Prevention of postparutm weight retention in low income WIC women

描述（由申请人提供）：大约25%的年轻成年女性发生产后体重保持率高，是长期体重增加、肥胖和肥胖相关合并症的独立预测因素。减少产后体重保留的初步努力取得了一些成功，但受到高损耗（30- 40%）和未能达到最高风险人群（即，多民族、低收入妇女）。需要创新的方法来利用妇女在产后时间段内自然发生的体重控制动机，同时吸引更大比例的高危人群。在过去的十年中，互联网的使用在美国呈指数级增长，在年轻人、低收入和少数族裔群体中增长最快。基于互联网的体重控制干预措施在促进肥胖人群显著减肥方面是有效的。然而，到目前为止，还没有研究评估基于互联网的计划对预防低收入妇女产后体重保持率高的影响。我们建议开发和测试一个基于互联网的体重控制计划为低收入的产后母亲量身定制的长期疗效。我们将与妇女、婴儿和儿童（WIC）计划合作，这是一个由联邦政府资助的以社区为基础的计划，为低收入多种族妇女提供营养支持。在这项随机分组试验中，408名产后体重保持率高的产后妇女将由诊所（N = 12）随机分配至12个月的标准WIC或12个月的WIC增强型加基于互联网的产后减肥计划。将在基线、6个月和12个月时对受试者进行评估。主要假设是，WIC增强加互联网计划在6个月和12个月时将产生比WIC标准护理更大的体重减轻;预计干预措施还将增加6个月和12个月后恢复到怀孕前体重的女性比例。该项目将提供一个急需的服务，以服务不足的人口，并产生一个基于药物的治疗包，旨在通过WIC在加州州和超越传播。 公共卫生相关性：在美国，大约25%的女性在怀孕后保持超重。产后体重保持率高的妇女长期体重增加、肥胖、心血管疾病和2型糖尿病的风险增加。帮助妇女在怀孕后减肥有可能预防这些严重的慢性健康问题。

DESCRIPTION (provided by applicant): High postpartum weight retention occurs in approximately 25 percent of young adult women and is an independent predictor of long-term weight gain, obesity, and obesity-related comorbidities. Preliminary efforts to reduce postpartum weight retention have met with some success but been limited by high attrition (30-40 percent) and failing to reach the populations at greatest risk (i.e., multiethnic, low income women). Innovative methods are needed to leverage women's naturally occurring motivation for weight control during the postpartum time period while captivating a greater proportion of the at risk population. Over the past decade, Internet use has increased exponentially in the US and most rapidly among young adult, low income, and minority sub-groups. Internet-based weight control interventions have been effective in promoting significant weight loss in obese populations. However, to date, no study has evaluated the effects an Internet-based program to prevent high postpartum weight retention in low-income women. We propose to develop and test the long-term efficacy of an Internet-based weight control program tailored for low-income postpartum mothers. We will be collaborating with the Women, Infants, and Children (WIC) program, which is a federally- funded community-based program providing nutritional support for low income multi-ethnic women. In this clustered randomized trial, 408 postpartum women with high postpartum weight retention will be randomized by clinic (N = 12) to either 12-month standard WIC or to a 12-month WIC Enhanced plus Internet-based postpartum weight loss program. Participants will be assessed at baseline, 6, and 12 months. The primary hypothesis is that the WIC Enhanced plus Internet program will produce significantly greater weight losses than the WIC Standard Care at 6 and 12 months; the intervention is also expected to increase the proportion of women who return to pre-pregnancy weight after 6 and 12 months. The project will provide a much-needed service to an underserved poplation and produce an empirically-based treatment package designed to be disseminated through WIC in the state of California and beyond. PUBLIC HEALTH RELEVANCE: Approximately 25 percent of women in the United States retain excess weight after pregnancy. Women with high postpartum weight retention are at increased risk of long-term weight gain, obesity, cardiovascular disease, and type 2 diabetes. Helping women lose weight after pregnancy has the potential to prevent these serious chronic health problems.