This article demonstrates the potential for real-world applications of an adaptive intervention to manage gestational weight gain and moderate infant birth weight. This model could be expanded to examine the long-term sustainable impacts of an intervention that varies according to the participant's needs on maternal postpartum weight retention and child postnatal eating behavior.

Control engineering offers a systematic and efficient method to optimize the effectiveness of individually tailored treatment and prevention policies known as adaptive or “just-in-time” behavioral interventions. The nature of these interventions requires assigning dosages at categorical levels, which has been addressed in prior work using Mixed Logical Dynamical (MLD)-based hybrid model predictive control (HMPC) schemes. However, certain requirements of adaptive behavioral interventions that involve sequential decision making have not been comprehensively explored in the literature. This paper presents an extension of the traditional MLD framework for HMPC by representing the requirements of sequential decision policies as mixed-integer linear constraints. This is accomplished with user-specified dosage sequence tables, manipulation of one input at a time, and a switching time strategy for assigning dosages at time intervals less frequent than the measurement sampling interval. A model developed for a gestational weight gain (GWG) intervention is used to illustrate the generation of these sequential decision policies and their effectiveness for implementing adaptive behavioral interventions involving multiple components.

Excessive gestational weight gain (GWG) represents a major public health concern. In this paper, we present a dynamical systems model that describes how a behavioral intervention can influence weight gain during pregnancy. The model relies on the integration of a mechanistic energy balance with a dynamical behavioral model. The behavioral model incorporates some well-accepted concepts from psychology: the Theory of Planned Behavior (TPB) and the principle of selfregulation which describes how internal processes within the individual can serve to reinforce the positive outcomes of an intervention. A hypothetical case study is presented to illustrate the basic workings of the model and demonstrate how the proper design of the intervention can counteract natural trends towards declines in healthy eating and reduced physical activity during the course of pregnancy. The model can be used by behavioral scientists to evaluate decision rules for adaptive time-varying behavioral interventions, or as the open-loop model for hybrid model predictive control algorithms acting as decision frameworks for such interventions.