Many trials have focused on prevention of excessive gestational weight gain (GWG), but mixed results suggest an innovative strategy may be needed. Development of an easy to use, engaging digital media intervention may increase compliance and overcome participation barriers. The Fit4Mom project will pilot test the feasibility and acceptability of mobile and social media to reduce GWG among African American postpartum women who present for OB/GYN care at Medstar Washington Hospital Center (MWHC). Internet-based interventions have shown clinically-meaningful effects on weight loss. However, there are many high risk populations for which these approaches have yet to be translated and customized. These include postpartum women and populations facing health disparities. We hypothesize that a culturally tailored digital media intervention may overcome barriers to healthy eating and active living (HEAL) and will be effective with the at risk population of postpartum African American women. The proposed Fit4Mom intervention is significant for 3 primary reasons. Previous studies have identified intervention content and used digital technologies to promote weight management and increase physical activity, but there is limited work in applying these components to postpartum women with a high risk profile, including AA women. Second, the new Fit4Mom intervention will use digital technologies so that it is easy to access from a mobile phone or other device and addresses engagement barriers, and no studies have used this approach with high risk women. These technologies will enable us to enhance social support, provide structure, and individual tailoring. Third, we will test alternative explanations (pathways) of intervention effects on outcomes. By creating a digital weight management tool that is culturally tailored and addresses time, effort, and engagement barriers, we will increase HEAL behavior and weight loss outcomes. Focusing on cultural tailoring and engagement with a digital weight loss intervention and how to maximize it is a novel approach. Engagement is crucial to translation and dissemination of evidence- based weight loss interventions. We hypothesize that development of participant identification with the Fit4Mom program and its benefits will mediate treatment effects on behavioral and weight loss outcomes. We will ?brand? Fit4Mom and thereby build participant engagement with those behaviors, leading to improved outcomes. The study has two phases: Phase I, intervention development, and Phase II, a randomized trial. We will conduct focus group and in-depth interviews to design Fit4Mom in Phase I. In Phase II, we will recruit and randomly assign 136 overweight and obese (BMI >25 and <40kg/m2) women (ages 18-40) over a 3-month recruitment period to one of two 3-month intervention arms: 1) Fit4Mom; 2) Standard Maternal and Child Care. All recruitment will take place at MWHC. We will implement the intervention with treatment participants using social media, text messages, audience co-creation of messages, and a variety of games/contests designed to increase program engagement. The study is powered to evaluate weight loss of > 2.5kg at follow up.

Public Health Relevance

Many trials have focused on prevention of excessive gestational weight gain (GWG), but mixed results suggest novel strategies are needed. Development of a culturally tailored, easy to use, engaging digital media intervention may increase compliance and participation. Fit4Mom will pilot test the feasibility and acceptability of digital media to increase engagement and reduce GWG among African American postpartum women.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory/Developmental Grants (R21)
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Health Disparities and Equity Promotion Study Section (HDEP)
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Mujuru, Priscah
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George Washington University
Public Health & Prev Medicine
Schools of Public Health
United States
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