Developing a complex intervention for diet and activity behaviour change in obese pregnant women (the UPBEAT trial); Assessment of behavioural change and process evaluation in a pilot randomised controlled trial

BMC Pregnancy and Childbirth

Volumn 13, Issue , 2013, Pages

  Poston, Lucilla ^a   Briley, Annette L ^a   Barr, Suzanne ^b   Bell, Ruth ^c   Croker, Helen ^e   Coxon, Kirstie ^a   Essex, Holly N ^d   Hunt, Claire ^a   Hayes, Louise ^c   Howard, Louise M ^a   Khazaezadeh, Nina ^a   Kinnunen, Tarja ^g   Nelson, Scott M ^f   Oteng Ntim, Eugene ^a   Robson, Stephen C ^c   Sattar, Naveed ^f   Seed, Paul T ^a   Wardle, Jane ^e   Sanders, Thomas A B ^b   Sandall, Jane ^a  

^a ST THOMAS HOSPITAL   (United Kingdom)

^b KING'S COLLEGE LONDON   (United Kingdom)

^c NEWCASTLE UNIVERSITY   (United Kingdom)

^d UNIVERSITY OF YORK   (United Kingdom)

^e UNIVERSITY COLLEGE LONDON   (United Kingdom)

^f UNIVERSITY OF GLASGOW   (United Kingdom)

^g TAMPERE UNIVERSITY OF TECHNOLOGY   (Finland)

Author keywords

Complex intervention; Diet; Evaluation; Obesity; Physical activity; Pregnancy

Indexed keywords

SATURATED FATTY ACID;

ACCELEROMETRY; ADULT; ARTICLE; BEHAVIOR CHANGE; CLINICAL EVALUATION; CONTROLLED STUDY; FEASIBILITY STUDY; FEMALE; GESTATION PERIOD; GLYCEMIC LOAD; HUMAN; LOW FAT DIET; MAJOR CLINICAL STUDY; MATERNAL ATTITUDE; MATERNAL BEHAVIOR; MATERNAL NUTRITION; MATERNAL OBESITY; PATIENT COMFORT; PATIENT COMPLIANCE; PHYSICAL ACTIVITY; PILOT STUDY; PREGNANT WOMAN; PRENATAL CARE; QUALITY OF LIFE; QUESTIONNAIRE; RANDOMIZED CONTROLLED TRIAL; ADOLESCENT; BEHAVIOR THERAPY; BODY MASS; DIABETES, GESTATIONAL; DIET THERAPY; KINESIOTHERAPY; MOTOR ACTIVITY; OBESITY; PREGNANCY; PREGNANCY COMPLICATIONS; PROCEDURES; YOUNG ADULT;

ACCELEROMETRY; ADOLESCENT; ADULT; BEHAVIOR THERAPY; BODY MASS INDEX; DIABETES, GESTATIONAL; DIET THERAPY; EXERCISE THERAPY; FEASIBILITY STUDIES; FEMALE; HUMANS; MOTOR ACTIVITY; OBESITY; PILOT PROJECTS; PREGNANCY; PREGNANCY COMPLICATIONS; PRENATAL CARE; YOUNG ADULT;

EID: 84880110744     PISSN: None     EISSN: 14712393     Source Type: Journal    
DOI: 10.1186/1471-2393-13-148     Document Type: Article

References (69)

