scholarly journals Effects of a Prenatal Lifestyle Intervention in Routine Care on Maternal Health Behaviour in the First Year Postpartum—Secondary Findings of the Cluster-Randomised GeliS Trial

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1310
Author(s):  
Kristina Geyer ◽  
Monika Spies ◽  
Julia Günther ◽  
Julia Hoffmann ◽  
Roxana Raab ◽  
...  
Keyword(s):  
Physical Activity ◽  
Maternal Health ◽  
Lifestyle Intervention ◽  
Health Behaviour ◽  
Intervention Group ◽  
Routine Care ◽  
Healthy Eating Index ◽  
Dietary Behaviour ◽  
First Year ◽  
Cluster Randomised

Lifestyle interventions during pregnancy were shown to beneficially influence maternal dietary behaviour and physical activity, but their effect on health behaviour after delivery is unclear. The objective of this secondary analysis was to investigate the sustained effect of a lifestyle intervention in routine care on maternal health behaviour during the first year postpartum. The cluster-randomised controlled “Healthy living in pregnancy” (GeliS) study included 2286 pregnant women. Data on maternal health behaviour were collected at 6–8 weeks (T1pp) and one year postpartum (T2pp) using validated questionnaires. The intervention group showed a lower mean intake of fast food (T1pp: p = 0.016; T2pp: p < 0.001) and soft drinks (T1pp: p < 0.001), a higher mean intake of vegetables (T2pp: p = 0.015) and was more likely to use healthy oils for meal preparation than the control group. Dietary quality rated by a healthy eating index was higher in the intervention group (T1pp: p = 0.093; T2pp: p = 0.043). There were minor trends towards an intervention effect on physical activity behaviour. The proportion of smokers was lower in the intervention group (p < 0.001, both time points). The lifestyle intervention within routine care modestly improved maternal postpartum dietary and smoking behaviours.

scholarly journals Correction To: Effects of a lifestyle intervention in routine care on prenatal physical activity – findings from the cluster-randomised GeliS trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Julia Hoffmann ◽  
Julia Günther ◽  
Kristina Geyer ◽  
Lynne Stecher ◽  
Kathrin Rauh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Lifestyle Intervention ◽  
Routine Care ◽  
Cluster Randomised

Following publication of the original article [1], the author notified us about incorrectly formatted of Table 2 and Table 3.

scholarly journals Effects of a lifestyle intervention in routine care on prenatal physical activity – findings from the cluster-randomised GeliS trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Julia Hoffmann ◽  
Julia Günther ◽  
Kristina Geyer ◽  
Lynne Stecher ◽  
Kathrin Rauh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Light Intensity ◽  
Pregnant Women ◽  
Care Setting ◽  
Intervention Group ◽  
Late Pregnancy ◽  
Routine Care ◽  
Control Group ◽  
Cluster Randomised ◽  
Vigorous Intensity

Abstract Background Excessive gestational weight gain (GWG) is associated with an increased risk of pregnancy and obstetric complications. The “healthy living in pregnancy” (GeliS) study was performed in a routine care setting with the aim of limiting excessive GWG. The purpose of this secondary analysis is to evaluate the effect of the intervention on physical activity (PA) behaviour and to assess the impact of PA intensities on GWG. Methods The cluster-randomised, multicentre GeliS trial was performed in a routine care setting alongside scheduled prenatal visits. Pregnant women with a pre-pregnancy BMI between 18.5 and 40.0 kg/m2 were either assigned to the control group receiving usual care or to the intervention group. Participants in the intervention group attended three antenatal counselling sessions on diet and PA and one additional postpartum session. Data on PA behaviour were collected twice, before the end of the 12th (baseline) and after the 29th week of gestation using the Pregnancy Physical Activity Questionnaire. Results PA data were available for 1061 (93%) participants in the intervention and 1040 (93%) in the control group. Women in the intervention group reported significant improvements in the levels of total PA (p < 0.001), total PA of light intensity and above (p < 0.001), moderate-intensity (p = 0.024) and vigorous-intensity activities (p = 0.002) as well as sport activities (p < 0.001) in late pregnancy compared to the control group. The proportion of women meeting the international PA recommendations in late pregnancy was significantly higher in the intervention (64%) versus the control group (49%, p < 0.001). Activities of light-intensity and above (p = 0.006), light-intensity (p = 0.002) and vigorous-intensity (p = 0.014) in late pregnancy were inversely associated with total GWG. Conclusion We found significant evidence of improvements in the PA pattern of pregnant women receiving lifestyle counselling within the framework of routine care. Most PA intensities were inversely associated with total GWG which indicates that PA across different intensities should be promoted. Trial registration NCT01958307, ClinicalTrials.gov, retrospectively registered 9 October, 2013.

