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媒介(基于网络的)行为干预措施，扩大对如何减缓育龄妇女体重累积的理解，一种是针对孕妇，另一种是针对产后妇女。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产后头18个月体重过度滞留(5磅)的发生率，这些样本包括高收入和低收入(贫困线的185%)的不同种族样本，这些妇女进入怀孕时身体质量指数正常(19.8-26.0)、超重(26.1-29.0)和肥胖(&gt；29.0)。在第一阶段，将对电子媒介行为干预措施(e干预措施)进行调整或新开发，然后进行测试。在第二阶段，将进行一项随机对照试验，以评估单独进行妊娠电子干预和与产后电子干预相结合的效果。5000名怀孕前20周的妇女将被随机分为三组：干预1组将仅在怀孕期间接受电子中介行为干预计划(e-interventlon 1)。干预2组将接受电子干预1加上产后18个月的电子中介干预(e-干预2)。控制女性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和干预组2(合并)中孕期体重增加超过医学研究所建议的比例将比对照组中过度增加的比例低33%。H2：干预组1和干预组2产后6个月、12个月和18个月体重超过5磅的妇女比例将比对照组(每个干预组与对照组相比)减少33%至50%。H3：对照组产后6个月、12个月和18个月的平均体重保留率高于干预组1，恢复到孕前体重的比例低于干预组1，而干预组1在产后三个时间点的平均体重保留率高于干预组2，恢复到孕前体重的比例低于干预组2。关于体重增加的遗传易感性和干预效果的行为中介的研究问题也将被讨论。相关性(见说明)：该项目旨在寻找策略，帮助女性在育龄期间避免体重过度增加，这是心血管疾病的一个风险因素。该项目利用互联网有效地接触到一大批可能接受健康信息的孕妇。该项目有可能降低年轻女性在中年变得肥胖的比例。(摘要结束)

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)