Maternal Obesity Management Using Mobile Technology: A Feasibility Study to Evaluate a Text Messaging Based Complex Intervention during Pregnancy

Abstract

Background. Maternal obesity and excessive gestational weight gain (GWG) are on the rise with negative impact on pregnancy and birth outcomes. Research into managing GWG using accessible technology is limited. The maternal obesity management using mobile technology (MOMTech) study aimed at evaluating the feasibility of text messaging based complex intervention designed to support obese women (BMI ≥ 30) with healthier lifestyles and limit GWG. Methods. Participants received two daily text messages, supported by four appointments with healthy lifestyle midwife, diet and activity goal setting, and self-monitoring diaries. The comparison group were obese mothers who declined to participate but consented for their routinely collected data to be used for comparison. Postnatal interviews and focus groups with participants and the comparison group explored the intervention's acceptability and suggested improvements. Results. Fourteen women completed the study which did not allow statistical analyses. However, participants had lower mean GWG than the comparison group (6.65 kg versus 9.74 kg) and few (28% versus 50%) exceeded the Institute of Medicine's upper limit of 9 kg GWG for obese women. Conclusions. MOMTech was feasible within clinical setting and acceptable intervention to support women to limit GWG. Before further trials, slight modifications are planned to recruitment, text messages, and the logistics of consultation visits.

The Usability and Effectiveness of Mobile Health Technology�Based Lifestyle and Medical Intervention Apps Supporting Health Care During Pregnancy: Systematic Review

“…Moreover, the lifestyle apps with a target on improvement of health behavior, less gestational weight gain, and smoking cessation showed positive results on effectiveness. However, due to small sample size, significances could often not be demonstrated [21][22][23]27,28,[31][32][33][34][35]. These results are in line with the systematic review by Badawy et al, which evaluated texting and apps for preventive behavior in adolescents [46].…”

“…In total, 10 studies reported on effectiveness of the app [20][21][22][23]28,[31][32][33][34][35]. Moreover, 5 studies reported on smoking cessation [22,23,32,33,35].…”

“…In total, 8 studies reported on interest or intention to use of the app offered by the mHealth app [19,20,22,24,[26][27][28][29]. These studies focused on nutrition [19,26], vitamin use [26], smoking cessation [22,24,29], to stop alcohol consumption [19,26], physical activity [20], weight control [27,28], and mental health [24].…”

Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial

“…Smartphone applications have been used to provide information regarding pregnancy care (Kaewkungwal et al, 2010), and although pregnant women use these tools to seek health-related advice, evaluation of both content and efficacy is limited (Hearn, Miller, & Lester, 2014). Several small pilot studies have investigated smartphone applications as a tool to prevent excessive gestational weight gain or to promote weight loss after birth (Herring, Cruice, Bennett, Davey, & Foster, 2014;Knight-Agarwal et al, 2015;Pollak et al, 2014;Soltani et al, 2015;Willcox et al, 2017), although robust evaluation of their impact on relevant clinical pregnancy and nutritional outcomes is limited by both their small sample size and poor reporting of outcomes indicative of behavioural change, including modification of dietary and physical activity patterns.…”

Text Messages Based Interventions for Pregnant Women’s Health: Systematic Review

“…Result of this rewiev found that text messages are effective in antenatal health knowledge and awareness, increasing nutrition knowledge and creating behavioral changes in the fight against obesity among the individuals (27,28,37,38).…”