Journal of Behavioral Medicine

, Volume 39, Issue 5, pp 793–803 | Cite as

Can a health coaching intervention delivered during pregnancy help prevent excessive gestational weight gain?

  • Briony Hill
  • Helen Skouteris
  • Matthew Fuller-Tyszkiewicz
  • Skye McPhie


This study evaluated: (1) the efficacy of a health coaching (HC) intervention designed to prevent excessive gestational weight gain (GWG); and (2) whether there were improved psychological, motivational, and behavioural outcomes for women in the HC intervention compared to a “usual care” control group. In this quasi-experimental study, 267 pregnant women ≤18 weeks gestation were recruited between August 2011 and June 2013 from two hospital antenatal clinics in Melbourne, Australia. Intervention women received four individual HC and two group HC/educational sessions informed by theories of behaviour change. Women completed questionnaires assessing psychological, motivational and behavioural outcomes at 16–18 (baseline) and 33 (post-intervention) weeks gestation. Weight measures were collected. Compared to usual care, the intervention did not limit GWG or prevent excessive GWG. However, HC women reported greater use of active coping skills post-intervention. Despite lack of success of the HC intervention, given the risks associated with excessive weight gain in pregnancy, health professionals should continue to recommend appropriate GWG.


Gestational weight gain Health coaching Intervention studies Motivation Health behaviour change Behavioural medicine 



We would like to thank the staff at the Eastern Health and Western Health antenatal clinics for their support of the study, and our participants for taking part. There are no conflicts of interest to disclose.


Briony Hill was funded by a National Health and Medical Research Council (NHMRC, Australia; GNT1018000) Ph.D. Scholarship. The Health Coaching portion of this study was funded by a NHMRC Project Grant (GNT1009324).

Compliance with ethical standards

Conflict of interest

Briony Hill, Helen Skouteris, Matthew Fuller-Tyszkiewicz and Skye McPhie declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Supplementary material

10865_2016_9743_MOESM1_ESM.docx (38 kb)
Supplementary material 1 (DOCX 38 kb)


