A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial

J C Willcox; S A Wilkinson; M Lappas; K Ball; D Crawford; E A McCarthy; B Fjeldsoe; R Whittaker; R Maddison; K J Campbell

doi:10.1111/1471-0528.14552

A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial

BJOG. 2017 Oct;124(11):1718-1728. doi: 10.1111/1471-0528.14552. Epub 2017 Feb 20.

Authors

J C Willcox¹, S A Wilkinson^{2

3}, M Lappas⁴, K Ball¹, D Crawford¹, E A McCarthy^{4

5}, B Fjeldsoe⁶, R Whittaker⁷, R Maddison¹, K J Campbell¹

Affiliations

¹ Institute for Physical Activity and Nutrition, Deakin University, Burwood, Vic., Australia.
² Mater Research Institute, University of Queensland, South Brisbane, QLD, Australia.
³ Department of Nutrition & Dietetics, Mater Mothers Hospital, South Brisbane, QLD, Australia.
⁴ Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic., Australia.
⁵ Mercy Hospital for Women, Melbourne, Vic., Australia.
⁶ School of Public Health, The University of Queensland, Herston, QLD, Australia.
⁷ National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.

PMID: 28220604
DOI: 10.1111/1471-0528.14552

Abstract

Objective: To determine the feasibility and effectiveness of an mHealth intervention promoting healthy diet, physical activity and gestational weight gain in pregnant women.

Design: Randomised controlled trial (RCT).

Setting: Australian tertiary obstetric hospital.

Population: One hundred pregnant women who were overweight or obese prior to pregnancy.

Methods: Women recruited at the first antenatal clinic visit were randomised to either an intervention or a control group. The intervention consisted of a tailored suite of strategies delivered (from first antenatal visit until 36 weeks' gestation) via multiple modalities available on mobile devices.

Main outcome measures: The primary outcome was intervention feasibility and secondary outcomes were objectively measured changes in gestational weight gain (GWG) and self-reported dietary intake and physical activity.

Results: Ninety-one women completed the study. Delivery to protocol provides evidence of program feasibility. Most women engaged regularly with the program, with the majority (97.6%) reporting that the intervention was helpful. Secondary outcomes demonstrated a significantly lower GWG in the intervention group (7.8 kg ± 4.7 versus 9.7 kg ± 3.9; P =0.041) compared with the control group at intervention completion. Intervention group women reported significantly smaller reductions in total, light- and moderate-intensity physical activity from baseline to completion of the intervention (P = 0.001) compared with the control group, but no differences in consumption frequencies of key food groups.

Conclusion: An intervention that aimed to deliver healthy diet, physical activity and GWG guidance utilising innovative technology can be feasibly implemented and produce positive physical activity and GWG outcomes. TWEETABLE ABSTRACT: txt4two mHealth study improved gestational weight gain and physical activity in pregnant women with high BMIs.

Keywords: Diet; gestational weight gain; intervention; mHealth; physical activity; pregnancy.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Australia / epidemiology
Body Mass Index
Diet
Exercise
Female
Gestational Weight Gain / physiology*
Health Knowledge, Attitudes, Practice
Health Promotion
Humans
Overweight / epidemiology
Overweight / prevention & control*
Pilot Projects
Pregnancy
Pregnancy Complications / epidemiology
Pregnancy Complications / prevention & control*
Pregnant Women*
Prenatal Care / methods*
Telemedicine*