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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Preparing for a trial to test a postpartum weight retention intervention among low income women: feasibility of a protocol in a community-based organization

Authors: Charmaine Wright, Marjie Mogul, Glamarys Acevedo, Jaya Aysola, Florence Momplaisir, Sandy Schwartz, Judy Shea

Published in: BMC Women's Health | Issue 1/2018

Login to get access

Abstract

Background

Postpartum weight retention (PPWR) causes intergenerational harm, negatively affecting a mother’s cardiovascular health and ability to have future healthy pregnancies. Low-income minority women are at highest risk for PPWR with little guidance concerning timeline or strategy to lose weight after delivery. An academic-community partnership conducted observational and focus group work to develop an intervention for PPWR among low-income mothers. This study’s objective is to determine the feasibility of implementing a PPWR intervention trial in partnership with a community-based organization (CBO) serving low-income families with social service support.

Methods

We analyzed five implementation outcomes in this feasibility study: acceptability, adoption, appropriateness, penetration, and sustainability. Other secondary outcomes were the change in psychosocial and clinical outcomes from baseline to one year following the intervention delivery.

Results

An academic-community partnership developed and piloted a postpartum weight retention intervention among 17 participants that included 1) six weeks of interactive daily health texting, 2) exercise assistance with baby carrier, home exercise program, and pedometer provision, 3) two live healthy eating and baby feeding workshops, and 4) two 45-min home visits over one year to provide social support and acquire followup data. Implementation outcomes demonstrate an intervention supported by the organization and accepted by end-users, with increased capacity of the CBO to test and deliver an effective intervention. Weight loss was achieved by the majority of participants at one year (Md − 5 pounds (IQR = − 14.5 - 0.3).

Conclusion

We made protocol enhancements to the developed intervention based on the analysis of this study, and now prepare for a funded randomized controlled trial (RCT) in a community-based setting. Our central hypothesis is that low-income women who participate in a multi-component, low cost-intervention delivered by a CBO will have less postpartum weight retention than those women who do not participate in the program.