  1. Australian Institute of Health and Welfare. (2003). The Active Australia Survey: A guide and manual for implementation, analysis and reporting. Canberra: Australian Institute of Health and Welfare.Google Scholar
  2. Ben-Tovim, D. I., & Walker, M. K. (1991). The development of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ), a new measure of women’s attitudes towards their own bodies. Psychological Medicine, 21, 775–784.CrossRefPubMedGoogle Scholar
  3. Brown, M. J., Sinclair, M., Liddle, D., Hill, A. J., Madden, E., & Stockdale, J. (2012). A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain. PLoS ONE, 7, e39503.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.CrossRefPubMedGoogle Scholar
  5. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.CrossRefPubMedGoogle Scholar
  6. de Jersey, S. J., Nicholson, J. M., Callaway, L. K., & Daniels, L. A. (2012). A prospective study of pregnancy weight gain in Australian women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 52, 545–551. doi: 10.1111/ajo.12013 CrossRefPubMedGoogle Scholar
  7. Fahey, J. O., & Shenassa, E. (2013). Understanding and meeting the needs of women in the postpartum period: The perinatal maternal health promotion model. Journal of Midwifery and Women’s Health, 58, 613–621. doi: 10.1111/jmwh.12139 CrossRefPubMedGoogle Scholar
  8. Gaillard, R., Steegers, E. A. P., Franco, O. H., Hofman, A., & Jaddoe, V. W. V. (2015). Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study. International Journal of Obesity, 39, 677–685. doi: 10.1038/ijo.2014.175 CrossRefPubMedGoogle Scholar
  9. Gale, J. (2010). The Health Coaching Australia (HCA) Model: An integrated model of health behaviour change for chronic disease prevention and chronic condition self-management. In J. Gale (Ed.), Health coaching guide for health practitioners: Using the HCA model of health coaching. Health Coaching Australia: New South Wales.Google Scholar
  10. Gale, J., & Skouteris, H. (2013). Health coaching: Facilitating health behaviour change for chronic condition prevention and self-management. In M. Caltabiano & L. Ricciardelli (Eds.), Handbook of applied topics in health psychology. London: APS Health College, Wiley.Google Scholar
  11. Gardner, B., Wardle, J., Poston, L., & Croker, H. (2011). Changing diet and physical activity to reduce gestational weight gain: A meta-analysis. Obesity Reviews, 12, e602–e620. doi: 10.1111/j.1467-789X.2011.00884.x CrossRefPubMedGoogle Scholar
  12. Guardino, C. M., & Dunkel Schetter, C. (2014). Coping during pregnancy: A systematic review and recommendations. Health Psychology Review, 8, 70–94. doi: 10.1080/17437199.2012.752659 CrossRefPubMedGoogle Scholar
  13. Gunnarsdottir, T., Njardvik, U., Olafsdottir, A. S., Craighead, L. W., & Bjarnason, R. (2011). The role of parental motivation in family-based treatment for childhood obesity. Obesity, 19, 1654–1662.CrossRefPubMedGoogle Scholar
  14. Haugen, M., Brantsæter, A. L., Winkvist, A., Lissner, L., Alexander, J., Oftedal, B., & Meltzer, H. M. (2014). Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: A prospective observational cohort study. BMC Pregnancy and Childbirth, 14, 1–24. doi: 10.1186/1471-2393-14-201 CrossRefGoogle Scholar
  15. Herring, S. J., Cruice, J. F., Bennett, G. G., Rose, M. Z., Davey, A., & Foster, G. D. (2016). Preventing excessive gestational weight gain among African American women: A randomized clinical trial. Obesity, 24, 30–36. doi: 10.1002/oby.21240 CrossRefPubMedGoogle Scholar
  16. Hill, B., Richardson, B., & Skouteris, H. (2015). Do we know how to design effective health coaching interventions: A systematic review of the state of the literature. American Journal of Health Promotion, 29, e158–e168. doi: 10.4278/ajhp.130510-LIT-238 CrossRefPubMedGoogle Scholar
  17. Hill, B., Skouteris, H., & Fuller-Tyszkiewicz, M. (2013a). Interventions designed to limit gestational weight gain: A systematic review of theory and meta-analysis of intervention components. Obesity Reviews, 14, 435–450. doi: 10.1111/obr.12022 CrossRefPubMedGoogle Scholar
  18. Hill, B., Skouteris, H., McCabe, M., & Fuller-Tyszkiewicz, M. (2013b). Body image and gestational weight gain: A prospective study. Journal of Midwifery and Women’s Health, 58, 189–194. doi: 10.1111/j.1542-2011.2012.00227.x CrossRefPubMedGoogle Scholar
  19. Hill, B., Skouteris, H., McCabe, M., Milgrom, J., Kent, B., Herring, S. J., & Gale, J. (2013c). A conceptual model of psychosocial risk and protective factors for excessive gestational weight gain. Midwifery, 29, 110–114. doi: 10.1016/j.midw.2011.12.001 CrossRefPubMedGoogle Scholar
  20. Huizink, A. C., de Medina, P. G. R., Mulder, E. J. H., Visser, G. H. A., & Buitelaar, J. K. (2002). Coping in normal pregnancy. Annals of Behavioral Medicine, 24, 132–140.CrossRefPubMedGoogle Scholar
