A pragmatic, scalable e-health intervention for management of gestational weight gain in low-income mothers

用于管理低收入母亲妊娠期体重增加的务实、可扩展的电子健康干预措施

• 批准号: 10299628
• 负责人: Leanne Maree Redman
• 金额: $ 56.52万
• 依托单位: LSU PENNINGTON BIOMEDICAL RESEARCH CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-12-18 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10299628
• 关键词: Acculturation; Adherence; Attenuated; Behavior; Behavioral; Belief; Birth; Body Weight decreased; Body mass index; Categories; Cellular Phone; Child; Chronic Disease; Client; Clinical Trials; Communities; Consultations; Cultural Sensitivity; Diet; Educational Curriculum; Enrollment; Ensure; Food; Fostering; Funding; Funding Opportunities; Future Generations; Goals; Guidelines; Health; Health Status; High Prevalence; Incidence; Infant; Institute of Medicine (U.S.); Intervention; Interview; Louisiana; Low income; Minority Women; Moods; Mothers; Nutritional; Nutritional status; Obesity; Outcome; Overweight; Participant; Pattern; Peer Group; Persons; Phase; Physical activity; Physiological; Positioning Attribute; Poverty; Pregnancy; Pregnant Women; Prenatal Nutrition; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Research; Risk; Risk Factors; Site; Smoking; Special Supplemental Nutrition Program for Women, Infants, and Children; Structure; Surveys; System; Testing; Theory of Change; Time; Transportation; Underserved Population; United States Department of Agriculture; United States National Institutes of Health; Weight; Weight Gain; Weight maintenance regimen; Woman; Women Status; base; behavior change; cost; cost effective; design; dietary supplements; eHealth; early childhood; effectiveness testing; efficacy testing; excessive weight gain; gestational weight gain; health care service; health disparity; health literacy; healthy weight; improved; innovation; intergenerational; intervention effect; lifestyle intervention; maternal obesity; maternal risk; mother nutrition; novel; nutrition; obesity in children; participant retention; patient oriented; peer; phase 1 testing; pilot trial; postpartum weight; prepregnancy obesity; prevent; programs; racial diversity; response; retention rate; service providers; smartphone Application; treatment as usual; underserved minority; voucher

Project Summary Pregnancy is critical nutritional time point that influences the immediate and long-term health of both the mother and child. While the health and nutritional status of women (eg. obesity, smoking etc.) prior to pregnancy is arguably the most important for long-term health outcomes, the nutritional status of women during pregnancy including gestational weight gain, influences birth outcomes, health, and long-term risk for chronic disease. More than one in eight women in the U.S. lived in poverty in 2015 and women with low incomes are the most vulnerable to poor nutrition, maternal obesity, excess weight gain in pregnancy and poor birth outcomes. Lifestyle interventions during pregnancy positioned to reduce excess gestational weight gain may reduce risk factors for chronic disease in women and obesity in children. To impact the health of the most vulnerable pregnant women, infants and children in the U.S., there is a critical need for scalable and effective healthcare services targeting under-served, minority women through community-based programs. The USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) – a National program – is highly suited to deliver scalable and effective lifestyle interventions in low income and nutritionally at risk pregnant women. However, there is a dearth of clinical trials testing efficacious, well-designed, culturally relevant and appropriately powered interventions aimed to promote healthy weight gain in pregnant women with low incomes. In response to the National Institutes of Health funding opportunity (PA-18-135); Maternal nutrition and pre-pregnancy obesity: effects on mothers, infants and children, the overarching goal of this research is to develop and test the effectiveness of SmartMoms® a patient-centered, pragmatic and scalable weight management program previously shown to foster healthy gestational weight gain and to increase the proportion of pregnant women who achieve appropriate gestational weight gain. This research will be conducted in two phases; Acculturation of SmartMoms (Aim 1), and a state-wide, randomized controlled trial in 432 pregnant women enrolled in the Louisiana Women’s, Infants and Children (WIC) program (Aim 2). The primary hypothesis is that compared to WIC participants receiving usual care, participants receiving SmartMoms a smartphone based, high-intensity, health literacy-appropriate and culturally adapted lifestyle intervention promoting healthy gestational weight gain will have greater adherence to the 2009 IOM gestational weight gain guidelines and significant improvements in physiological and behavioral factors.

项目摘要 怀孕是关键的营养时间点，影响母亲和母亲的直接和长期健康。 孩子而妇女的健康和营养状况（如。肥胖、吸烟等）在怀孕前， 对长期健康结果最重要的是，妇女在怀孕期间的营养状况， 体重增加，影响出生结果，健康和慢性病的长期风险。超过八分之一的女性在 2015年，美国生活在贫困之中，低收入的妇女最容易受到营养不良、孕产妇死亡和营养不良的影响。 肥胖、怀孕期间体重过度增加和出生结果不佳。孕期生活方式干预 减少妊娠期体重过度增加可能会减少妇女慢性病和儿童肥胖的风险因素。 为了影响美国最脆弱的孕妇、婴儿和儿童的健康，迫切需要掌握 通过社区方案，为服务不足的少数民族妇女提供可扩展和有效的保健服务。 美国农业部妇女、婴儿和儿童特别补充营养计划（WIC）是一项国家计划， 非常适合为低收入和营养不良的孕妇提供可扩展和有效的生活方式干预 妇女然而，缺乏有效的、设计良好的、与文化相关的和 适当的干预措施旨在促进低收入孕妇健康地增加体重。在 对国立卫生研究院资助机会的回应（PA-18-135）;孕产妇营养和孕前 肥胖：对母亲，婴儿和儿童的影响，这项研究的首要目标是开发和测试 SmartMoms®是一个以患者为中心，务实和可扩展的体重管理计划， 显示促进健康的妊娠期体重增加，并增加孕妇的比例， 适当的妊娠期体重增加。本研究将分两个阶段进行：智能妈妈的文化适应（Aim 1），以及一项在路易斯安那州妇女，婴儿和 儿童方案（目标2）。主要假设是，与接受常规护理的WIC参与者相比， 接受SmartMoms的参与者基于智能手机，高强度，健康素养适当， 促进健康妊娠期体重增加的适应性生活方式干预将更多地遵循2009年IOM 妊娠期体重增加指南和生理和行为因素的显着改善。