An mHealth Walking Intervention for Pregnant Women with Obesity

Introduction: Adverse maternal and infant health outcomes are associated with a rise in obesity and excessive gestational weight gain, which may be modified with physical activity in pregnancy. Using mobile health technology has the potential to reach widely at a low cost, to deliver physical activity interventions founded upon behaviour change theory to support women with gestational weight gain management. Aim: To establish the feasibility, practicality and acceptability of a walking-based intervention for women who are pregnant and obese. Specific objectives were to; conduct a systematic literature review; develop and test the feasibility, of a walking intervention for women who are pregnant and obese using mobile health technology; qualitatively evaluate participants' and health professionals' views on the intervention design; design a protocol for a definitive RCT intervention. Methods: A systematic review was conducted investigating the components and effectiveness of walking interventions for women who are pregnant and obese. Following this, feasibility randomised controlled trial, of a physical activity intervention to women who are pregnant and obese, delivered via Facebook, was implemented. It was developed using the Capability, Opportunity, Motivation- Behaviour model as per National Institute of Health and Care Excellence guidelines, to deliver self-monitoring, goal-setting and 'information about health consequences' behaviour change techniques. Semi-structured interviews with participants and health professionals assessed the acceptability of the intervention. Primary outcome measures were feasibility of recruitment, attrition, and trial procedures. Secondary outcomes were: engagement in Facebook group, physical activity, gestational weight gain, maternal and infant outcomes. Results: The systematic review identified two eligible studies, both underpowered but showing a trend in improved maternal outcomes. For the feasibility trial, 40 women were recruited. Retention rate was 85% in the intervention and 75% in the control group. Participants were compliant to wearing Fitbit (intervention arm 32/35 days and the control 28/35 days). In the intervention arm, 20/20 participants joined the Facebook group. The level of engagement varied, with some active and some 'lurking' participants. The interviews revealed that participants found it practical and convenient to access health information via a closed Facebook group. Conclusion: Recruitment and adherence rates and Facebook participation, suggest that the study is feasible and acceptable. Findings from the feasibility study informed the final protocol of a large size randomised controlled trial, to test the effectiveness of a mobile health-based walking intervention.