This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The percentage of African American and Latino women of childbearing age who are obese or have type 2 diabetes is rising, with severe consequences for individuals, families and communities. Diet and exercise behaviors, excessive pregnancy weight gain and postpartum weight retention may lead to long-term obesity that contributes to this trend. Pregnancy and the period after childbirth offer unique opportunities to reduce these risks. Nonetheless, few healthy lifestyle interventions have focused on reducing the risk of obesity during this period, or among women of childbearing age, particularly in low income and minority communities. The overall project aim is to demonstrate the effectiveness of a healthy lifestyle intervention tailored to the needs of pregnant and postpartum African American and Latino women in Eastside and Southwest Detroit, and designed to reduce risk factors for obesity and diabetes. The primary objectives are to increase women regular physical activity and healthy eating practices. Secondary objectives are to achieve appropriate weight gain during pregnancy and decreased weight retention after pregnancy, and to improve other measures of anthropometric and metabolic status. Additional objectives include assessment of whether changes in attitudes, beliefs, intentions and social support change from baseline, and whether these changes influence behavioral outcomes. A process evaluation objective aims to identify and assess aspects of project planning and implementation that contribute to achievement of project objectives. African American and Latino women who were less than 5 months pregnant will be recruited from community and prenatal care settings in the Eastside and Southwest communites of Detroit, MI. After a qualifying period that includes baseline data collection, women will be randomly assigned to participate in either the healthy lifestyle intervention (HLI) or healthy pregnancy education (control) intervention group (HPI). The healthy lifestyle intervention includes a 14-session curriculum led by trained community resident Womens Health Advocates (WHA) that empowers women to develop knowledge and skills related to healthy eating, exercise, stress management and provide education regarding pregnancy, childbirth and the postpartum period. This includes 2 home visits and 9 group meetings conducted weekly with women who are between 14 and 33 weeks of pregnancy; and 2 home visits and 1 group meeting conducted between 2 and 6 weeks postpartum. Optional group healthy eating and exercise activities, such as walking groups, aerobic dancing, recipe, shopping and cooking demonstrations provide additional social support for women in the healthy lifestyle intervention group during and after the periods of their curriculum sessions. The healthy pregnancy education (control) intervention group will receive a 4-session curriculum that includes pregnancy, childbirth and postpartum education, delivered by trained staff from Detroit community organizations, and written healthy lifestyles materials.'
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