Trial registration

The trial was retrospectively registered, ID NCT02867631, 8/11/16.
Literature
1.
Castro LC, Avina RL. Maternal obesity and pregnancy outcomes. Curr Opin Obstet Gynecol. 2002;14(6):601–6.CrossRefPubMed
2.
Olson CM. A call for intervention in pregnancy to prevent maternal and child obesity. Am J Prev Med. 2007;33(5):435–6.CrossRefPubMed
3.
Schieve LA, Cogswell ME, Scanlon KS. Trends in pregnancy weight gain within and outside ranges recommended by the Institute of Medicine in a WIC population. Matern Child Health J. 1998;2(2):111–6.CrossRefPubMed
4.
Gore SA, Brown DM, West DS. The role of postpartum weight retention in obesity among women: a review of the evidence. Ann Behav Med. 2003;26:149–59.CrossRefPubMed
5.
Baker JL, Gamborg M, Heitmann BL, Lissner L, Sorensen TIA, Rasmussen KM. Breastfeeding reduces postpartum weight retention. Am J Clin Nutr. 2008;88(6):1543–51.CrossRefPubMed
6.
Kinnunen TI, Pasanen M, Aittasalo M, Fogelholm M, Weiderpass E, Luoto R. Reducing postpartum weight retention--a pilot trial in primary health care. Nutr J. 2007;6(21)
7.
Leermakers EA, Anglin K, Wing RR. Reducing postpartum weight retention through a correspondence intervention. Int J Obes Relat Metab Disord. 1998;22(11):1103.CrossRefPubMed
8.
Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord. 2002;26(11):1494–502.CrossRefPubMed
9.
Taveras E. First steps for mommy and me: a pilot intervention to improve nutrition and physical activity behaviors of postpartum mothers and their infants. Matern Child Health J. 2011;15:1217–27.CrossRefPubMedPubMedCentral
10.
Lipsky LM, Strawderman MS, Olson CM. Maternal weight change between 1 and 2 years postpartum: the importance of 1 year weight retention. Obesity (Silver Spring). 2012;20(7):1496–502.CrossRef
11.
12.
Schauberger CW, Rooney BL, Brimer LM. Factors that influence weight loss in the puerperium. Obstet Gynecol. 1992;79(3):424–9.CrossRefPubMed
13.
Wright CS, Mogul M, Shea J. Psychosocial factors associated with gestational weight gain in a low income cohort. JHCPU. 2013;241:332–43.
14.
Lipsky LM, Strawderman MS, Olson CM. Weight-related self-efficacy in relation to maternal body weight from early pregnancy to 2 years post-partum. Matern Child Nutr. 2016;12(3):569–78.CrossRefPubMed
15.
Amorim AR, Linne YM, Lourenco PMC. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev. 2007;3:CD005627.
16.
Kuhlmann AKS, Dietz PM, Galavotti C, England LJ. Weight-management interventions for pregnant or postpartum women. Am J Prev Med. 2008;34(6):523–8.CrossRefPubMed
17.
van der Pligt P, Willcox J, Hesketh KD, Ball K, Wilkinson S, Crawford D, Campbell K. Systematic review of lifestyle interventions to limit postpartum weight retention: implications for future opportunities to prevent maternal overweight and obesity following childbirth. Obes Rev. 2013;14(10):792–805.CrossRefPubMed
18.
Phelan S, Brannen A, Erickson K, Diamond M, Schaffner A, Munoz-Christian K, Stewart A, Sanchez T, Rodriguez VC, Ramos DI, et al. 'Fit moms/mamas Activas' internet-based weight control program with group support to reduce postpartum weight retention in low-income women: study protocol for a randomized controlled trial. Trials. 2015;16(59)
19.
Phelan S, Phipps MG, Abrarms B, Darroch F, Grantham K, Schaffner A, Wing RR. Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the fit for delivery randomized trial. Am J Clin Nutr. 2014;99(2):302–11.CrossRefPubMed
20.
van der Pligt P, Ball K, Hesketh KD, Teychenne M, Crawford D, Morgan PJ, Collins CE, Campbell KJ. A pilot intervention to reduce postpartum weight retention and central adiposity in first-time mothers: results from the mums OnLiNE (Online, lifestyle, Nutrition & Exercise) study. J Hum Nutr Diet. 2017;56:23–38.
21.
Fernandez ID, Groth SW, Reschke JE, Graham ML, Strawderman M, Olson CM. eMoms: electronically-mediated weight interventions for pregnant and postpartum women. Study design and baseline characteristics. Contemp Clin Trials. 2015;43:63–74.CrossRefPubMedPubMedCentral
22.
Chasan-Taber L, Marcus BH, Rosal MC, Tucker KL, Hartman SJ, Pekow P, Stanek E 3rd, Braun B, Solomon CG, Manson JE, et al. Proyecto mama: a lifestyle intervention in overweight and obese Hispanic women: a randomised controlled trial--study protocol. BMC Pregnancy Childbirth. 2015;15:157.CrossRefPubMedPubMedCentral
23.
Phelan S, Hagobian T, Brannen A, Hatley KE, Schaffner A, Munoz-Christian K, Tate DF. Effect of an internet-based program on weight loss for low-income postpartum women: a randomized clinical trial. JAMA. 2017;317(23):2381–91.CrossRefPubMed
24.
Gould Rothberg BE, Magriples U, Kershaw TS, Rising SS, Ickovics JR. Gestational weight gain and subsequent postpartum weight loss among young, low-income, ethnic minority women. Am J Obstet Gynecol. 2011;204(1):52.e51–11.CrossRef
25.
Asci O, Rathfisch G. Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial. J Health Popul Nutr. 2016;35:7.CrossRefPubMedPubMedCentral
26.
Davis JN, Shearrer GE, Tao W, Hurston SR, Gunderson EP. Dietary variables associated with substantial postpartum weight retention at 1-year among women with GDM pregnancy. BMC Obesity. 2017;4:31.CrossRefPubMedPubMedCentral
27.
Elliott-Sale KJ, Barnett CT, Sale C. Systematic review of randomised controlled trials on exercise interventions for weight management during pregnancy and up to one year postpartum among normal weight, overweight and obese women. Pregnancy hypertension. 2014;4(3):234.CrossRefPubMed
28.
Herring SJ, Cruice JF, Bennett GG, Darden N, Wallen JJ, Rose MZ, Davey A, Foster GD. Intervening during and after pregnancy to prevent weight retention among African American women. Prev Med Rep. 2017;7:119–23.CrossRefPubMedPubMedCentral
29.
Spencer L, Rollo M, Hauck Y, MacDonald-Wicks L, Wood L, Hutchesson M, Giglia R, Smith R, Collins C. The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol. JBI Database System Rev Implement Rep. 2015;13(1):88–98.CrossRefPubMed
30.
van der Pligt P, Ball K, Hesketh KD, Crawford D, Teychenne M, Campbell K. The views of first time mothers completing an intervention to reduce postpartum weight retention: a qualitative evaluation of the mums OnLiNE study. Midwifery. 2017(56):23–8.
31.
Amorim Adegboye AR, Linne YM. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev. 2013;(7):Cd005627.
32.
Ajzen I. From intentions to actions: a theory of planned behavior. In: Kuhi J, Beckmann J, editors. Action and control: From cognition to behavior. Heidelberg: Springer; 1985. p. 11–39.CrossRef
33.
Ajzen I, Madden TJ. Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. J Exp Soc Psychol. 1986;22:45374.CrossRef
34.
Olson CM, Baker IR, Demment MM, Graham ML, May JJ, Strawderman MS, Wells NM. The healthy start partnership: an approach to obesity prevention in young families. Family Commun Health. 2014;37(1):74–85.CrossRef
35.
Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Admin Pol Ment Health. 38(2):65–76.
36.
Boyd RC, Le HN, Somberg R. Review of screening instruments for postpartum depression. Archives of Women's Mental Health. 2005;8(3):141–53.CrossRefPubMed
37.
Flores G. Devising, implementing, and evaluating interventions to eliminate health care disparities in minority children. Pediatrics. 2009;124(Suppl 3):S214–23.CrossRefPubMedPubMedCentral
Metadata
Title
Preparing for a trial to test a postpartum weight retention intervention among low income women: feasibility of a protocol in a community-based organization
Authors
Charmaine Wright
Marjie Mogul
Glamarys Acevedo
Jaya Aysola
Florence Momplaisir
Sandy Schwartz
Judy Shea
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0517-0

Other articles of this Issue 1/2018

BMC Women's Health 1/2018 Go to the issue

Research article

Is the likelihood of spousal violence lower or higher among childless women? Evidence from Nigeria demographic and health surveys

Research article

Trichomonas vaginalis infection and the diagnostic significance of detection tests among Ghanaian outpatients

Research article

Married women’s autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo

Research article

Perceptions and decision-making with regard to pregnancy among HIV positive women in rural Maputo Province, Mozambique – a qualitative study

Research article

The effect of sleep pattern changes on postpartum depressive symptoms

Research article

Loneliness among mothers raising children under the age of 3 years and predictors with special reference to the use of SNS: a community-based cross-sectional study