Optimising Health in Women across Pre-Pregnancy, Pregnancy & Post-Birth.

Description of intervention(s) / exposure: OptimalMe is a pragmatic, randomised controlled trial delivered to women with private healthcare (Medibank Private Ltd) that have recently upgraded or joined with pregnancy and birth cover. The intervention comprises a healthy lifestyle program, OptimalMe involving three components delivered prior to pregnancy (Pre-pregnancy), during pregnancy (Pregnancy) and post-birth (Post-birth). The program is delivered individually, online, in the form of 3 interactive and personalised modules that focus on simple and effective healthy lifestyle messages. Women are recruited prior to pregnancy (Pre-pregnancy) and are followed during preconception, during pregnancy and are given information for the post-birth period (Post-birth). Modules have been developed explicitly for this program and have been designed to accessed in succession according to each relevant life-phase. Modules are personalised with information provided to participants tailored according to a set of standard screening questions related to their preconception and pregnancy health. Healthy lifestyle information is accompanied with behavioural change components, underpinned by the Social Cognitive Theory including goal planning, problem solving, self-monitoring and relapse prevention. These components are practised through a series of interactive activities delivered in the online platform. Each module follows a similar format of relevant information according to reproductive phase and behaviour change and self-monitoring tools. Each module takes approximately 45 minutes to complete, however is designed to be iteratively accessed at any time during each phase (i.e. pre-pregnancy, pregnancy and post-birth). When women preconception become pregnant, they enter the next module (i.e. pregnancy) by entering their estimate due date, enabling access. Access is only made available on entering an estimated due date and is ultimately controlled by the participant. The estimate due date is used to automatically enable access to the post-birth module from approximately 20-week gestation. This is to ensure the pregnancy module is accessed first and additionally, to reduce participant burden with information received. In addition to the OptimalMe program, participants are randomised to receive health coaching delivered via telephone or video conference. Health coaching will reiterate program messages, encourage compliance and practice behavioural skills delivered within the platform. Health coaching will be delivered twice in pre-pregnancy at 2-4 weeks and 6-8 weeks post study commencement and twice during pregnancy in the first and second trimester. Health coaching will be delivered by health professionals with qualifications in nutrition, dietetics and exercise physiology. Participants are considered to have completed the study when they have completed all relevant modules in order of succession- Pre-pregnancy, Pregnancy, Post-birth, and completed all associated questionnaires and program evaluation up to and including 36 weeks gestation. Women will remain in the intervention with support provided for up to 2 years, irrespective of pregnancy outcome. Following two years, women will be provided with access to the online platform (funding permitting), but will not receive ongoing support.