A Feasibility Study to Promote Optimal Weight in First Time Pregnant Mothers and Their Babies: Lessons Learned in a US-Mexico Border Community
- 153 Downloads
Introduction Obesity rates among US Hispanic women and children are high. Childhood obesity prevention beginning prenatally is desirable, but studies show mixed results. Methods We tested a pilot intervention to promote optimal gestational and infant weight with primigravid Hispanic women at a Federally Qualified Health Center (FQHC) on the U.S.-Mexico border. The intervention included promotora-led exercise, nutrition, breastfeeding activities (n = 23), supported by text/social media messaging (text messaging prenatally, private Facebook page postnatally). Measures included demographics, BMI, weight gain/retention, infant feeding, and attendance. Results Most women were U.S. born (73%), Spanish-language dominant (83%), with ≤ high school education (65%), and overweight/obese (56%). Retention rates were modest for the prenatal component (50%), supported by an SMS text-messaging program. Retention of the remaining postnatal sample, supported by a private Facebook® page, was 100%. Of women who regularly attended group sessions pre and postpartum, over 70% were within 5 lbs of pre-pregnancy weight at 6 months postpartum. A private Facebook® group was feasible for out-of-class support, including among women with regular cross-border mobility. Discussion While the intervention was well-received, almost 2/3 of the original participants did not follow up postpartum. Importantly, the findings indicate the use of social media (private Facebook® page) was more feasible than the SMS text-messaging program and may be a successful approach to reach and engage women living in mobile and transnational settings. Future studies should examine social media as an intervention tool to influence optimal weight and encourage healthy behaviors in primigravidas living near the U.S.-Mexico border.
KeywordsHispanic Obesity Pregnancy U.S.-Mexico border Social media
We gratefully acknowledge the study participants and their babies as well as our collaborators at the San Ysidro Health Center, the FQHC where this study took place, especially the study promotora, breastfeeding peer counselor, clinic provider and staff, and research department staff. Pilot funding was provided for this study by: UC San Diego Academic Senate Research Grant #’s RM077M and RL039H and UC San Diego Department of Pediatrics Division of Child Development and Community Health Pilot Grant # CDCH2011-1952-003.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- Chasan-Taber, L., Marcus, B. H., Rosal, M. C., Tucker, K. L., Hartman, S. J., Pekow, P., et al. (2015). Proyecto Mama: A lifestyle intervention in overweight and obese Hispanic women: A randomised controlled trial–study protocol. BMC Pregnancy Childbirth, 15, 157. https://doi.org/10.1186/s12884-015-0575-3.CrossRefGoogle Scholar
- Gruver, R. S., Bishop-Gilyard, C. T., Lieberman, A., Gerdes, M., Virudachalam, S., Suh, A. W., et al. (2016). A social media peer group intervention for mothers to prevent obesity and promote healthy growth from infancy: Development and pilot trial. JMIR Research Protocols, 5(3), e159. https://doi.org/10.2196/resprot.5276.CrossRefGoogle Scholar
- Hawkins, M., Hosker, M., Marcus, B. H., Rosal, M. C., Braun, B., Stanek, E. J., et al (2015). A pregnancy lifestyle intervention to prevent gestational diabetes risk factors in overweight Hispanic women: A feasibility randomized controlled trial. Diabetic Medicine, 32(1), 108–115. https://doi.org/10.1111/dme.12601.CrossRefGoogle Scholar
- Herring, S. J., Cruice, J. F., Bennett, G. G., Davey, A., & Foster, G. D. (2014). Using technology to promote postpartum weight loss in urban, low-income mothers: A pilot randomized controlled trial. Journal of Nutrition Education and Behavior, 46(6), 610–615. https://doi.org/10.1016/j.jneb.2014.06.002.CrossRefGoogle Scholar
- Houghton, L. C., Ester, W. A., Lumey, L. H., Michels, K. B., Wei, Y., Cohn, B. A., et al. (2016). Maternal weight gain in excess of pregnancy guidelines is related to daughters being overweight 40 years later. American Journal of Obstetrics and Gynecology, 215(2), e241–248. https://doi.org/10.1016/j.ajog.2016.02.034.CrossRefGoogle Scholar
- Kaiser Family Foundation. (2015). State health facts, providers and service use: Federally qualified health centers. Retrieved 25 April 2017 from http://kff.org/state-category/providers-service-use/federally-qualified-health-centers/.
- Kim, L. P., Koleilat, M., & Whaley, S. E. (2016). A qualitative study to examine perceptions and barriers to appropriate gestational weight gain among participants in the special supplemental nutrition program for Women Infants and Children Program. Journal of Pregnancy. https://doi.org/10.1155/2016/4569742.Google Scholar
- Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403. https://doi.org/10.1056/NEJMoa012512.CrossRefGoogle Scholar
- Mourtakos, S. P., Tambalis, K. D., Panagiotakos, D. B., Antonogeorgos, G., Alexi, C. D., Georgoulis, M., et al. (2016). Association between gestational weight gain and risk of obesity in preadolescence: A longitudinal study (1997–2007) of 5125 children in Greece. Journal of Human Nutrition and Dietetics. https://doi.org/10.1111/jhn.12398.Google Scholar
- Nader, P. R., Huang, T. T., Gahagan, S., Kumanyika, S., Hammond, R. A., & Christoffel, K. K. (2012). Next steps in obesity prevention: Altering early life systems to support healthy parents, infants, and toddlers. Childhood Obesity, 8(3), 195–204. https://doi.org/10.1089/chi.2012.0004.CrossRefGoogle Scholar
- Ogden, C. L., Carroll, M. D., Fryar, C. D., & Flegal, K. M. (2015). Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief 219, 1–8.Google Scholar
- Thoren, E. M., Metze, B., Buhrer, C., & Garten, L. (2013). Online support for parents of preterm infants: A qualitative and content analysis of Facebook ‘preemie’ groups. Archives of Disease in Childhood-Fetal and Neonatal Edition, 98(6), F534–F538. https://doi.org/10.1136/archdischild-2012-303572.CrossRefGoogle Scholar
- Whitaker, K. M., Wilcox, S., Liu, J., Blair, S. N., & Pate, R. R. (2016). Provider advice and women’s intentions to meet weight gain, physical activity, and nutrition guidelines during pregnancy. Maternal and Child Health Journal, 20(11), 2309–2317. https://doi.org/10.1007/s10995-016-2054-5.CrossRefGoogle Scholar