1. World Health Organisation WHO global info database. Data for saving lives Internet: https://apps.who.int/infobase/ (accessed July 16th 2013), World Health Organisation.
2. Heslehurst N. Identifying 'at risk' women and the impact of maternal obesity on national health service maternity services. Proc Nutr Soc 2011, 70:439-449. 10.1017/S0029665111001625, 21854697.
3. IOM (Institute of Medicine) and NRC (National Research Council) Weight Gain During Pregnancy: Reexamining the Guidelines 2009, Washington, DC: The National Academies Press, IOM (Institute of Medicine) and NRC (National Research Council).
4. Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Roseboom T, Tomlinson JW, Kunz R, Mol BW, Coomarasamy A, Khan KS. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012, 344:e2088. 10.1136/bmj.e2088, 3355191, 22596383.
5. Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P. Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med 2012, 10:47. 10.1186/1741-7015-10-47, 3355057, 22574949.
6. Gardner B, Wardle J, Poston L, Croker H. Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obesity Reviews 2011, 12:e602-e620. 10.1111/j.1467-789X.2011.00884.x, 21521451.
7. Nelson S, Matthews P, Poston L. Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Hum Reprod Update 2010, 16:255-275. 10.1093/humupd/dmp050, 2849703, 19966268.
8. Louie J, Brand-Miller JC, Moses RG. Carbohydrates, glycemic index, and pregnancy outcomes in gestational diabetes. Curr Diab Rep 2013, 13:6-11. 10.1007/s11892-012-0332-1, 23065366.
9. Tobias D, Zhang C, van Dam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care 2011, 34:223-229. 10.2337/dc10-1368, 3005457, 20876206.
10. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new medical research council guidance. BMJ 2008, 337:a1655. 10.1136/bmj.a1655, 2769032, 18824488.
11. Oteng-Ntim E, Pheasant H, Khazaezadeh N, Mohidden A, Bewley S, Wong J, Oke B. Developing a community-based maternal obesity intervention: a qualitative study of service providers' views. Br J Obstet Gynaecol 2010, 117:1651-1655.
12. Gardner B, Croker H, Barr S, Briley A, Poston L, Wardle J, UPBEAT Trial Psychological predictors of dietary intentions in pregnancy. J Hum Nutr Diet 2012, 25(4):345-353. 10.1111/j.1365-277X.2012.01239.x, 22380723, UPBEAT Trial.
13. English Indices of Deprivation Internet: https://www.gov.uk/government/publications/english-indices-of-deprivation-2010 (accessed July 16th 2013).
14. Scottish Indices of Multiple Deprivation Internet: http://www.scotland.gov.uk/Publications/2009/10/28104046/0 (accessed July 16th 2013).
15. National Institute for Health and Clinical Excellence Dietary interventions and physical activity interventions for weight management before, during and after pregnancy NICE PH27. Internet: http://guidance.nice.org.uk/PH27/Guidance/pdf/English (accessed July 16th 2013), National Institute for Health and Clinical Excellence.
16. Carver C, Scheier M. Origins and functions of positive and negative affect: a control-process view. Psychological Review 1990, 97:19-35.
17. Bandura A. Health promotion by social cognitive means. Health Educ Behav 2004, 31:143-164. 10.1177/1090198104263660, 15090118.
18. Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol 2009, 28:690-701.
19. Royal College of Obstetrics and Gynaecology Exercise in pregnancy. Statement No. 4 2006, Internet: http://www.rcog.org.uk/womens-health/clinical-guidance/exercise-pregnancy (accessed July 16th, 2013), Royal College of Obstetrics and Gynaecology.
20. Sechrist KR, Walker S, Pender NJ. Development and psychometric evaluation of the exercise benefits/barriers scale. Res Nurs Health 1987, 10:357-365. 10.1002/nur.4770100603, 3423307.
21. Tiedje LB, Kingry MJ, Stommel M. Patient attitudes concerning health behaviors during pregnancy: initial development of a questionnaire. Health Educ Q 1992, 19:481-493. 10.1177/109019819201900411, 1452448.
22. The EuroQol Group EuroQol-a new facility for the measurement of health-related quality of life. 1990, 16:199-208. Health Policy. Internet: http://www.euroqol.org (accessed 16th July 2013), The EuroQol Group.
23. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psych 1987, 150:782-786.
24. Steckler A, Linnan L. Process evaluation for public health interventions and research San Francisco, CA, US: Jossey-Bass, xxviii 400 pp 2002.
25. Metzger B, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, Dyer AR, Leiva A, Hod M, Kitzmiler JL, Lowe LP, McIntyre HD, Oats JJ, Omori Y, Schmidt MI. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010, 33:676-682. 2827530, 20190296.
26. Gardosi J, Francis A. Customised weight centile calculator - GROW - centile v5.15/6.4. Gestational Network 2009, Internet: http://www.gestation.net/birthweight_centiles/online/centile_online_uk.htm (accessed 10th July, 2013).
