Problems recruiting and retaining postnatal women to a pilot randomised controlled trial of a web-delivered weight loss intervention

Haste, Anna; Adamson, Ashley J.; McColl, Elaine; Araujo‐Soares, Vera; Bell, Ruth

doi:10.1186/s13104-018-3305-x

Cited by 16 publications

(22 citation statements)

References 42 publications

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“…One recent study of postpartum women recruited women from general practices only and was unable to meet the recruitment target of 60 women: 16 were recruited. 166 In the Supporting MumS pilot RCT, multiple community-based approaches were used to reach postpartum women. The majority of participants were recruited via social media, which included paid advertisements and also a post from a mother and toddler group leader, with the latter being the biggest contributor to the sample recruitment.…”

Section: Feasibility Of Recruitmentmentioning

confidence: 99%

“…However, issues of poor recruitment and retention still affect some studies in this area. 166,175,200 The five feasibility and pilot RCTs described in the following paragraphs, all from the USA, have used different intervention approaches ranging from group based to the use of technology to deliver postpartum weight management interventions.…”

Section: Interventions For Weight Management In the Postpartum Periodmentioning

confidence: 99%

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Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

et al. 2020

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Background There is a need to develop weight management interventions that fit seamlessly into the busy lives of women during the postpartum period. Objective The objective was to develop and pilot-test an evidence- and theory-based intervention, delivered by short message service, which supported weight loss and weight loss maintenance in the postpartum period. Design Stage 1 involved the development of a library of short message service messages to support weight loss and weight loss maintenance, with personal and public involvement, focusing on diet and physical activity with embedded behaviour change techniques, and the programming of a short message service platform to allow fully automated intervention delivery. Stage 2 comprised a 12-month, single-centre, two-arm, pilot, randomised controlled trial with an active control. Setting This study was set in Northern Ireland; women were recruited via community-based approaches. Participants A total of 100 women with overweight or obesity who had given birth in the previous 24 months were recruited. Interventions The intervention group received an automated short message service intervention about weight loss and weight loss maintenance for 12 months. The active control group received automated short message service messages about child health and development for 12 months. Main outcome measures The main outcomes measured were the feasibility of recruitment and retention, acceptability of the intervention and trial procedures, and evidence of positive indicative effects on weight. Weight, waist circumference and blood pressure were measured by the researchers; participants completed a questionnaire booklet and wore a sealed pedometer for 7 days at baseline, 3, 6, 9 and 12 months. Outcome assessments were collected during home visits and women received a voucher on completion of each of the assessments. Qualitative interviews were conducted with women at 3 and 12 months, to gather feedback on the intervention and active control and the study procedures. Quantitative and qualitative data were used to inform the process evaluation and to assess fidelity, acceptability, dose, reach, recruitment, retention, contamination and context. Results The recruitment target of 100 participants was achieved (intervention, n = 51; control, n = 49); the mean age was 32.5 years (standard deviation 4.3 years); 28 (28%) participants had a household income of < £29,999 per annum. Fifteen women became pregnant during the follow-up (intervention, n = 9; control, n = 6) and withdrew from the study for this reason. At the end of the 12-month study, the majority of women remained in the study [85.7% (36/42) in the intervention group and 90.7% (39/43) in the active control group]. The research procedures were well accepted by women. Both groups indicated a high level of satisfaction with the short message service intervention that they were receiving. There was evidence to suggest that the intervention may have a positive effect on weight loss and prevention of weight gain during the postpartum period. Limitations The interviews at 3 and 12 months were conducted by the same researchers who collected other outcome data. Conclusions An evidence- and theory-based intervention delivered by short message service was successfully developed in conjunction with postpartum women with overweight and obesity. The intervention was acceptable to women and was feasible to implement in the 12-month pilot randomised controlled trial. The progression criteria for a full randomised controlled trial to examine effectiveness and cost-effectiveness were met. Future work Some minor refinements need to be made to the intervention and trial procedures based on the findings of the pilot trial in preparation for conducting a full randomised controlled trial. Trial registration Current Controlled Trial ISRCTN90393571. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 4. See the NIHR Journals Library website for further project information. The intervention costs were provided by the Public Health Agency, Northern Ireland.

