Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 8/2015

Open Access 01-08-2015

Feasibility and Initial Efficacy Evaluation of a Community-Based Cognitive-Behavioral Lifestyle Intervention to Prevent Excessive Weight Gain During Pregnancy in Latina Women

Authors: Sabina B. Gesell, Jeffrey A. Katula, Carmen Strickland, Mara Z. Vitolins

Published in: Maternal and Child Health Journal | Issue 8/2015

Login to get access

Abstract

About 48 % of US women gain more weight during pregnancy than recommended by the Institute of Medicine (IOM). Excessive gestational weight gain is a major risk factor for obesity in both women and offspring over their lifetimes, and should be avoided. This study was designed to test the feasibility and initial efficacy of a prenatal behavioral intervention in a sample of low-income, predominantly Latina women. The intervention was delivered in groups of 8–10 women in a community recreation center, and structured to reduce the proportion of women who gained weight in excess of IOM guidelines. Recruitment targets were met in 3 months: 135 pregnant women (>10 and <28 weeks) were randomly assigned to receive a 12-week intervention (n = 68) or usual care (n = 67). Retention rate was 81 %. On average, women attended 4 of 12 group sessions, and each session had 4 of the 8–10 assigned participants in attendance. Initial efficacy analyses were based on 87 women. Compared to usual care, fewer normal-weight women in the intervention exceeded IOM recommendations (47.1 % usual care vs. 6.7 % intervention; absolute difference 40.4 %; p = .036). Recommendations for recruitment, retention, and delivery are discussed. A community-based cognitive-behavioral lifestyle intervention during pregnancy was feasible in a hard-to-reach, high-risk population of low-income Latina women, and showed efficacy in preventing excessive gestational weight gain. Due to frequently changing work schedules, strategies are needed to either increase attendance at group sessions (e.g., within a group prenatal care format) or to build core skills necessary for behavior change through other modalities.
Appendix
Available only for authorised users
Literature
1.
2.
Viswanathan, M., Siega-Riz, A. M., Moos, M. K., et al. (2008). Outcomes of maternal weight gain. Evidence Report Technology Assessment (Full Rep), 168, 1–223.
3.
Kinnunen, T. I., Pasanen, M., Aittasalo, M., et al. (2007). Reducing postpartum weight retention: A pilot trial in primary health care. Nutrition Journal, 6, 21.PubMedCentralPubMedCrossRef
4.
Gore, S. A., Brown, D. M., & West, D. S. (2003). The role of postpartum weight retention in obesity among women: A review of the evidence. Annals of Behavioral Medicine, 26, 149–159.PubMedCrossRef
5.
Amorim, A. R., Rössner, S., Neovius, M., Lourenço, P. M., & Linné, Y. (2007). Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity, 15, 1278–1286.PubMedCrossRef
6.
Josefson, J. L., Hoffmann, J. A., & Metzger, B. E. (2013). Excessive weight gain in women with a normal pre-pregnancy BMI is associated with increased neonatal adiposity. Pediatric Obesity, 8, e33–e36.PubMedCentralPubMedCrossRef
7.
Moreira, P., Padez, C., Mourao-Carvalhal, I., & Rosado, V. (2007). Maternal weight gain during pregnancy and overweight in Portuguese children. International Journal of Obesity (London), 31, 608–614.CrossRef
8.
Mamun, A. A., Mannan, M., & Doi, S. A. (2014). Gestational weight gain in relation to offspring obesity over the life course: A systematic review and bias-adjusted meta-analysis. Obesity Reviews, 15(4), 338–347.PubMedCrossRef
9.
Wrotniak, B. H., Shults, J., Butts, S., & Stettler, N. (2008). Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. American Journal of Clinical Nutrition, 87, 1818–1824.PubMed
10.
Mamun, A. A., O’Callaghan, M., Callaway, L., et al. (2009). Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: Evidence from a birth cohort study. Circulation, 119, 1720–1727.PubMedCrossRef
11.
Nader, P., Huang, T., Gahagan, S., et al. (2012). Next steps in obesity prevention: Altering early life systems to support healthy parents, infants, and toddlers. Childhood Obesity, 8, 195–204.PubMed
12.
Herring, S. J., Rose, M. Z., Skouteris, H., & Oken, E. (2012). Optimizing weight gain in pregnancy to prevent obesity in women and children. Diabetes, Obesity and Metabolism, 14, 195–203.PubMedCentralPubMedCrossRef
13.
Thangaratinam, S., Rogozinska, E., Jolly, K., et al. (2012). Effects of interventions in pregnancy on maternal weight and obstetric outcomes: Meta-analysis of randomised evidence. BMJ, 344, e2088.PubMedCentralPubMedCrossRef
