Txt4two: Testing the Feasibility of an M-Health Intervention to Promote Healthy Nutrition, Physical Activity and Weight Gain in Pregnant Women
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Abstract
Willcox JC1, Campbell KJ1, McCarthy E2, Wilkinson SA3, Lappas M2, Ball K1, Fjeldsoe B4, Whittaker R 5, Maddison R5, Shub A2, Pidd D6, Fraser E 6, Moshanos N6, Crawford D1
1 Centre for Physical Activity and Nutrition Research, Deakin University2 Department of Obstetrics and Gynaecology, University of Melbourne 3 Mater Mothers Hospital/Mater Research 4 School of Population Health, University of Queensland 5 National Institute for Health Innovation, University of Auckland 6 Mercy Hospital for Women
Background: Excess gestational or pregnancy weight gain (GW) is a key determinant of subsequent adiposity in mother and child, and underscores the need to promote healthy GWG. Women who are overweight or obese at conception are at greater risk of exceeding GWG guidelines than those who are not. Systematic reviews of interventions promoting healthy GWG report mixed results, and show that the majority of previous interventions were time and cost intensive, limiting scalability. Novel approaches to extend the reach of interventions to the large numbers of women experiencing excess GWG are required.
Utilising outcomes from our previous studies including acceptability of potential intervention delivery modalities, a mobile phone (m-health) intervention (txt4two) focusing on behaviour change pertinent to healthy nutrition, physical activity and GWG has been developed. The aim of this pilot study is to test the feasibility of the txt4two intervention to promote healthy nutrition, physical activity and weight gain in pregnant women who were overweight or obese prior to pregnancy.
The objective of this paper is to present the protocol for the feasibility testing of the txt4two intervention and present preliminary outcome data.
Method:
Design: Pilot randomised controlled trial, commencing April 2014.
Inclusion criteria: Women with a singleton, live gestation between 10+0-16+0 weeks at the first hospital antenatal visit who have a pre-pregnancy BMI>25kg/m2 and mobile phone ownership. Exclusion criteria: < 18 years of age; comorbidities requiring medical and dietary management eg type 1 and 2 diabetes; or insufficient English.
Trial entry: Eligibility will be identified by a research midwife at initial hospital antenatal visit. One hundred consenting women will be randomised to intervention or control groups (1:1).
Intervention: Intervention group women will receive a tailored suite of intervention strategies focusing on healthy nutrition, physical activity and GWG for 20 weeks from 16 weeks gestation. This includes: tailored mobile phone text and video messages; mobile phone texts promoting goal setting and self-monitoring; print and accessible website nutrition, physical activity and GWG information; and a private moderated Facebook® chat forum. Women randomised to the control group will continue to receive standard antenatal care.
Behaviour change theory: Taxonomy of behaviour change techniques (Abraham & Michie, 2008; Michie et al, 2011).
Primary study outcome: Relevance, applicability and feasibility of the intervention.
Secondary study outcomes: Effect of the intervention on excess GWG and quality and knowledge of diet and physical activity.
Results: Baseline characteristics of the 100 participants, preliminary process evaluation data and preliminary outcome data on completed participants will be presented.
Conclusion: Findings will inform the development of larger-scale m-health programs to improve the delivery of healthy pregnancy nutrition, physical activity and GWG in this critical target group that could easily be up-scaled for wide translation and dissemination.
1 Centre for Physical Activity and Nutrition Research, Deakin University2 Department of Obstetrics and Gynaecology, University of Melbourne 3 Mater Mothers Hospital/Mater Research 4 School of Population Health, University of Queensland 5 National Institute for Health Innovation, University of Auckland 6 Mercy Hospital for Women
Background: Excess gestational or pregnancy weight gain (GW) is a key determinant of subsequent adiposity in mother and child, and underscores the need to promote healthy GWG. Women who are overweight or obese at conception are at greater risk of exceeding GWG guidelines than those who are not. Systematic reviews of interventions promoting healthy GWG report mixed results, and show that the majority of previous interventions were time and cost intensive, limiting scalability. Novel approaches to extend the reach of interventions to the large numbers of women experiencing excess GWG are required.
Utilising outcomes from our previous studies including acceptability of potential intervention delivery modalities, a mobile phone (m-health) intervention (txt4two) focusing on behaviour change pertinent to healthy nutrition, physical activity and GWG has been developed. The aim of this pilot study is to test the feasibility of the txt4two intervention to promote healthy nutrition, physical activity and weight gain in pregnant women who were overweight or obese prior to pregnancy.
The objective of this paper is to present the protocol for the feasibility testing of the txt4two intervention and present preliminary outcome data.
Method:
Design: Pilot randomised controlled trial, commencing April 2014.
Inclusion criteria: Women with a singleton, live gestation between 10+0-16+0 weeks at the first hospital antenatal visit who have a pre-pregnancy BMI>25kg/m2 and mobile phone ownership. Exclusion criteria: < 18 years of age; comorbidities requiring medical and dietary management eg type 1 and 2 diabetes; or insufficient English.
Trial entry: Eligibility will be identified by a research midwife at initial hospital antenatal visit. One hundred consenting women will be randomised to intervention or control groups (1:1).
Intervention: Intervention group women will receive a tailored suite of intervention strategies focusing on healthy nutrition, physical activity and GWG for 20 weeks from 16 weeks gestation. This includes: tailored mobile phone text and video messages; mobile phone texts promoting goal setting and self-monitoring; print and accessible website nutrition, physical activity and GWG information; and a private moderated Facebook® chat forum. Women randomised to the control group will continue to receive standard antenatal care.
Behaviour change theory: Taxonomy of behaviour change techniques (Abraham & Michie, 2008; Michie et al, 2011).
Primary study outcome: Relevance, applicability and feasibility of the intervention.
Secondary study outcomes: Effect of the intervention on excess GWG and quality and knowledge of diet and physical activity.
Results: Baseline characteristics of the 100 participants, preliminary process evaluation data and preliminary outcome data on completed participants will be presented.
Conclusion: Findings will inform the development of larger-scale m-health programs to improve the delivery of healthy pregnancy nutrition, physical activity and GWG in this critical target group that could easily be up-scaled for wide translation and dissemination.
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