The effectiveness of an online intervention in preventing excessive gestational weight gain: the e-moms roc randomized controlled trial

Olson, Christine M.; Groth, Susan W.; Graham, Meredith L.; Reschke, Jennifer E.; Strawderman, Myla; Fernandez, I. Diana

doi:10.1186/s12884-018-1767-4

Cited by 51 publications

(106 citation statements)

References 34 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…However, the usage level slumped after the initial excitement to a rather moderate level, which was more evident among inactive users. While the engagement level of the current study was better than the e-moms roc trial reported by Olson et al, it remained shy of anticipated as indicated by the nonsigni cant improvement in diet or physical activity (14).…”

Section: Discussioncontrasting

confidence: 74%

See 1 more Smart Citation

An eHealth-based intervention against metabolic risks during pregnancy: learnings and challenges

Wang

Huang

Hua

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Excessive gestational weight gain (eGWG) is one of the major metabolic risks for fetal macrosomia, maternal overweight, gestational diabetes mellitus (GDM), and gestational hypertension during pregnancy, which also increase the risk of postpartum weight retention. Gestational weight gain (GWG) management is rising to be attractive during prenatal care, however, there is still lack of effective tools to assist health care providers (HCPs) to efficiently and continuously implement intervention and monitor from the early phase of pregnancy. The current study tested a prototype eHealth solution aiming to assist clinicians to prevent eGWG and associated gestational metabolic complications. Methods A randomized controlled study was conducted in a private hospital in Beijing, China, with control group (N = 181) and intervention group (N = 181) recruited in rolling fashion. The control group received standard prenatal care, while the intervention group was additionally provided with the integrated prenatal care eHealth solution, Pregnancy Butler, which includes mobile application-enabled on-line service and off-line consultation session. The prevalence of eGWG, associated metabolic health parameters, and final pregnancy outcome were evaluated. Results Although mostly with normal pre-pregnancy BMI, the incidence for eGWG was high among the study subjects, at 35%. Engagement with the eHealth platform of the intervention group was stable after initial phase, but less than desired. Pregnancy Butler intervention showed significant benefit (p-value = 0.0496) in preventing eGWG among obese and overweight subjects. And highly engaged active users in the intervention group had more favorable GWG classification (p-value = 0.022). The time-course data collected indicated that the metabolic risks were largely set early in the first trimester already. Conclusions Our preliminary results indicated that the effectiveness of the eHealth intervention considerably depend on each participant’s engagement level and baseline risk factors. In order to achieve more consistent and impactful outcome improvement, focusing on those with pre-existing metabolic risks, increasing engagement and adherence level, and emphasizing intervention from the first trimester could be promising directions. Trial registration: This study was retrospectively registered as “Pregnancy Butler for gestational weight gain management” (ChiCTR1800014647) under the China Clinical Trial Registry in 2018-Jan-26. http://www.chictr.org.cn/showprojen.aspx?proj=24171

show abstract

Section: Discussioncontrasting

confidence: 74%

“…eHealth solutions provide a promising tool to enable such intervention in a more resource and user friendly manner. So far, limited examples, including the unsuccessful e-moms roc trial, and partially successful SmartMoms intervention, call for more endeavors to identify approach that can consistently deliver positive results (14,15).…”

Section: Introductionmentioning

confidence: 99%

An eHealth-based intervention against metabolic risks during pregnancy: learnings and challenges

Wang

Huang

Hua

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…All studies were published between 2012 and 2019. Of the 11 studies, 7 were randomized pilot or feasibility studies [ 31 - 37 ] and 4 were RCTs [ 38 - 41 ]. Of the 4 RCTs, 2 reported being adequately powered [ 39 , 41 ], whereas the other 2 reported being underpowered as a result of a small starting sample [ 40 ] or low follow-up rate [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis

Rhodes¹,

Smith²,

Chadwick³

et al. 2020

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

Background Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. Objective This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. Methods A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. Results In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (−0.28 kg; 95% CI −1.43 to 0.87) or per-protocol data (−0.65 kg; 95% CI −1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the goals and planning, and feedback and monitoring domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. Conclusions In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.

show abstract

“…Herring et al [ 117 ] and Willcox et al [ 118 ] provided regular health coaching regarding lifestyle, physical activity, and GWG to women via Facebook, text-messaging and/or a website, booklets, and phone-calls. Olsen et al [ 119 ] and Smith et al [ 120 ] based their interventions on websites and Jackson et al [ 121 ] described an intervention that added ‘Video Doctor’ counseling in addition to their routine antenatal care ( Table S3 ). Three eHealth interventions [ 117 , 118 , 120 ] were included in a meta-analysis which favored neither intervention nor control (WMD: −1.06; 95% CI: −4.13, 2.00, p = 0.50; I 2 = 73.6%) ( Table 1 ) ( Figure S4 ).…”

Section: Resultsmentioning

confidence: 99%

Attenuating Pregnancy Weight Gain—What Works and Why: A Systematic Review and Meta-Analysis

et al. 2018

View full text Add to dashboard Cite

Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: −3.27; 95% CI: −4.96, −1.58, p < 0.01), physical activity (PA) (WMD: −1.02; 95% CI: −1.56, −0.49, p < 0.01), and lifestyle interventions (combining diet and PA) (WMD: −0.84; 95% CI: −1.29, −0.39, p < 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: −1.06; 95% CI: −4.13, 2.00, p = 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success.

show abstract

The effectiveness of an online intervention in preventing excessive gestational weight gain: the e-moms roc randomized controlled trial

Cited by 51 publications

References 34 publications

An eHealth-based intervention against metabolic risks during pregnancy: learnings and challenges

An eHealth-based intervention against metabolic risks during pregnancy: learnings and challenges

Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis

Attenuating Pregnancy Weight Gain—What Works and Why: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About