Healthy for Two/Healthy for You: Pilot testing a remotely-delivered health coaching intervention in women at risk for hypertension or diabetes in pregnancy

Johns Hopkins University, Baltimore MD

Investigators

Linked publications, trials & patents

Abstract

Project Summary Women with common pregnancy complications, gestational diabetes mellitus (GDM) and hypertensive disorders in pregnancy (HDP), are at increased risk for cardiovascular disease (CVD). Pregnancy and the postpartum period provide ?teachable moments? to promote CVD- preventive health behaviors in women at highest risk for pregnancy complications and future CVD. Growing evidence supports behavioral interventions to limit gestational weight gain (GWG) and thereby reduce GDM and HDP, as well as future obesity. However, few behaviorally-focused weight management trials in pregnancy have: 1) targeted racially-diverse women at greatest risk for future obesity and CVD; 2) developed patient- and provider-centered interventions that interface with ?real world? prenatal care settings; 3) continued beyond pregnancy into the postpartum period; or 4) employed remotely delivered interventions that have potential for scalability. Informed by our prior qualitative work, we developed an evidence- based, telephonically-delivered health coaching program called ?Healthy for Two/ Healthy for You? (?H42/H4U?) to help women limit GWG and facilitate postpartum weight loss. In this study, we aim to address evidence gaps by translating the paper-based H42/H4U intervention onto an existing, interactive web-based platform. In Aim 1 we will create the H42/H4U web- based intervention to host learning materials, as well as audio/video content for lower literacy populations, integrate data from a smart-phone health behavior tracking application, enable a health coaching interface, send text messages and deliver progress reports to prenatal care providers via the electronic medical record. In Aim 2 we will estimate the effectiveness of H42/H4U web-based remotely delivered health coaching program on GWG compared with a usual care control group among 40 high-risk, racially-diverse pregnant and postpartum women. We anticipate this R03 will enable the acquisition of data necessary to submit a R01 to test the web-based H42/H4U intervention in a multi-site trial aimed at limiting GWG in pregnant women at highest risk for GDM or HDP. Ultimately, our goal is to design and produce an effective and scalable behavioral strategy to reduce perinatal complications and future CVD risk.