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Section: Feasibility Of Recruitmentmentioning

confidence: 99%

Section: Interventions For Weight Management In the Postpartum Periodmentioning

confidence: 99%

Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

et al. 2020

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“…Slower than expected recruitment rates are not uncommon in postnatal weight management studies [ 41 , 42 ]; recruitment also proved challenging in this trial for which there may be specific reasons. All practices except one were located in areas of high deprivation serving a high proportion of ethnic minority patients.…”

Section: Discussionmentioning

confidence: 99%

“…Slower than expected recruitment rates are not uncommon in postnatal weight management studies [41,42];…”

Section: Recruitmentmentioning

confidence: 99%

Feasibility and acceptability of a brief routine weight management intervention for postnatal women embedded within the national child immunisation programme in primary care: randomised controlled cluster feasibility trial

Daley

Jolly

Bensoussane

et al. 2020

Trials

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Background: The prevalence of obesity in women continues to rise and pregnancy is a high-risk time for excessive weight gain. The period after childbirth represents an opportunity to offer women support to manage their weight. The primary aim here was to investigate the acceptability and feasibility of delivering a self-management intervention to postnatal women to support weight loss, embedded within the national child immunisation programme. Methods: The research involved a randomised controlled cluster feasibility trial. Data were collected at baseline and 3 months later. Twenty-eight postnatal women living with overweight or obesity were recruited via Birmingham Women Hospital or general practices. Babies are routinely immunised at 2, 3 and 4 months of age; the intervention was embedded within these appointments. The intervention involved brief motivation/support by practice nurses to encourage participants to make healthier lifestyle choices through self-monitoring of weight and signposting to an online weight management programme, when they attended their practice to have their child immunised. The role of the nurse was to provide external accountability for weight loss. Participants were asked to weigh themselves weekly and record this on a record card or using the online programme. The weight goal was for participants to lose 0.5 to 1 kg per week. Usual care received a healthy lifestyle leaflet. The primary outcome was the feasibility of a phase III trial to test the subsequent effectiveness of the intervention, as assessed against three stop-go traffic light criteria (recruitment, adherence to regular self-weighing and registration with an online weight management programme).

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“…Indeed, 99% of postpartum women own a mobile phone and up to 86% of women have access to the Internet via smartphone or Internet connection in their household (20, 21). Favored attributes of DHIs include their convenience and ease of use (22). However, some research suggests that engagement in DHIs by postpartum women remains sub-optimal, impacting intervention effectiveness (22, 23).…”

Section: Introductionmentioning

confidence: 99%

Health Professionals' and Postpartum Women's Perspectives on Digital Health Interventions for Lifestyle Management in the Postpartum Period: A Systematic Review of Qualitative Studies

et al. 2019

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Objective: To explore postpartum women and health professionals' perspectives of digital health interventions (DHIs) for lifestyle management in postpartum women.Design: A systematic review and thematic synthesis of peer-reviewed qualitative studies. Relevant databases were searched from 1990 to 2019. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist.Setting and participants: Studies describing postpartum women's or health professionals' views regarding DHIs for lifestyle management in postpartum women.Findings: Nine studies with postpartum women were included in the thematic synthesis. Four common themes emerged: “personal facilitators and barriers to lifestyle modification,” “intervention-related strategies for lifestyle modification,” “user experience of the technology,” “suggestions for improvement.” The review indicated that DHIs are highly acceptable among postpartum women. Postpartum women valued behavior change strategies that were delivered through DHIs including goal-setting and self-monitoring, however personal barriers such as lack of motivation or childcare priorities were cited.Key conclusions and implications for practice: DHIs should be considered for lifestyle management in postpartum women. The development of DHIs should focus on delivering behavior change strategies and addressing practical barriers faced by postpartum women.

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Problems recruiting and retaining postnatal women to a pilot randomised controlled trial of a web-delivered weight loss intervention

Cited by 16 publications

References 42 publications

Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

Feasibility and acceptability of a brief routine weight management intervention for postnatal women embedded within the national child immunisation programme in primary care: randomised controlled cluster feasibility trial

Health Professionals' and Postpartum Women's Perspectives on Digital Health Interventions for Lifestyle Management in the Postpartum Period: A Systematic Review of Qualitative Studies

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