scholarly journals Effects of a Lifestyle Intervention in Routine Care on Prenatal Dietary Behavior—Findings from the Cluster-Randomized GeliS Trial

2019 ◽  
Vol 8 (7) ◽  
pp. 960 ◽  
Author(s):  
Julia Günther ◽  
Julia Hoffmann ◽  
Julia Kunath ◽  
Monika Spies ◽  
Dorothy Meyer ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Soft Drink ◽  
Intervention Group ◽  
Dietary Behavior ◽  
Late Pregnancy ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Weight Retention ◽  
Maternal Weight ◽  
Cluster Randomized

The antenatal lifestyle and excessive gestational weight gain (GWG) modify the risk of obstetric complications, maternal weight retention, and the risk of obesity for the next generation. The cluster-randomized controlled “Healthy living in pregnancy” (GeliS) study, recruiting 2286 women, was designed to examine whether a lifestyle intervention reduced the proportion of women with excessive GWG. Trained healthcare providers gave four counseling sessions covering a healthy diet, regular physical activity, and self-monitoring of GWG in the intervention group. In this secondary analysis, the effect on maternal dietary behavior was analyzed. Dietary behavior was assessed by means of a 58-item food frequency questionnaire in early and late pregnancy. The intervention resulted in a significant reduction in soft drink intake (p < 0.001) and an increase in the consumption of fish (p = 0.002) and vegetables (p = 0.023). With the exception of higher percentage energy from protein (p = 0.018), no effects of the intervention on energy and macronutrient intake were observed. There was no evidence for an overall effect on dietary quality measured with a healthy eating index. Some dietary variables were shown to be associated with GWG. In a routine prenatal care setting in Germany, lifestyle advice modified single aspects of dietary behavior, but not energy intake or overall dietary quality.

scholarly journals The Impact of a Web-Based Mindfulness, Nutrition and Fitness Platform on the Health Status of First-Year University Students: Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Claire F Trottier ◽  
Jessica RL Lieffers ◽  
Steven T Johnson ◽  
João F Mota ◽  
Roshni K Gill ◽  
...  
Keyword(s):  
Physical Activity ◽  
University Students ◽  
Intervention Group ◽  
Mental Wellbeing ◽  
Control Group ◽  
First Year ◽  
Web Based ◽  
Related Quality ◽  
First Year University ◽  
The Impact

BACKGROUND First-year university students are at increased risk for presenting with anxiety, depression, suicidal thoughts and poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent/treat stress, anxiety and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared to conventional methods. Such tools are also popular among university students. OBJECTIVE The primary objective of this 12-week randomized control trial was to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The study’s secondary outcome was to assess the effects of the platform on diet quality and exploratory outcomes were body composition, health related quality of life, mindfulness, mental wellbeing and physical activity. METHODS Ninety-seven first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan® (MVP) which aims to support healthy living on the topics of mindfulness, nutrition, and fitness. The platform is fully automated and is guided by principals of cognitive behavior theory. Participants in the intervention group were instructed to use MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6 and week 12. Three day food records were used to analyze dietary intake at baseline and week 12. Health related quality of life, mindfulness, mental wellbeing and physical activity questionnaires were completed at baseline, week 6 and week 12 and body composition was assessed at baseline and week 12. Study assessments were completed in-person at baseline and week 12 and electronically at week 6. RESULTS Study recruitment started in August 2018 with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta. Eighty participants completed the 12-week trial (n=35 in the intervention group; n=45 in the control group). All data collection ended in May 2019. CONCLUSIONS This project is the first to explore the impact of an online platform designed to promote health and wellness; it will also shed light into its applicability in first-year university students. If successful, this may become an important health care tool for preventative care in first year university students. CLINICALTRIAL ClinicalTrials.gov NCT03579264

