Electronically-Mediated Weight Interventions for Pregnant and Postpartum Women

描述（由申请人提供）：该项目旨在通过开发，实施和评估两种电子介导（基于网络）的行为干预措施，一种针对孕妇，一种针对产后妇女，来扩大对如何减缓育龄妇女体重积累的理解。这些干预措施的目标分别是减少怀孕期间体重过度增加和体重过度保持的发生率（> 5磅）在产后的前18个月，在高收入和低收入的种族/民族多样化样本中，（<贫困线的185%）怀孕时体重指数（BMI）正常（19.8-26.0）、超重（26.1-29.0）和肥胖（>29.0）的妇女。在第一阶段，电子介导的行为干预（电子干预）将被调整或新开发，然后进行测试。在第2阶段，将进行一项随机对照试验，以评估单独使用妊娠电子干预和与产后电子干预联合使用的疗效。在怀孕的前20周，5000名妇女将被随机分为三组：干预组1将只在怀孕期间接受电子介导的行为干预计划（e-干预1）。干预组2将接受电子干预1加产后18个月的电子介导干预（电子干预2）。对照组妇女将在项目网站上收到与体重无关的内容。主要假设如下：H1：干预组1和2（合并）中怀孕期间体重增加超过医学研究所推荐体重的妇女比例比对照组中体重过度增加的比例低33%。H2：与对照组相比，干预组1和干预组2中产后6个月、12个月和18个月保留超过5磅的女性比例将减少33%至50%（每个干预组与对照组相比）。H3：与干预组1相比，对照组在产后6、12和18个月时具有更高的平均体重保持率和更小比例的恢复到其孕前体重的女性，并且在三个产后时间点，干预组1将具有更高的平均体重保持率和更小比例的恢复到其孕前体重的女性。还将讨论有关体重增加的遗传易感性和干预效果的行为介质的研究问题。相关性（参见说明）：该项目旨在发现有助于妇女在生育年龄避免体重过度增加的策略，体重过度增加是心血管疾病的风险因素。该项目利用因特网有效地接触到可能接受保健信息的大批孕妇。该项目有可能减少中年肥胖的年轻妇女的比例。(End摘要）

DESCRIPTION (provided by applicant): This project alms to expand the understanding of how to slow the accumulation of weight in childbearing women by developing, implementing and evaluating two electronically-mediated (web-based) behavioral interventions, one for pregnant women and one for postpartum women. The goals of the interventions are, respectively, to decrease the prevalence of excessive weight gain during pregnancy and excessive weight retention (> 5 pounds) in the first 18 months postpartum in a racially/ethnically diverse sample of both higher and lower income (<185% of the poverty line) women who enter pregnancy with normal (19.8-26.0), overweight (26.1-29.0), and obese (>29.0) body mass indices (BMI). In phase 1, the electronically-mediated behavioral interventions (e-interventions) will be either adapted or newly developed, and then tested. In phase 2, a randomized controlled trial will be conducted to evaluate the efficacy of the pregnancy e- intervention alone and in combination with the postpartum e-intervention. Five thousand women in the first 20 weeks of pregnancy will be randomized to one of three groups: Intervention Group 1 will receive the electronically-mediated behavioral intervention program only during pregnancy (e-interventlon 1). Intervention Group 2 will receive e-intervention 1 plus an electronically-mediated intervention for 18 months postpartum (e-intervention 2). Control women will receive non-weight related content at the project web site. The primary hypotheses are as follows: H1: The proportion of women in Intervention Groups 1 and 2 (combined) who gain more weight in pregnancy than is recommended by the Institute of Medicine will be 33% less than the proportion in the Control Group who gain excessively. H2: The proportion of women in Intervention Group 1 and Group 2 who retain more than 5 pounds at 6, 12, and 18 months postpartum will be reduced by 33 to 50% compared to the Control Group (each Intervention Group compared to Control Group). H3: The Control Group will have a higher mean weight retention and a smaller proportion of women returning to their pre-pregnancy weights at 6, 12 and 18 months postpartum than Intervention Group 1, and Intervention Group 1 will have a higher mean weight retention and a smaller proportion of women returning to their pre-pregnancy weights than Intervention Group 2 at the three postpartum time points. Research questions concerning genetic susceptibility to weight gain and behavioral mediators of intervention effects will also be addressed. RELEVANCE (See instructions): This project aims to discover strategies that will help women avoid excessive weight gain, a risk factor for cardiovascular disease, during the childbearing years. The project uses the Internet to efficiently reach a large group of pregnant women who are likely to be receptive to health information. The project has the potential to decrease the proportion of young women who become obese by mid-life. (End of Abstract)