Promoting healthy weight across the pregnancy and postpartum period through dissemination of an evidence based intervention

通过传播基于证据的干预措施，促进怀孕和产后期间的健康体重

基本信息

批准号：
9760377
负责人：
Debra Haire-Joshu
金额：
$ 68.1万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-06-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9760377
关键词：
Address Adherence Adopted Adoption Behavior Beverages Body Weight Characteristics Charge Child Child Rearing Chronic Disease Communities Diabetes Mellitus Diet Education Educational Curriculum Educational Intervention Effectiveness Elements Evaluation Evidence based intervention Exposure to Family Home visitation Infrastructure Intervention Intervention Studies Life Life Style Modification Maintenance Maternal Health Measures Mothers Obesity Outcome Overweight Parents Participant Physical activity Population Postpartum Period Pregnancy Pregnant Women Prevalence Randomized Randomized Controlled Trials Research Services Site Structure Teacher Professional Development Time Training Training and Infrastructure Visit Walking Weight Weight Gain Woman Work base child bearing contextual factors design evidence base experience gestational weight gain healthy weight implementation research implementation science improved innovation intervention participants kindergarten lifestyle intervention men obese mothers obesity development population health postpartum weight prenatal prevent programs routine practice sugar teacher treatment as usual trend uptake young woman

项目摘要

PROJECT SUMMARY The childbearing years are a particularly vulnerable time period for women during which they tend to gain disproportionately large amounts of weight when compared to men or other life periods. Weight gained during pregnancy and retained after the postpartum period contributes to obesity development and progression. Our team developed a lifestyle modification intervention in partnership with Parents as Teachers (PAT), a national home visiting, community based organization with significant reach in this population. PAT provides parent-child education and services free-of-charge to families through frequent home visits every year from the prenatal period until the child enters kindergarten. The intervention (EMPOWER) prevented excessive gestational weight gain and postpartum weight retention by embedding content within the existing PAT visit structure. This study will extend these findings with a pragmatic cluster randomized controlled trial to evaluate dissemination and implementation of EMPOWER across multiple levels (mother, parent educator, PAT site) to achieve widespread impact. We will evaluate the impact of EMPOWER on gestational weight gain and postpartum weight retention among mothers with overweight and obesity across the US (N= 266 EMPOWER; N= 266 usual care). Parent educators from 28 existing PAT sites (14 EMPOWER, 14 usual care) will receive the EMPOWER training curriculum through the PAT National Center using the existing training infrastructure. An extensive evaluation guided by RE-AIM, will determine implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, and adaptation). The Conceptual Framework for Implementation Research will characterize determinants that influence EMPOWER dissemination and implementation at multiple levels (mother, parent educator, PAT site) to enhance external validity (reach and maintenance) and population level impact. The findings from this innovative study will reach young women who have experienced the greatest increase in obesity prevalence in the past 45 years compared to other groups, due in part to weight gain associated with child bearing.

项目摘要生育年份是妇女倾向于获得的妇女特别脆弱的时期与男性或其他寿命相比，重量不成比例的体重。体重在期间增加了产后怀孕并保留，导致肥胖的发展和进展。我们的团队与父母担任老师（PAT），开发了生活方式修改干预措施，家庭访问，基于社区的组织，在该人群中具有很高的影响力。 Pat提供亲子每年从产前频繁的家庭访问免费向家庭提供教育和服务直到孩子进入幼儿园。干预措施（授权）阻止了过度的妊娠体重通过将内容嵌入现有的PAT访问结构中来增加和产后保留。这项研究将通过一项务实的聚类随机对照试验扩展这些发现，以评估传播和跨多个级别（母亲，家长教育者，PAT网站）实施授权，以实现广泛的影响。我们将评估授权对妊娠体重增加和产后保持体重的影响在整个美国拥有超重和肥胖的母亲中（n = 266授权； n = 266通常的护理）。父母来自28个PAT网站的教育工作者（14个授权，14个通常的护理）将获得授权培训使用现有的培训基础设施通过PAT国家中心的课程。广泛的评估在re-aim的指导下，将确定实施结果（可接受性，采用，适当性，可行性，忠诚和适应）。实施研究的概念框架将表征决定因素这会影响多个层次的传播和实施权力（母亲，家长教育者，PAT 站点）以提高外部有效性（覆盖范围和维护）和人口水平的影响。从中的发现创新的研究将吸引年轻女性的肥胖症患病率最大的年轻女性与其他群体相比，过去45年相比，部分原因是与儿童轴承相关的体重增加。