Optimizing Gestational Weight Gain With the Eating4Two Smartphone App

Protocol for a Randomized Controlled Trial

Deborah Davis, Rachel Davey, Lauren T Williams, Maralyn Foureur, Ellen Nohr, Catherine Knight-Agarwal, Tanya Lawlis, Jeremy Oats, Helen Skouteris, Matthew Fuller-Tyszkiewicz

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Abstract

BACKGROUND: Approximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy.

OBJECTIVE: The primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention.

METHODS: This randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women's weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care.

RESULTS: Recruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign.

CONCLUSION: Feasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo).

REGISTERED REPORT IDENTIFIER: RR1-10.2196/9920.

Original languageEnglish
Pages (from-to)e146
JournalJMIR Research Protocols
Volume7
Issue number5
DOIs
Publication statusPublished - 30 May 2018

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Weight Gain
Randomized Controlled Trials
Pregnancy
Prenatal Care
Social Class
Serving Size
Mobile Applications
Social Media
Smartphone
Weights and Measures
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Cell Phones
Women's Health
Financial Management
New Zealand
Registries
Body Mass Index
Mothers
Clinical Trials
Parturition

Cite this

Davis, Deborah ; Davey, Rachel ; Williams, Lauren T ; Foureur, Maralyn ; Nohr, Ellen ; Knight-Agarwal, Catherine ; Lawlis, Tanya ; Oats, Jeremy ; Skouteris, Helen ; Fuller-Tyszkiewicz, Matthew. / Optimizing Gestational Weight Gain With the Eating4Two Smartphone App : Protocol for a Randomized Controlled Trial. In: JMIR Research Protocols. 2018 ; Vol. 7, No. 5. pp. e146.
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Davis, D, Davey, R, Williams, LT, Foureur, M, Nohr, E, Knight-Agarwal, C, Lawlis, T, Oats, J, Skouteris, H & Fuller-Tyszkiewicz, M 2018, 'Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial', JMIR Research Protocols, vol. 7, no. 5, pp. e146. https://doi.org/10.2196/resprot.9920

Optimizing Gestational Weight Gain With the Eating4Two Smartphone App : Protocol for a Randomized Controlled Trial. / Davis, Deborah; Davey, Rachel; Williams, Lauren T; Foureur, Maralyn; Nohr, Ellen; Knight-Agarwal, Catherine; Lawlis, Tanya; Oats, Jeremy; Skouteris, Helen; Fuller-Tyszkiewicz, Matthew.

In: JMIR Research Protocols, Vol. 7, No. 5, 30.05.2018, p. e146.

Research output: Contribution to journalArticle

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N1 - ©Deborah Davis, Rachel Davey, Lauren T. Williams, Maralyn Foureur, Ellen Nohr, Catherine Knight-Agarwal, Tanya Lawlis, Jeremy Oats, Helen Skouteris, Matthew Fuller-Tyszkiewicz. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 30.05.2018.

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Y1 - 2018/5/30

N2 - BACKGROUND: Approximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy.OBJECTIVE: The primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention.METHODS: This randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women's weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care.RESULTS: Recruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign.CONCLUSION: Feasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo).REGISTERED REPORT IDENTIFIER: RR1-10.2196/9920.

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