27. Dolan P. Modeling valuations for EuroQol health states. Med Care 1997, 35:1095-1108. 10.1097/00005650-199711000-00002, 9366889.
28. Dolan P, Gudex C, Kind P, Williams A. The time trade-off method: results from a general population study. Health Econ 1996, 5:141-154. 10.1002/(SICI)1099-1050(199603)5:2<141::AID-HEC189>3.0.CO;2-N, 8733106.
29. Atkinson FS, Foster-Powell K, Brand-Miller JC. International tables of glycemic index and glycemic load values: 2008. Diabetes Care 2008, 31:2281-2283. 10.2337/dc08-1239, 2584181, 18835944.
30. Aston LM, Jackson D, Monsheimer S, Whybrow S, Handjieva-Darlenska T, Kreutzer M, Kohl A, Papadaki A, Martinez JA, Kunova V, van Baak MA, Astrup A, Saris WH, Jebb SA, Lindroos AK. Developing a methodology for assigning glycaemic index values to foods consumed across Europe. Obes Rev 2010, 11:92-100. 10.1111/j.1467-789X.2009.00690.x, 20653850.
31. Medical Research Council Epidemiology Unit; MAHUffe program 2012, Internet: http://www.mrc-epid.cam.ac.uk/research/resources/materials-transfer-disclaimer/physical-activity-downloads/ (accessed July 15th 2013), Medical Research Council.
32. Freedson PS, Melanson E, Sirard J. Calibration of the computer science and applications, Inc. accelerometer. Med Sci Sports Exerc 1998, 30:777-781. 10.1097/00005768-199805000-00021, 9588623.
33. Matthew CE. Calibration of accelerometer output for adults. Med Sci Sports Exerc 2005, 37(11 Suppl):S512-S522.
34. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O'Brien WL, Bassett DR, Schmitz KH, Emplaincourt PO, Jacobs DR, Leon AS. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000, 32(9 Suppl):S498-S504.
35. Green J, Thorogood N. Qualitative Methods for Health Research 2 2009, London: Ed Sage.
36. Centre for Maternal and Child Enquiries and the Royal College of Obstetricians and Gynaecologists Joint Guideline Management of women with obesity in pregnancy 2010, Internet; http://www.rcog.org.uk/womens-health/clinical-guidance/management-women-obesity-pregnancy (accessed July 10th 2013), Centre for Maternal and Child Enquiries and the Royal College of Obstetricians and Gynaecologists Joint Guideline.
37. Quinlivan JA, Lam LT, Fisher J. A randomised trial of a four-step multidisciplinary approach to the antenatal care of obese pregnant women. Aust N Z J Obstet Gynaecol 2011, 51:141-146. 10.1111/j.1479-828X.2010.01268.x, 21466516.
38. Guelinckx I, Devlieger R, Mullie P, Vansant G. Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial. Am J Clin Nutr 2010, 91:373-380. 10.3945/ajcn.2009.28166, 19955397.
39. Bogaerts A, Devlieger R, Nuyts E, Witters I, Gyselaers W, Van den Bergh BR. Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial. Int J Obes (Lond) 2012, Epub ahead of print.
40. Whitton C, Nicholson SK, Roberts C, Prynne CJ, Pot GK, Olson A, Fitt E, Cole D, Teucher B, Bates B, Henderson H, Pigott S, Deverill C, Swan G, Stephen AM. National diet and nutrition survey: UK food consumption and nutrient intakes from the first year of the rolling programme and comparisons with previous surveys. Br J Nutr 2011, 106:1899-1914. 10.1017/S0007114511002340, 3328127, 21736781.
41. Fabricatore AN, Wadden TA, Ebbeling CB, Thomas JG, Stallings VA, Schwartz S, Ludwig DS. Targeting dietary fat or glycemic load in the treatment of obesity and type 2 diabetes: a randomized controlled trial. Diabetes Res Clin Pract 2011, 92:37-45. 10.1016/j.diabres.2010.12.016, 3079199, 21208675.
42. Walsh JM, McGowan CA, Mahony R, Foley ME, McAuliffe FM. Low glycaemic index diet in pregnancy to prevent macrosomia (ROLO study): randomised control trial. BMJ 2012, 345:e5605. 10.1136/bmj.e5605, 3431285, 22936795.
43. Jebb SA, Lovegrove JA, Griffin BA, Frost GS, Moore CS, Chatfield MD, Bluck LJ, Williams CM, Sanders TA, RISCK Study Group Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) Trial. Am J Clin Nutr 2010, 92:748-758. 10.3945/ajcn.2009.29096, 3594881, 20739418, RISCK Study Group.
44. Thomas DE, Elliott EJ, Baur L. Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev 2007, 3. CD005105.
45. Department of Health Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects 41 1991, HSMO, London: The Stationary Office, Department of Health.
46. Hui A, Back L, Ludwig S, Gardiner P, Sevenhuysen G, Dean H, Sellers E, McGavock J, Morris M, Bruce S, Murray R, Shen GX. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. Br J Obstet Gynaecol 2012, 119:70-77.
47. Callaway LK, Colditz PB, Byrne NM, Lingwood BE, Rowlands IJ, Foxcroft K, McIntyre HD, BAMBINO Group Prevention of gestational diabetes: feasibility issues for an exercise intervention in obese pregnant women. Diabetes Care 2010, 33:1457-1459. 10.2337/dc09-2336, 2890340, 20357374, BAMBINO Group.
48. Evenson KR, Wen F. Prevalence and correlates of objectively measured physical activity and sedentary behavior among US pregnant women. Prev Med 2011, 53:39-43. 10.1016/j.ypmed.2011.04.014, 21575654.
