Prevention of postparutm weight retention in low income WIC women

描述（由申请人提供）：大约25%的年轻成年女性出现高产后体重潴留，是长期体重增加、肥胖和肥胖相关合并症的独立预测因素。减少产后体重潴留的初步努力取得了一些成功，但受到高损失率（30- 40%）的限制，并且未能达到风险最大的人群（即多种族，低收入妇女）。需要创新的方法来利用女性在产后控制体重的自然动机，同时吸引更大比例的风险人群。在过去的十年里，互联网的使用在美国呈指数级增长，在年轻人、低收入者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的显著体重减轻方面是有效的。然而，到目前为止，还没有研究评估了基于互联网的预防低收入妇女产后体重潴留的效果。我们建议为低收入的产后母亲开发和测试一个基于互联网的体重控制程序的长期效果。我们将与妇女、婴儿和儿童（WIC）项目合作，这是一个由联邦政府资助的以社区为基础的项目，为低收入的多民族妇女提供营养支持。在这项聚类随机试验中，408名产后体重潴留率高的产后妇女将按临床（N = 12）随机分为12个月的标准WIC或12个月的WIC增强+基于互联网的产后减肥计划。参与者将在基线、6个月和12个月时进行评估。主要假设是在6个月和12个月时，WIC增强加上互联网计划将比WIC标准护理产生更大的体重减轻；干预措施也有望增加妇女在6个月和12个月后恢复到孕前体重的比例。该项目将为服务不足的人群提供急需的服务，并制定一套基于经验的治疗方案，旨在通过WIC在加利福尼亚州及其他地区传播。

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.