Feasibility and Lessons Learned from the FIRST WIND (Weight loss Interventions after Delivery) Intervention for Urban-based, Postpartum African American Women
|Nicholson WK1-4*, Cox R2, Ghosh P9, Gayles D7,8, McCarron PB7,8, Powe NR6, Kimmel M5, Samantha Meltzer-Brody5, Charleston J7,8 and Appel LJ7,8|
|1Program on Women’s Endocrine and Reproductive Health (PoWER), University of California at San Francisco, USA|
|2Diabetes and Obesity Core, Center for Women’s Health Research, University of California at San Francisco, USA|
|3Department of Obstetrics and Gynecology, University of California at San Francisco, USA|
|4Diabetes Center, University of California at San Francisco, USA|
|5Center for Perinatal Moods Disorders, University of California at San Francisco, USA|
|6University of North Carolina School of Medicine, Department of Medicine, University of California at San Francisco, USA|
|7Department of Medicine, University of Florida, USA|
|8Welch Center for Prevention Epidemiology and Clinical Research, University of Florida, USA|
|9Johns Hopkins School of Medicine, and the Department of Sports Medicine, University of Florida, USA|
|Corresponding Author :||Wanda Nicholson
Professor, Obstetrics and Gynecology
University of North Carolina 3027 Old Clinic Building
Chapel Hill, NC 27599, USA
E-mail: [email protected]
|Received: October 15, 2015 Accepted: November 21, 2015 Published: November 26, 2015|
|Citation: Nicholson WK, Cox R, Ghosh P, Gayles D, McCarron PB, et al. (2015) Feasibility and Lessons Learned from the FIRST WIND (Weight loss Interventions after Delivery) Intervention for Urban-based, Postpartum African American Women. J Preg Child Health 2:208. doi: 10.4172/2376-127X.1000208|
|Copyright: © 2015 Nicholson WK et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: Rates of overweight, obesity and glucose intolerance of pregnancy are rapidly increasing among pregnant women, and particularly among women of color. We developed and pilot-tested an evidenced-based behavioral weight-loss intervention, tailored for urban-based, postpartum African America women.
Methods: We conducted a feasibility trial among 32 overweight or obese postpartum, urban-based African American women (15 in intervention group; 17 in the usual care group), who had recently delivered at a communitybased hospital in Baltimore city. Participants were randomized to the active intervention or the self-directed arm of the study. Both groups received an initial 1-hour session with a behavioral interventionist. The 24-week intervention included five individual sessions and 10 group classes on weight management, mental wellness and exercise. Group sessions consisted of 60 minutes of lessons on behavioral strategies and 30 minutes of organized physical activity (e.g. walking, aerobics). The primary outcome was weight change from enrollment to the end of the intervention.
Results: A total of 64% of those potentially eligible at the in-person screen were enrolled in the study. Participants in the active intervention group were slightly younger with lower income levels, compared to those in the selfdirected group. In total, 23 (82%) participants completed the study. Average attendance across all individual sessions was 50%(70% if contact made via email or phone) and 60% for group classes. Average weight loss at 6 months in the active intervention group was 0.49 kgs (4) compared to an average weight gain of 4 kgs (7) in the selfdirected group. From a baseline of 80.8 (12.5), mental functioning scores in the active group remained stable at 84 (15) at 6 months. Average scores in the self-directed group decreased from 83 (15) to 68 (17). In post-intervention focus groups, women verbalized the need for group session, but advocated for alternative methods of individual contacts, including phone calls, emails and text messaging.
Conclusion: This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in postpartum, urban-based African American women with perinatal obesity. Study participants favorably received the intervention. The results may have implications for integrating weight-loss interventions into the early postpartum period in other urban-based communities.