnancy weight after childbirth. The goal of this application is to test GROWell: Goals for Reaching Optimal Wellness, an innovative, mHealth tool based on Self-regulation Theory that we designed in pilot work to achieve appropriate gestational weight gain and safe postpartum weight loss. We propose a blinded randomized controlled trial to test the efficacy of GROWell compared to an attention control also developed in our pilot. We will recruit 480 women ages 18-44 with prepregnancy BMI 25-<40 and 10-16 weeks gestation of a singleton, uncomplicated pregnancy. Block randomization based on BMI, race, and recruitment clinic will be used to assign participants equally to arm 1, GROWell (n=240), or arm 2, the attention control (n=240). Upon study enrollment and through 6 months postpartum, GROWell participants will receive daily text messages that provide tailored education, problem-solving skills, and support to aid their personalized dietary goals. Once weekly, participants self-monitor overall adherence to their goals using text messages that prompt them to report on how they did in the past week. When users respond to this prompt, they immediately receive a text with tailored feedback on their adherence and long-term progress toward their goals. Control participants will receive weekly texts that provide personalized self-care, pregnancy, labor, delivery, and early infancy education. The specific aims are to: (1) Compare the efficacy of GROWell to the attention control in reducing the proportion of women who gain excess gestational weight based on IOM guidelines (>25 lbs for overweight and >20 lbs for obese) controlling for demographics, parity, physical activity, diet quality, and depression/anxiety; and (2) Compare the efficacy of GROWell to the attention control in reducing postpartum weight retention at 6 months post-birth as measured by the proportion of women who are within 5% of their prepregnancy weight, controlling for demographics, parity, physical activity, diet quality, breastfeeding, and depression/anxiety. This research addresses PA 18-135 (Maternal Nutrition and Pre-pregnancy Obesity) and will provide an innovative, evidence-based, standalone mHealth tool to reduce excess gestational weight gain and postpartum weight retention among overweight and obese women, currently an unavailable resource.

研究试图防止妊娠期体重过度增加，定义为在怀孕期间增加更多体重 妊娠医学研究所(IOM)关于孕前体重指数(BMI)的指南，在很大程度上 一直不成功。大约62%的超重和45%的肥胖女性仍然比 建议，增加产后体重滞留的风险。很少有移动医疗(MHealth)干预措施 已经进行了试验，以解决与怀孕相关的体重增加问题，这是一个错失的机会。成年女性 是寻求和共享一般和特定于怀孕的健康信息的技术的高级用户。填满 这一差距，我们的长期目标是将一种有效的独立移动健康工具传播到临床实践中 对于超重和肥胖的孕妇，在国际移民组织的建议内实现妊娠体重增加 并在分娩后恢复到孕前体重。这个应用程序的目标是测试Growell： 达到最佳健康，这是一个创新的移动健康工具，基于自我调节理论，我们在 试点工作，实现适当的孕期体重增加和安全的产后减肥。我们提出了一个 测试格罗韦尔与注意力对照组疗效的随机对照盲法试验也 在我们的试点中开发出来的。我们将招募480名年龄在18-44岁、孕前体重分别为25-40和10-16周的女性 单胎妊娠，无并发症妊娠。基于BMI、种族和招募的区组随机化 诊所将被用来将参与者平均分配到注意控制组1、Growell(n=240)或2组 (n=240)。在注册学习和产后6个月期间，Growell参与者将每天收到文本 提供量身定制的教育、解决问题的技能和支持的信息，以帮助他们个性化的饮食 目标。每周一次，参与者使用提示的短信自我监控对其目标的总体遵守情况 让他们报告他们在过去一周的表现。当用户响应此提示时，他们会立即收到 一份文本，针对他们的坚持和朝着目标的长期进展提供量身定做的反馈。对照参与者 每周将收到提供个性化自我护理、怀孕、分娩、分娩和早期婴儿的短信 教育。具体目的是：(1)比较格罗韦尔和注意控制在减少 根据国际移民组织的指导方针，孕妇超重的比例(超重25磅) 控制人口统计、产次、体力活动、饮食质量以及 抑郁/焦虑；和(2)比较格罗韦尔和注意力控制在减少产后的效果 出生后6个月的体重保留率，以5%以内的女性比例衡量 孕前体重，控制人口统计，产次，体力活动，饮食质量，母乳喂养，以及 抑郁/焦虑。这项研究涉及PA 18-135(母亲营养和孕前肥胖)和 将提供创新的、基于证据的、独立的mHealth工具，以减少过多的妊娠体重增加 以及超重和肥胖妇女的产后体重保留，目前这是一项不可用的资源。