Weight Management in Obese Pregnant Underserved African American Women

母亲肥胖和不适当的妊娠体重增加会增加母亲和新生儿的体重 发病率和死亡率。此外，肥胖女性的后代神经发育风险增加 延迟，变得肥胖，并发展为代谢性疾病。社会经济地位较高的女性 弱势(SED)，特别是来自非裔美国人(AA)人口，特别容易患上 与妊娠相关的不良后果，因为他们肥胖率很高。因此， 在SED，AA妇女在孕期成功的体重控制有相当大的公共健康 这意味着什么。我们在测试SED非怀孕女性的生活方式干预方面有经验 已在社区组织内实施和维持，例如家长为教师(PAT)， 全国家访计划，免费为高需求人群提供亲子教育和服务 妇女，产前和产后，每年最多25次家访，直到幼儿园。 我们建议进行为期24个月(产前6个月，产后18个月)的随机对照研究 在肥胖的自闭症AA妇女中进行试验，以评估创新的生活方式干预计划(PAT-I-)的能力， 由帕特家长教育工作者在产前和产后家访期间提供，以改善产妇和 新生儿/婴儿体重、代谢和健康结果。广泛的方案评估将确定 通过测量方案覆盖范围来衡量PAT+干预在现实世界环境中的适用性， 可实施性、可接受性和可持续性。如果有效，PAT+可以通过这个国家传播 该组织目前惠及249,000多名母亲和319,000名儿童，参与2,173个PAT 所有50个州的项目。

Maternal obesity and inappropriate gestational weight gain (GWG) increase both maternal and neonatal morbidity and mortality. In addition, offspring of obese women are at increased risk for neurodevelopmental delay, becoming obese, and developing metabolic diseases. Women who are socio-economically disadvantaged (SED), especially from African American (AA) populations, are particularly susceptible to adverse pregnancy-related outcomes because of their high prevalence rates of obesity. Therefore, successful weight management during pregnancy in SED, AA women has considerable public health implications. We have experience in testing lifestyle interventions among SED nonpregnant women that have been implemented and sustained within community organizations such as Parents As Teachers (PAT), a national home visiting program that provides parent-child education and services free-of-charge to highneeds women, prenatally and post-partum, through up to 25 home visits per year until kindergarten. We propose to conduct a 24-month (6-month prenatal and 18-month post-partum) randomized, controlled trial in obese SED AA women to evaluate the ability of an innovative lifestyle intervention program (PAT-i-), delivered by PAT parent educators during prenatal and post-partum home visits, to improve maternal and neonatal/infant weight, metabolic and health outcomes. An extensive programmatic evaluation will determine the applicability of the PAT+ intervention in real world settings by measuring programmatic reach, implementation, acceptability, and sustainability. If effective, PAT+ can be disseminated through this national organization, which currently reaches over 249,000 mothers and 319,000 children participating in 2,173 PAT programs across all 50 states.