Examining associations between social network characteristics, obesity-related health behaviors, and weight retention among racially/ethnically diverse postpartum women

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PROJECT SUMMARY/ABSTRACT Postpartum weight retention (PPWR), or the failure to return to pre-pregnancy weight by 1-year postpartum (PP), impacts approximately 75% of women. PPWR can lead to serious morbidity including insulin resistance, hypertension, cardiovascular disease, and type 2 diabetes. These risks are magnified among the 25% of women who enter pregnancy overweight or obese. Moreover, racial/ethnic disparities exist related to PPWR, with women of color being more likely to begin pregnancy overweight or obese and more likely to experience PPWR. The PP year is characterized by unique challenges and changing social networks, impacting women’s ability to prioritize healthy diet and activity. These social network dynamics may be compounded for mothers of color for whom network influence and norms can be particularly salient. Understanding these dynamics is essential for the development of culturally-relevant PPWR interventions. This proposal, if funded, will explore the associations between postpartum social networks and diet, activity, and PPWR by 1) Quantitatively investigating how diet, activity, and PPWR at 1-year PP are associated with structural and functional features of social networks among a sample of racially/ethnically diverse women, 2) Qualitatively exploring mothers’ perceptions about the influence of their social networks on weight-related health behaviors and PPWR and 3) Triangulating qualitative and quantitative data using an explanatory sequential mixed methods design. A cross-sectional, mixed-methods approach will leverage quantitative survey and social-network data to create network visualizations that will be used to facilitate semi-structured interviews with mothers. Targeted follow-up of qualitative data will be triangulated with quantitative data to provide a rich understanding of how postpartum social networks are associated with diet, activity and PPWR. Training Plan: The aims of the proposed training during the award period are: 1) Develop methodological and analytical skills in the ethical conduct of mixed methods and social network analysis; 2) Advance knowledge and understanding of women from racially/ethnically diverse backgrounds, and about the social influence literature; 3) Develop and implement a secure and efficient database, online survey, and social-network interview protocol; and 4) Acquire experience in professional development preparatory to a post-doctoral position which will lead to an R1 tenure-track faculty position and contribute to growth as an independent scientist. Environment: The College of Nursing at the University of Utah has a strong PhD program, well known for their NIH funding and women’s health and caregiving research. Further, the University provides numerous opportunities for interdisciplinary collaboration for training, professional development, and research, including the Obstetrics and Gynecology Research Network.