Goals for Reaching Optimal Wellness: GROWell

达到最佳健康的目标：GROWell

• 批准号: 10025267
• 负责人: Leigh Ann Simmons
• 金额: $ 52.31万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-26 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10025267
• 关键词: Address; Adherence; Adult; Age; Algorithms; Anxiety; Behavior monitoring; Behavioral; Birth; Blinded; Body Weight decreased; Body mass index; Breast Feeding; Categories; Cellular Phone; Cesarean section; Child; Childbirth; Clinic; Diet; Education; Energy Intake; Enrollment; Feedback; Female; Fetal Growth; Food; Frequencies; Gestational Age; Gestational Diabetes; Goals; Guidelines; Health; Human; Individual; Infant; Informal Social Control; Institute of Medicine (U.S.); Internet; Intervention; Link; Maternal and Child Health; Measures; Mental Depression; Methodology; Monitor; Mothers; Nutrient; Obesity; Occupations; Overweight; Participant; Physical activity; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Birth; Problem Solving; Public Health; Race; Randomized; Randomized Controlled Trials; Recipe; Recommendation; Reporting; Research; Resources; Risk; Self Care; Small for Gestational Age Infant; Technology; Testing; Text; Text Messaging; Time; Weight; Weight Gain; Weight maintenance regimen; Woman; Women' s Health; Work; arm; attentional control; base; clinical care; clinical practice; clinical research site; comparative efficacy; demographics; design; efficacy testing; evidence base; gestational weight gain; improved; infancy; innovation; mHealth; maternal outcome; meetings; member; mother nutrition; neonatal outcome; obesity treatment; obstetric outcomes; parity; postpartum weight; prenatal; prepregnancy; prepregnancy obesity; prevent; recruit; retention rate; skills; social media; theories; tool; weight maintenance; young adult

Research attempts to prevent excess gestational weight gain, defined as gaining more weight during pregnancy than Institute of Medicine (IOM) guidelines for prepregnancy body mass index (BMI), have largely been unsuccessful. Roughly 62% of overweight and 45% of obese women still gain more weight than recommended, increasing risk for postpartum weight retention. Few mobile health (mHealth) interventions have been trialed to address pregnancy-associated weight gain, which is a missed opportunity. Adult women are high users of technology for general and pregnancy-specific health information seeking and sharing. To fill this gap, our long-term goal is to disseminate into clinical practice a standalone mHealth tool that is effective for overweight and obese pregnant women to achieve gestational weight gain within IOM recommendations and return to prepregnancy weight after childbirth. The goal of this application is to test GROWell: Goals for Reaching Optimal Wellness, an innovative, mHealth tool based on Self-regulation Theory that we designed in pilot work to achieve appropriate gestational weight gain and safe postpartum weight loss. We propose a blinded randomized controlled trial to test the efficacy of GROWell compared to an attention control also developed in our pilot. We will recruit 480 women ages 18-44 with prepregnancy BMI 25-<40 and 10-16 weeks gestation of a singleton, uncomplicated pregnancy. Block randomization based on BMI, race, and recruitment clinic will be used to assign participants equally to arm 1, GROWell (n=240), or arm 2, the attention control (n=240). Upon study enrollment and through 6 months postpartum, GROWell participants will receive daily text messages that provide tailored education, problem-solving skills, and support to aid their personalized dietary goals. Once weekly, participants self-monitor overall adherence to their goals using text messages that prompt them to report on how they did in the past week. When users respond to this prompt, they immediately receive a text with tailored feedback on their adherence and long-term progress toward their goals. Control participants will receive weekly texts that provide personalized self-care, pregnancy, labor, delivery, and early infancy education. The specific aims are to: (1) Compare the efficacy of GROWell to the attention control in reducing the proportion of women who gain excess gestational weight based on IOM guidelines (>25 lbs for overweight and >20 lbs for obese) controlling for demographics, parity, physical activity, diet quality, and depression/anxiety; and (2) Compare the efficacy of GROWell to the attention control in reducing postpartum weight retention at 6 months post-birth as measured by the proportion of women who are within 5% of their prepregnancy weight, controlling for demographics, parity, physical activity, diet quality, breastfeeding, and depression/anxiety. This research addresses PA 18-135 (Maternal Nutrition and Pre-pregnancy Obesity) and will provide an innovative, evidence-based, standalone mHealth tool to reduce excess gestational weight gain and postpartum weight retention among overweight and obese women, currently an unavailable resource.

研究试图防止妊娠期体重过度增加，定义为在怀孕期间增加更多的体重。 怀孕比医学研究所（IOM）的孕前体重指数（BMI）指南，在很大程度上 没有成功。大约62%的超重妇女和45%的肥胖妇女体重仍然增加， 建议，增加产后体重保持的风险。移动的保健干预措施很少 已经尝试解决怀孕相关的体重增加，这是一个错过的机会。成年妇女 在寻求和分享一般和具体妊娠健康信息方面，妇女是技术的高度使用者。填补 为了弥补这一差距，我们的长期目标是在临床实践中传播一种有效的独立移动健康工具， 超重和肥胖孕妇达到IOM建议的妊娠期体重增加 并在分娩后恢复到怀孕前的体重。此应用程序的目标是测试GROWell： 达到最佳健康，一个创新的，移动健康工具的基础上自我调节理论，我们设计的， 开展试点工作，以实现适当的妊娠期体重增加和安全的产后体重减轻。我们提出了一个 盲法随机对照试验，以测试GROWell与注意力对照相比的疗效， 在我们的飞行员。我们将招募480名年龄在18-44岁之间，孕前BMI 25-<40，孕10-16周的女性。 单胎妊娠，无并发症。基于BMI、人种和招募的区组随机化 将使用诊所将受试者平等分配至第1组GROWell（n=240）或第2组注意力控制组 （n=240）。在研究入组后和产后6个月内，GROWell参与者将接受每日文本 提供量身定制的教育，解决问题的技能和支持，以帮助他们个性化的饮食信息， 目标.每周一次，参与者通过短信自我监测他们对目标的总体坚持程度， 让他们报告他们在过去一周的表现。当用户响应此提示时，他们立即收到 一个文本，其中包含针对他们的坚持和实现目标的长期进展的定制反馈。对照参与者 每周都会收到短信，提供个性化的自我护理，怀孕，分娩，分娩和婴儿早期 教育具体目的是：（1）比较GROWell与注意控制在降低 根据IOM指南，妊娠期体重增加过多的妇女比例（>25磅为超重 和>20磅的肥胖），控制人口统计学、产次、体力活动、饮食质量， （2）比较GROWell与注意力控制在减少产后抑郁/焦虑方面的疗效 出生后6个月的体重保持率，以体重保持率在5%以内的妇女比例衡量， 孕前体重，控制人口统计学、产次、体力活动、饮食质量、母乳喂养， 抑郁/焦虑。本研究涉及PA 18-135（孕产妇营养和孕前肥胖）， 将提供一个创新的，以证据为基础的，独立的移动健康工具，以减少过度妊娠体重增加 以及超重和肥胖妇女的产后体重保持率，这是目前无法获得的资源。