scholarly journals Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial

2020 ◽  
Author(s):  
Edurne Zabaleta-del-Olmo ◽  
Marc Casajuana-Closas ◽  
Tomàs López-Jiménez ◽  
Haizea Pombo ◽  
Mariona Pons-Vigués ◽  
...  
Keyword(s):  
Physical Activity ◽  
Usual Care ◽  
Behaviour Change ◽  
Health Behaviour ◽  
Implementation Strategy ◽  
Health Behaviour Change ◽  
Implementation Outcomes ◽  
Cluster Randomised ◽  
Multiple Health ◽  
Determinants Of Implementation

Abstract Background This aim of this study was to evaluate the effectiveness of: a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45-75 years compared to usual care; and b) an implementation strategy. Methods A cluster randomised effectiveness-implementation hybrid trial type 2 with two parallel groups was conducted in 25 Primary Health Care centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention focused on all target behaviours and used individual, group and community approaches. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR) and a set of discrete implementation strategies which included planning, educating, financing, restructuring and managing quality. Data were analysed using generalised linear mixed models, accounting for clustering. A mixed methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. Results MHBC was greater in the intervention (14.5%) than in the usual care group (8.9%). The overall adoption rate by professionals was 48.7. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate, with a lower initial than final appropriateness perception. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of percentage of approaches with fidelity ≥ 50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five of them corresponding to the Inner Setting domain. Conclusions Compared to usual care, the EIRA intervention was more effective in promoting MHBC. Implementation outcomes were satisfactory except for the fidelity to the planned intervention which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. Trial registration ClinicalTrials.gov, NCT03136211. Registered 2 May 2017, “retrospectively registered”: https://clinicaltrials.gov/ct2/show/NCT03136211

scholarly journals Effectiveness of a Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Randomized Controlled Trial

10.2196/26091 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e26091
Author(s):  
Johanna Sandborg ◽  
Emmie Söderström ◽  
Pontus Henriksson ◽  
Marcus Bendtsen ◽  
Maria Henström ◽  
...  
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Weight Gain ◽  
Intervention Group ◽  
Healthy Eating Index ◽  
Overweight And Obesity ◽  
Smartphone App ◽  
Control Group ◽  
Body Fatness

Background Excessive gestational weight gain (GWG) during pregnancy is a major public health concern associated with negative health outcomes for both mother and child. Scalable interventions are needed, and digital interventions have the potential to reach many women and promote healthy GWG. Most previous studies of digital interventions have been small pilot studies or have not included women from all BMI categories. We therefore examined the effectiveness of a smartphone app in a large sample (n=305) covering all BMI categories. Objective To investigate the effectiveness of a 6-month intervention (the HealthyMoms app) on GWG, body fatness, dietary habits, moderate-to-vigorous physical activity (MVPA), glycemia, and insulin resistance in comparison to standard maternity care. Methods A 2-arm parallel randomized controlled trial was conducted. Women in early pregnancy at maternity clinics in Östergötland, Sweden, were recruited. Eligible women who provided written informed consent completed baseline measures, before being randomized in a 1:1 ratio to either an intervention (n=152) or control group (n=153). The control group received standard maternity care while the intervention group received the HealthyMoms smartphone app for 6 months (which includes multiple features, eg, information; push notifications; self-monitoring; and feedback features for GWG, diet, and physical activity) in addition to standard care. Outcome measures were assessed at Linköping University Hospital at baseline (mean 13.9 [SD 0.7] gestational weeks) and follow-up (mean 36.4 [SD 0.4] gestational weeks). The primary outcome was GWG and secondary outcomes were body fatness (Bod Pod), dietary habits (Swedish Healthy Eating Index) using the web-based 3-day dietary record Riksmaten FLEX, MVPA using the ActiGraph wGT3x-BT accelerometer, glycemia, and insulin resistance. Results Overall, we found no statistically significant effect on GWG (P=.62); however, the data indicate that the effect of the intervention differed by pre-pregnancy BMI, as women with overweight and obesity before pregnancy gained less weight in the intervention group as compared with the control group in the imputed analyses (–1.33 kg; 95% CI –2.92 to 0.26; P=.10) and completers-only analyses (–1.67 kg; 95% CI –3.26 to –0.09; P=.031]). Bayesian analyses showed that there was a 99% probability of any intervention effect on GWG among women with overweight and obesity, and an 81% probability that this effect was over 1 kg. The intervention group had higher scores for the Swedish Healthy Eating Index at follow-up than the control group (0.27; 95% CI 0.05-0.50; P=.017). We observed no statistically significant differences in body fatness, MVPA, glycemia, and insulin resistance between the intervention and control group at follow up (P≥.21). Conclusions Although we found no overall effect on GWG, our results demonstrate the potential of a smartphone app (HealthyMoms) to promote healthy dietary behaviors as well as to decrease weight gain during pregnancy in women with overweight and obesity. Trial Registration ClinicalTrials.gov NCT03298555; https://clinicaltrials.gov/ct2/show/NCT03298555 International Registered Report Identifier (IRRID) RR2-10.2196/13011