49. Aittasalo M, Raitanen J, Kinnunen TI, Ojala K, Kolu P, Luoto R. Is intensive counseling in maternity care feasible and effective in promoting physical activity among women at risk for gestational diabetes? Secondary analysis of a cluster randomized NELLI study in Finland. Int J Behav Nutr Phys Act 2012, 9:104. 10.1186/1479-5868-9-104, 3511276, 22950716.
50. Oostdam N, van Poppel MN, Wouters MG, Eekhoff EM, Bekedam DJ, Kuchenbecker WK, Quartero HW, Heres MH, van Mechelen W. No effect of the FitFor2 exercise programme on blood glucose, insulin sensitivity, and birthweight in pregnant women who were overweight and at risk for gestational diabetes: results of a randomised controlled trial. Br J Obstet Gynecol 2012, 119:1098-1107.
51. Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act 2008, 5:56. 10.1186/1479-5868-5-56, 2588639, 18990237.
52. Schmidt MD, Freedson PS, Pekow P, Roberts D, Sternfeld B, Chasan-Taber L. Validation of the kaiser physical activity survey in pregnant women. Med Sci Sports Exerc 2006, 38:42-50.
53. McParlin C, Robson SC, Tennant PW, Besson H, Rankin J, Adamson AJ, Pearce MS, Bell R. Objectively measured physical activity during pregnancy: a study in obese and overweight women. BMC Pregnancy Childbirth 2010, 10:76. 3001702, 21114834.
54. Rousham EK, Clarke PE, Gross H. Significant changes in physical activity among pregnant women in the UK as assessed by accelerometry and self-reported activity. Eur J Clin Nutr 2006, 60:393-400. 10.1038/sj.ejcn.1602329, 16306930.
55. Evenson KR, Savitz DA, Huston SL. Leisure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004, 18:400-407. 10.1111/j.1365-3016.2004.00595.x, 15535815.
56. Townsend N, Bhatnagar P, Wickramasinghe K, Scarborough P, Foster C, Rayner M. Physical activity statistics 2012 2012, London: British Heart Foundation.
57. Stein AD, Rivera JM, Pivarnik JM. Measuring energy expenditure in habitually active and sedentary pregnant women. Med Sci Sports Exerc 2003, 35:1441-1446. 10.1249/01.MSS.0000079107.04349.9A, 12900702.
58. Lof M, Forsum E. Activity pattern and energy expenditure due to physical activity before and during pregnancy in healthy Swedish women. Br J Nutr 2006, 95:296-302. 10.1079/BJN20051497, 16469145.
59. Harrison CL, Lombard CB, Teede HJ. Understanding health behaviours in a cohort of pregnant women at risk of gestational diabetes mellitus: an observational study. Br J Obstet Gynaecol 2012, 119:731-738.
60. Claesson IM, Josefsson A, Sydsjo G. Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study. BMC Public Health 2010, 10:766. 10.1186/1471-2458-10-766, 3016389, 21162715.
61. Health and Social Care Information Centre Statistics on obesity, physical activity and diet: England Internet: http://www.hscic.gov.uk/catalogue/PUB10364 (accessed July 15th 2013), Health and Social Care Information Centre.
62. Gatineau M, Mathrani S. Public Health England. Obesity and Ethnicity Oxford: National Obesity Observatory 2011, Internet: http://www.noo.org.uk/NOO_pub/briefing_papers.
63. Kinnunen TI, Aittasalo M, Koponen P, Ojala K, Mansikkamaki K, Weiderpass E, Fogelholm M, Luoto R. Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care. BMC Pregnancy Childbirth 2008, 8:37. 10.1186/1471-2393-8-37, 2526978, 18694479.
64. Hoddinott P, Allan K, Avenell A, Britten J. Group interventions to improve health outcomes: a framework for their design and delivery. BMC Public Health 2010, 10:800. 10.1186/1471-2458-10-800, 3022868, 21194466.
65. National Institute for Health and Clinical Excellence The most appropriate means of generic and specific interventions to support attitude and behaviour change at population and community levels. Public health guidance, PH6 2007, Internet: http://publications.nice.org.uk/behaviour-change-ph6 (accessed 10th July 2013), National Institute for Health and Clinical Excellence.
66. Broekhuizen K, Althuizen E, van Poppel MN, Donker M, van Mechelen W. From theory to practice: intervention fidelity in a randomized controlled trial aiming to optimize weight development during pregnancy. Health Promot Pract 2012, 13:816-825. 10.1177/1524839912447190, 22773616.
67. Barnett J, Aguilar S, Brittner M, Bonuck K. Recruiting and retaining low-income, multi-ethnic women into randomized controlled trials: successful strategies and staffing. Contemp Clin Trials 2012, 33:925-932. 10.1016/j.cct.2012.06.005, 22732312.
68. Borodulin K, Evenson KR, Herring AH. Physical activity patterns during pregnancy through postpartum. BMC Womens Health 2009, 9:32. 10.1186/1472-6874-9-32, 2784751, 19925650.
69. Hallal P, Victora CG. Reliability and validity of the International Physical Activity Questionnaire (IPAQ). Med Sci Sports Exerc 2004, 36:556. 10.1249/01.MSS.0000117161.66394.07, 15076800.