  21. Institute of Medicine. (2007). Influence of pregnancy weight on maternal and child health: Workshop report. National Research Council Institute of Medicine.Google Scholar
  22. Kowal, C., Kuk, J., & Tamim, H. (2012). Characteristics of weight gain in pregnancy among Canadian women. Maternal and Child Health Journal, 16, 668–676. doi: 10.1007/s10995-011-0771-3 CrossRefPubMedGoogle Scholar
  23. Lally, P., van Jaarsveld, C. H. M., Potts, H. W. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology, 40, 998–1009. doi: 10.1002/ejsp.674 CrossRefGoogle Scholar
  24. Ledikwe, J. H., Blanck, H. M., Kettel Khan, L., Serdula, M. K., Seymour, J. D., Tohill, B. C., & Rolls, B. J. (2006). Dietary energy density is associated with energy intake and weight status in US adults. American Journal of Clinical Nutrition, 83, 1362–1368.PubMedGoogle Scholar
  25. Mannan, M., Doi, S. A., & Mamun, A. A. (2013). Association between weight gain during pregnancy and postpartum weight retention and obesity: A bias-adjusted meta-analysis. Nutrition Reviews, 71, 343–352. doi: 10.1111/nure.12034 CrossRefPubMedGoogle Scholar
  26. McLennan, W., & Podger, A. (1998). National Nutrition Survey users’ guide. Canberra: Australian Bureau of Statistics and Department of Health and Family Services.Google Scholar
  27. Morling, B., Kitayama, S., & Miyamoto, Y. (2003). American and Japanese women use different coping strategies during normal pregnancy. Personality and Social Psychology Bulletin, 29, 1533–1546. doi: 10.1177/0146167203256878 CrossRefPubMedGoogle Scholar
  28. Muktabhant, B., Lawrie, T. A., Lumbiganon, P., & Laopaiboon, M. (2015). Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database of Systematic Reviews, 6, Cd007145. doi: 10.1002/14651858.CD007145.pub3 PubMedGoogle Scholar
  29. Murray, D., & Cox, J. L. (1990). Screening for depression during pregnancy with the edinburgh depression scale (EDDS). Journal of Reproductive and Infant Psychology, 8, 99–107. doi: 10.1080/02646839008403615 CrossRefGoogle Scholar
  30. Oken, E., Rifas-Shiman, S. L., Field, A. E., Frazier, A. L., & Gillman, M. W. (2008). Maternal gestational weight gain and offspring weight in adolescence. Obstetrics and Gynecology, 112, 999–1006.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Rasmussen, K. M., & Yaktine, A. L. (2013). Weight gain during pregnancy: Reexamining the guidelines. Institute of Medicine, National Research Council.Google Scholar
  32. Schack-Nielsen, L., Michaelsen, K. F., Gamborg, M., Mortensen, E. L., & Sorensen, T. I. (2010). Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood. International Journal of Obesity (London), 34, 67–74. doi: 10.1038/ijo.2009.206 CrossRefGoogle Scholar
  33. Shin, D., Chung, H., Weatherspoon, L., & Song, W. O. (2014). Validity of prepregnancy weight status estimated from self-reported height and weight. Maternal and Child Health Journal, 18, 1667–1674. doi: 10.1007/s10995-013-1407-6 CrossRefPubMedGoogle Scholar
  34. Siega-Riz, A. M., Viswanathan, M., Moos, M. K., Deierlein, A., Mumford, S., Knaack, J., et al. (2009). A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: Birthweight, fetal growth, and postpartum weight retention. American Journal of Obstetrics and Gynecology, 201, 339.e331–339.e334. doi: 10.1016/j.ajog.2009.07.002 CrossRefGoogle Scholar
  35. Skouteris, H., Carr, R., Wertheim, E. H., Paxton, S. J., & Duncombe, D. (2005). A prospective study of factors that lead to body dissatisfaction during pregnancy. Body Image, 2, 347–361. doi: 10.1016/j.bodyim.2005.09.002 CrossRefPubMedGoogle Scholar
  36. Skouteris, H., McCabe, M., Milgrom, J., Kent, B., Bruce, L. J., Mihalopoulos, C., & Gale, J. (2012). Protocol for a randomized controlled trial of a specialized health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women: The HIPP study. BMC Public Health, 12, 78.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Skouteris, H., McPhie, S., Hill, B., McCabe, M., Milgrom, J., Kent, B., & Lachal, J. (2015). Health coaching to prevent excessive gestational weight gain: A randomized-controlled trial. British Journal of Health Psychology. doi: 10.1111/bjhp.12154 PubMedGoogle Scholar
  38. Streuling, I., Beyerlein, A., Rosenfeld, E., Hofmann, H., Schulz, T., & von Kries, R. (2011). Physical activity and gestational weight gain: A meta-analysis of intervention trials. British Journal of Obstetrics and Gynaecology, 118(3), 278–284. doi: 10.1111/j.1471-0528.2010.02801.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Briony Hill
    • 1
  • Helen Skouteris
    • 1
  • Matthew Fuller-Tyszkiewicz
    • 1
  • Skye McPhie
    • 1
  1. 1.School of PsychologyDeakin UniversityBurwoodAustralia

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