14.
Ronnberg, A., & Nilsson, K. (2010). Interventions during pregnancy to reduce excessive gestational weight gain: A systematic review assessing current clinical evidence using the grading of recommendations, assessment, development and evaluation (GRADE) system. BJOG, 117, 1327–1334.PubMedCrossRef
15.
Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA, 303, 235–241.PubMedCrossRef
16.
Siega-Riz, A. M., Evenson, K. R., & Dole, N. (2004). Pregnancy-related weight gain: A link to obesity? Nutrition Reviews, 62, S105–S111.PubMedCrossRef
17.
Davis, E. M., Zyzanski, S. J., Olson, C. M., Stange, K. C., & Horwitz, R. I. (2009). Racial, ethnic, and socioeconomic differences in the incidence of obesity related to childbirth. American Journal of Public Health, 99, 294–299.PubMedCentralPubMedCrossRef
18.
19.
20.
Oteng-Ntim, E., Varma, R., Croker, H., Poston, L., & Doyle, P. (2012). Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: Systematic review and meta-analysis. BMC Medicine, 10, 47.PubMedCentralPubMedCrossRef
21.
Ruifrok, A. E., Rogozinska, E., van Poppel, M. N., Rayanagoudar, G., Kerry, S., de Groot, C. J., & Thangaratinam, S. (2014). Study protocol: differential effects of diet and physical activity based interventions in pregnancy on maternal and fetal outcomes–individual patient data (IPD) meta-analysis and health economic evaluation. Systematic Reviews, 3(1), 131.PubMedCentralPubMedCrossRef
22.
Paul, K. H., & Olson, C. M. (2013). Moving beyond quantity of participation in process evaluation of an intervention to prevent excessive pregnancy weight gain. The International Journal of Behavioral Nutrition and Physical Activity, 10, 23.PubMedCentralPubMedCrossRef
23.
Guzman, A., Richardson, I. M., Gesell, S. B., & Barkin, S. L. (2009). Recruitment and retention of Latino children in a lifestyle intervention. American Journal of Health Behavior, 33, 581–586.PubMed
24.
Barkin, S. L., Gesell, S. B., Po’e, E. K., Escarfuller, J., & Tempesti, T. (2012). Culturally tailored, family-centered, behavioral obesity intervention for Latino-American preschool-aged children. Pediatrics, 130, 445–456.PubMedCentralPubMedCrossRef
25.
26.
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.
27.
Botvin, G. J., & Wills, T. A. (1985). Personal and social skills training: Cognitive -behavioral approaches to substance abuse prevention. In C. Bell & R. Battles (Eds.), Prevention research: Deterring drug abuse among children and adolescents, NIDA research monograph series. Washington, D.C: US Government Printing Office.
28.
Christakis, N. A., & Fowler, J. H. (2007). The spread of obesity in a large social network over 32 years. New England Journal of Medicine, 357, 370–379.PubMedCrossRef
29.
Green, L. (2001). From research to best practice in other settings and populations. American Journal of Health Behavior, 25, 165–178.PubMedCrossRef
30.
McTighe, J., & Wiggins, G. (2004). Understanding by design: Professional development workbook. Alexandria, VA: Association for Supervision and Curriculum Development.
31.
Vella, J. (2002). Learning to listen, learning to teach: The power of dialogue in educating adults. San Francisco, CA: Jossey-Bass.
32.
Botvin, G. J., Baker, E., Dusenbury, L., Botvin, E. M., & Diaz, T. (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. JAMA, 273, 1106–1112.PubMedCrossRef
33.
Fowler, N. (1998). Providing primary health care to immigrants and refugees: The North Hamilton experience. CMAJ, 159, 388–391.PubMedCentralPubMed
34.
Bellg, A. J., Borrelli, B., Resnick, B., et al. (2004). Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH behavior change consortium. Health Psychology, 23, 443–451.PubMedCrossRef
35.
36.
37.
Stevens-Simon, C., Roghmann, K. J., & McAnarney, E. R. (1992). Relationship of self-reported prepregnant weight and weight gain during pregnancy to maternal body habitus and age. Journal of the American Dietetic Association, 92, 85–87.PubMed
38.
Yu, S. M., & Nagey, D. A. (1992). Validity of self-reported pregravid weight. Annals of Epidemiology, 2, 715–721.PubMedCrossRef
39.
Phelan, S., Phipps, M. G., Abrams, B., et al. (2011). Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: The fit for delivery study. American Journal of Clinical Nutrition, 93, 772–779.PubMedCentralPubMedCrossRef
40.
Oken, E., Taveras, E. M., Kleinman, K. P., Rich-Edwards, J. W., & Gillman, M. W. (2007). Gestational weight gain and child adiposity at age 3 years. American Journal of Obstetrics and Gynecology, 196(322), e1–e8.PubMed
