Efficacy of the Eating4Two smartphone application for the prevention of excessive gestational weight gain.
Efficacy of the Eating4Two smartphone application for the prevention of excessive gestational weight gain: a randomised controlled trial.
University of Canberra
1,330 participants
Dec 22, 2016
Interventional
Conditions
Summary
Obesity is one of the most significant health issues of our time. Regardless of pre-pregnancy BMI, the amount of weight gained during pregnancy [gestational weight gain (GWG)] has the potential to impact the health and wellbeing of the childbearing woman and her baby in the short, medium and long term. Women who gain excessive weight in pregnancy are more likely to retain weight in the short, medium and long term, progressing from normal weight to obese over their childbearing years. The Institute of Medicine (IOM) offers the most robust guidance, recommending specific GWG target ranges for women who are underweight, normal, overweight and obese according to defined Body Mass Index (BMI) categories. Only 36% of Australian women have optimal GWG. Interventions targeting GWG have focused on overweight and obese women, been resource intensive and have had limited success. Behavioural change interventions have also been criticised for increasing the socio-economic gradient of obesity. There is a critical need to reduce the burden of maternal obesity and excessive GWG with programs that are effective, accessible and scalable for delivery at a population level and to understand how socio-economic factors impact on GWG and uptake of interventions. This project addresses these two key issues by examining the efficacy of the “Eating4Two” Smartphone application in a population of pregnant women of all BMI categories. We hypothesise that use of the Eating4Two smartphone App will reduce rates of excessive gestational weight gain.
Eligibility
Inclusion Criteria1
- (1) at least 18 years of age (2) ability to provide informed consent (3) fluent in written and oral English language (4) less than 15 weeks gestation (5) personal ownership of a smartphone device (6) access to weighing scales (7) a valid email address and access to Internet.
Exclusion Criteria1
- (1) planning to give birth in a non-participating hospital (2) multiple pregnancy (3) insulin or diet controlled diabetes prior to pregnancy (4) limitations to using a smartphone device (5) healthcare provider considers use of the App or GWG in accordance with IOM recommendations detrimental to the potential participant.
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Interventions
The intervention group will receive usual care and will also be provided access to the Eating4Two smartphone application at no cost. Women in the intervention group will enter their weight into the App on a weekly basis and be weighed by maternity caregivers at approximately 38 weeks gestation and the commencement of labour (or prior to elective caesarean section). The Eating4Two App provides women with advice on how to “eat for two” by increasing nutrient density rather than energy. Women are provided with information about food safety, nutrients, and their value in pregnancy, the nutrients provided in various foods and recommended daily serves. Sample meal plans demonstrate ways that nutrient needs in pregnancy can be met. In addition, the App provides information on managing common pregnancy related symptoms such as heartburn. The App calculates women’s BMI and prompts them to enter their weight weekly. The “weight tracker” graphs their weight gain, showing the weight gain range recommended by the Institute of Medicine (IOM) for their BMI category. When weight gain is above or below the recommended range, women are prompted to discuss the issue with their maternity caregiver so that individual advice can be provided. The App also sends regular messages to the participant (specific to their gestation) with information about their baby’s growth, development and nutritional needs, motivational messages, tips on weight management and physical activity in pregnancy and reminders to discuss weight gain with their maternity caregivers. These are sent approximately weekly. These messages are tailored to the woman’s BMI and gestation. The aim of the App is to augment usual care by providing timely and tailored information, motivation, encouraging lifestyle changes and discussions with caregivers. Women will have access to the App from enrolment in the study to birth. The only requirement is for women to use the weight tracker weekly and they may access other parts of the App as desired.
Locations(5)
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ACTRN12617000169347