Reducing Postpartum Weight Retention Among Low Income, Ethnically Diverse Women

University Of Texas At Austin, Austin TX

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Abstract

[unreadable] DESCRIPTION (provided by applicant): The epidemic of obesity in the US has raised awareness of the importance of weight gain and obesity development during the childbearing years. Low income and ethnic minority women may be especially vulnerable to weight gain after childbirth. To date, most weight loss studies targeting new mothers have focused almost exclusively on advantaged women. To address this health disparity, a 3-phase study is proposed in which an adaptation of positive deviance inquiry for archival data (APDI) is used as a springboard for development of ethnic-specific weight loss interventions. Positive deviance inquiry focuses on individuals in low resource communities who display uncommon practices that allow them to have healthy outcomes compared to their neighbors with the same resources. The study will draw on archival data from the Austin New Mothers Study (ANMS), a prospective study of low-income African American, White/Anglo, and Hispanic women, 0-12 months postpartum. The proposed aims are to: (1) Identify women using APDI who are positive deviants in the ANMS (i.e., they successfully attained their pre-pregnant weight at 12 months postpartum); and identify their ethnic-specific weight-relevant behaviors, attitudes, beliefs, and context that distinguish them from ethnically-similar women who retained postpartum weight; (2) Design an innovative postpartum weight loss program for each ethnic group (African American, Hispanic, and White/Anglo) of low-income women based on ethnic-specific weight-relevant behaviors, attitudes, and beliefs that distinguish positive deviants in the ANMS archival data; and (3) Test and evaluate the feasibility of each ethnic-specific weight loss intervention with a small sample of low-income women using formative and summative evaluation measures. In Phase 1, APDI will be applied to the ANMS dataset to uncover ethnic-specific behavioral (proximal), attitudes and beliefs (intermediate), and contextual factors associated with low-income women who successfully attain their pre-pregnant weight. These findings along with input from ethnic-specific Advisory Committees will be used to develop ethnic-specific weight loss interventions in Phase 2. These ethnic-specific weight loss interventions will then be tested during Phase 3 in small pilot trials (30 per ethnic group randomly assigned to intervention or control conditions). Outcome evaluations will include weight changes, and related behavioral and attitudinal changes. Findings of this study will contribute to developing weight loss interventions that are relevant to the context of low-income African American, White/Anglo, and Hispanic women after childbirth, especially the 40-50 percent who have excessive weight gains during pregnancy and are at risk for weight gain and obesity development as a result of childbearing. [unreadable] [unreadable] [unreadable] [unreadable]