Effect of a 3-Year Lifestyle Intervention in Patients with Chronic Kidney Disease: A Randomized Clinical Trial

2021 ◽  
pp. ASN.2021050668
Author(s):  
Kassia Beetham ◽  
Rathika Krishnasamy ◽  
Tony Stanton ◽  
Julian Sacre ◽  
Bettina Douglas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Exercise Capacity ◽  
Lifestyle Intervention ◽  
Cardiorespiratory Fitness ◽  
Intervention Group ◽  
Walk Distance ◽  
Minute Walk Distance ◽  
Minute Walk

Background Supervised lifestyle interventions have the potential to significantly improve physical activity and fitness in patients with chronic kidney disease (CKD). Methods To assess the efficacy of a lifestyle intervention in patients with CKD to improve cardiorespiratory fitness and exercise capacity over 36 months, we conducted a randomized clinical trial, enrolling 160 patients with stage 3-4 CKD, with 81 randomized to usual care and 79 to 3-year lifestyle intervention. The lifestyle intervention comprised care from a multidisciplinary team, including a nephrologist, nurse practitioner, exercise physiologist, dietitian, diabetes educator, psychologist, and social worker. The exercise training component consisted of an 8-week individualized and supervised gym-based exercise intervention followed by 34 months of a predominantly home-based program. Self-reported physical activity (metabolic equivalent of tasks [METs] min/wk), cardiorespiratory fitness (peak O2 consumption [VO2peak]), exercise capacity (maximum METs and 6-minute walk distance) and neuromuscular fitness (grip strength and get-up-and-go time) were evaluated at 12, 24, and 36 months. Results The intervention increased the percentage of patients meeting physical activity guideline targets of 500 MET min/wk from 29% at baseline to 63% at 3 years. At 12 months, both VO2peak and METs increased significantly in the intervention group by 9.7% and 30%, respectively, without change in the usual care group. Thereafter, VO2peak declined to near baseline levels, whereas METs remained elevated in the intervention group at 24 and 36 months. After 3 years, the intervention had increased the 6-minute walk distance and blunted declines in the get-up-and-go test. Conclusions A 3-year lifestyle intervention doubled the percentage of CKD patients meeting physical activity guidelines, improved exercise capacity, and ameliorated losses in neuromuscular and cardiorespiratory fitness.

scholarly journals Effect of a prenatal lifestyle intervention on physical activity level in late pregnancy and the first year postpartum

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0188102 ◽  
Author(s):  
Birgitte Sanda ◽  
Ingvild Vistad ◽  
Linda Reme Sagedal ◽  
Lene Annette Hagen Haakstad ◽  
Hilde Lohne-Seiler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Lifestyle Intervention ◽  
Physical Activity Level ◽  
Late Pregnancy ◽  
Activity Level ◽  
First Year
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