Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial.

Deborah Davis,Maralyn Foureur,Matthew Fuller-Tyszkiewicz,Jeremy Oats,Ellen Nohr,Catherine Knight-Agarwal,Tanya Lawlis,Lauren T Williams,Rachel Davey,Helen Skouteris

doi:10.2196/resprot.9920

Abstract

BackgroundApproximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy.ObjectiveThe primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention.MethodsThis randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women’s weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care.ResultsRecruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign.ConclusionFeasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo)Registered Report IdentifierRR1-10.2196/9920

Highlights

BackgroundObesity is one of the most significant health issues of our time
The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women’s weight change in relation to the range recommended by the Institute of Medicine
Regardless of prepregnancy body mass index (BMI), the amount of weight gained during pregnancy has the potential to impact the health and well-being of the childbearing woman and her baby in the short, medium, and long term

Summary

Introduction

Regardless of prepregnancy body mass index (BMI), the amount of weight gained during pregnancy (gestational weight gain, GWG) has the potential to impact the health and well-being of the childbearing woman and her baby in the short, medium, and long term. Independent of maternal BMI, excessive GWG is associated with childhood adiposity at birth [3] and 3 [4] and 5 years of age [5] These data suggest that careful management of gestational weight gain is as important for the offspring of underweight and normal weight women as it is for the overweight and obese. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; innovative strategies are required to assist women to manage weight gain in pregnancy

Methods

Results

Discussion

Conclusion