41.
Bodnar, L. M., Siega-Riz, A. M., Arab, L., Chantala, K., & McDonald, T. (2004). Predictors of pregnancy and postpartum haemoglobin concentrations in low-income women. Public Health Nutrition, 7, 701–711.PubMedCrossRef
42.
Jain, N. J., Denk, C. E., Kruse, L. K., & Dandolu, V. (2007). Maternal obesity: Can pregnancy weight gain modify risk of selected adverse pregnancy outcomes? American Journal of Perinatology, 24, 291–298.PubMedCrossRef
43.
Strychar, I. M., Chabot, C., Champagne, F., et al. (2000). Psychosocial and lifestyle factors associated with insufficient and excessive maternal weight gain during pregnancy. Journal of the American Dietetic Association, 100, 353–356.PubMedCrossRef
44.
Brawarsky, P., Stotland, N. E., Jackson, R. A., et al. (2005). Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. International Journal of Gynaecology and Obstetrics, 91, 125–131.PubMedCrossRef
45.
Phelan, S., Hart, C., Phipps, M., et al. (2011). Maternal behaviors during pregnancy impact offspring obesity risk. Experimental Diabesity Research, 2011, 985139.
46.
Eakin, E. G., Bull, S. S., Riley, K., et al. (2007). Recruitment and retention of Latinos in a primary care-based physical activity and diet trial: The resources for health study. Health Education Research, 22, 361–371.PubMedCrossRef
47.
Hendrickson, S. G. (2007). Video recruitment of non-English-speaking participants. Western Journal of Nursing Research, 29, 232–242.PubMedCrossRef
48.
Villarruel, A. M., Jemmott, L. S., Jemmott, J. B., & Eakin, B. L. (2006). Recruitment and retention of Latino adolescents to a research study: Lessons learned from a randomized clinical trial. Journal for Specialists in Pediatric Nursing, 11, 244–250.PubMedCrossRef
49.
Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27, 1–28.PubMedCrossRef
50.
Tanner-Smith, E. E., Steinka-Fry, K. T., & Gesell, S. B. (2014). Comparative effectiveness of group and individual prenatal care on gestational weight gain. Maternal and Child Health Journal, 8(7), 1711–1720.CrossRef
51.
Streuling, I., Beyerlein, A., & von Kries, R. (2010). Can gestational weight gain be modified by increasing physical activity and diet counseling? A meta-analysis of interventional trials. American Journal of Clinical Nutrition, 92(4), 678–687.PubMedCrossRef
52.
Gareen, I. F., Sicks, J. D., Jain, A. A., Moline, D., & Coffman-Kadish, N. (2013). Identifying and collecting pertinent medical records for centralized abstraction in a multi-center randomized clinical trial: the model used by the American college of radiology arm of the national lung screening trial. Contemporary Clinical Trials, 34, 36–44.PubMedCentralPubMedCrossRef
53.
Lubeck, D. P., & Hubert, H. B. (2005). Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors. Journal of Clinical Epidemiology, 58, 286–290.PubMedCrossRef
54.
Partin, M. R., Burgess, D. J., Halek, K., et al. (2008). Randomized trial showed requesting medical records with a survey produced a more representative sample than requesting separately. Journal of Clinical Epidemiology, 61, 1028–1035.PubMedCrossRef
55.
Ives, D. G., Fitzpatrick, A. L., Bild, D. E., et al. (1995). Surveillance and ascertainment of cardiovascular events: The cardiovascular health study. Annals of Epidemiology, 5, 278–285.PubMedCrossRef
Metadata
Title
Feasibility and Initial Efficacy Evaluation of a Community-Based Cognitive-Behavioral Lifestyle Intervention to Prevent Excessive Weight Gain During Pregnancy in Latina Women
Authors
Sabina B. Gesell
Jeffrey A. Katula
Carmen Strickland
Mara Z. Vitolins
Publication date
01-08-2015
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 8/2015
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-015-1698-x

Other articles of this Issue 8/2015

Maternal and Child Health Journal 8/2015 Go to the issue

Methodological Notes

Analysis of Human Milk Composition After Preterm Delivery With and Without Fortification

ReviewPaper

A Review of e-Health Interventions for Maternal and Child Health in Sub-Sahara Africa

OriginalPaper

Maternal Education and Immunization Status Among Children in Kenya

OriginalPaper

A Cluster Analysis of Reported Sleeping Patterns of 9-Month Old Infants and the Association with Maternal Health: Results from a Population Based Cohort Study

OriginalPaper

Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities

OriginalPaper

The Effect of Early Marriages and Early Childbearing on Women’s Nutritional Status in India