Effects of a lifestyle intervention on postpartum weight retention among women with elevated weight

Liu, Jihong; Wilcox, Sara; Hutto, Brent; Turner‐McGrievy, Gabrielle; Wingard, Ellen

doi:10.1002/oby.23449

Cited by 12 publications

(5 citation statements)

References 35 publications

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“…The aim of the Health In Pregnancy and Postpartum (HIPP) study, a randomized clinical trial, was to evaluate the impact of a lifestyle intervention (versus standard care) on gestational weight gain (primary outcome) and related outcomes in African American and white women who enter pregnancy living with overweight or obesity [ 13 ]. In earlier papers, we described the study design and methods, including the intervention [ 13 ], as well as recruitment strategies and yields [ 14 ] and the impact of the intervention on gestational weight gain [ 15 ] and postpartum weight retention [ 16 ]. In our two outcome papers [ 15 , 16 ], we reported associations between receipt of counseling calls and gestational weight gain / postpartum weight retention.…”

Section: Methodsmentioning

confidence: 99%

“…In earlier papers, we described the study design and methods, including the intervention [ 13 ], as well as recruitment strategies and yields [ 14 ] and the impact of the intervention on gestational weight gain [ 15 ] and postpartum weight retention [ 16 ]. In our two outcome papers [ 15 , 16 ], we reported associations between receipt of counseling calls and gestational weight gain / postpartum weight retention. However, these papers did not report other components of intervention delivery overall or with respect to weight-related outcomes.…”

Section: Methodsmentioning

confidence: 99%

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Process evaluation methods and results from the Health in Pregnancy and Postpartum (HIPP) randomized controlled trial

Wilcox

Dahl

Boutté

et al. 2022

BMC Pregnancy Childbirth

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Background Excessive gestational weight gain has increased over time and is resistant to intervention, especially in women living with overweight or obesity. This study described the process evaluation methods and findings from a behavioral lifestyle intervention for African American and white women living with overweight and obesity that spanned pregnancy (≤ 16 weeks gestation) through 6 months postpartum. Methods The Health in Pregnancy and Postpartum (HIPP) study tested a theory-based behavioral intervention (vs. standard care) to help women (N = 219; 44% African American, 29.1 ± 4.8 years) living with overweight or obesity meet weight gain guidelines in pregnancy and lose weight in postpartum. Participants completed process evaluation surveys at 32 weeks gestation (n = 183) and 6 months postpartum (n = 168) regarding their perceptions of most and least helpful aspects of the intervention. A database tracked delivery and receipt of intervention components (in-depth counseling session, telephone calls, podcasts). Descriptive statistics are used to report fidelity, dose, and participants’ perceptions. We also tested whether dose of behavioral intervention components was associated with gestational weight gain and 6-month postpartum weight retention with linear regression models controlling for baseline age and gestational weeks, receipt of Medicaid, race, parity, and marital status. A content analysis was used to code and analyze responses to open-ended survey questions. Results Over 90% of participants (both groups) would recommend the program to a friend. Implementation fidelity was moderately high and greater in pregnancy than postpartum for all intervention components. Dose received and participants’ ratings of the in-depth counseling session and telephone calls were more favorable than podcasts. The Facebook group was not perceived to be very helpful, likely because of low participant interaction. Although podcasts were created to reinforce call topics, this redundancy was viewed negatively by some. More calls completed and more podcasts downloaded related to lower gestational weight gain (p < .05). Conclusion Study findings underscore challenges in engaging this important but busy population, especially during the postpartum period. Trial registration: The study was registered at clinicaltrials.gov (NCT02260518) on 10/09/2014. https://clinicaltrials.gov/ct2/show/NCT02260518.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Process evaluation methods and results from the Health in Pregnancy and Postpartum (HIPP) randomized controlled trial

Wilcox

Dahl

Boutté

et al. 2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…An additional 5 randomized clinical trials tested interventions extending from pregnancy to postpartum. [72][73][74][75][76] Three of the 5 trials reported significant intervention effects on primary outcomes of body weight. One of the largest trials tested the comparative effectiveness of a health systembased, DPP-derived intervention on 12-month postpartum weight loss in 2280 individuals with gestational diabetes receiving care through Kaiser Permanente Northern California.…”

Section: Postpartum Weight Management Interventionsmentioning

confidence: 99%

Opportunities in the Postpartum Period to Reduce Cardiovascular Disease Risk After Adverse Pregnancy Outcomes: A Scientific Statement From the American Heart Association

Lewey,

Beckie,

Brown

et al. 2024

Circulation

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Adverse pregnancy outcomes are common among pregnant individuals and are associated with long-term risk of cardiovascular disease. Individuals with adverse pregnancy outcomes also have an increased incidence of cardiovascular disease risk factors after delivery. Despite this, evidence-based approaches to managing these patients after pregnancy to reduce cardiovascular disease risk are lacking. In this scientific statement, we review the current evidence on interpregnancy and postpartum preventive strategies, blood pressure management, and lifestyle interventions for optimizing cardiovascular disease using the American Heart Association Life’s Essential 8 framework. Clinical, health system, and community-level interventions can be used to engage postpartum individuals and to reach populations who experience the highest burden of adverse pregnancy outcomes and cardiovascular disease. Future trials are needed to improve screening of subclinical cardiovascular disease in individuals with a history of adverse pregnancy outcomes, before the onset of symptomatic disease. Interventions in the fourth trimester, defined as the 12 weeks after delivery, have great potential to improve cardiovascular health across the life course.

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“…At 32 weeks, 191 participants (87%) completed the measurement visit; all completed the dietary and HRQOL measures, but 22 did not wear the SenseWear armband. Study adverse events during pregnancy (n=24; 11 behavioral intervention, 13 standard care) are reported elsewhere [35], with all determined to be unrelated to the intervention.…”

Section: Samplementioning

confidence: 99%

Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial

Wilcox

Liu

Turner‐McGrievy

et al. 2022

Int J Behav Nutr Phys Act

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Background Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight. Methods Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain. Results Treatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain. Conclusions The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy. Trial registration This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518

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Effects of a lifestyle intervention on postpartum weight retention among women with elevated weight

Cited by 12 publications

References 35 publications

Process evaluation methods and results from the Health in Pregnancy and Postpartum (HIPP) randomized controlled trial

Process evaluation methods and results from the Health in Pregnancy and Postpartum (HIPP) randomized controlled trial

Opportunities in the Postpartum Period to Reduce Cardiovascular Disease Risk After Adverse Pregnancy Outcomes: A Scientific Statement From the American Heart Association

Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial

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