Degree Type

Dissertation

Date of Award

2017

Degree Name

Doctor of Philosophy

Department

Food Science and Human Nutrition

Major

Nutritional Sciences

First Advisor

Christina G. Campbell

Abstract

Obesity is the second largest modifiable cause of preventable death in the United States. Pregnancy is an ideal time to prevent the development of obesity as it offers the opportunity to influence the health of both the current and future generations. The Be-Well, Behavioral Wellness in Pregnancy, intervention is a randomized-controlled, multi-component self-determination theory (SDT)-based intervention designed to help pregnant women meet the current pregnancy weight gain guidelines through diet and physical activity (PA) modification.

Fifty-six women were randomized to either usual care (UC) or intervention; 48 (n = 23 intervention; n = 25 UC) completed the study. The intervention group met one-on-one with a Registered Dietitian Nutritionist monthly, beginning at weeks 8-14 gestation. Sessions discussed PA, diet, and the 2009 IOM pregnancy weight gain guidelines. Motivational interviewing (MI) was used to target the constructs of SDT and facilitate behavior change. The intervention group used a wrist-worn activity tracker to monitor daily step goals and followed an individualized meal plan designed to improve diet quality and modify carbohydrate intake.

The intervention group was significantly more likely to gain within the 2009 IOM guidelines (p = 0.019). Additionally, 36.4% were at or below pre-pregnancy weight at two months postpartum compared to 12.5% of UC (p = 0.05). The intervention group increased PA in mid-pregnancy (average step/day, p = 0.0002; moderate-vigorous PA in bouts of ≥30 minutes, p = 0.008) and improved diet quality (Healthy Eating Index-2010, p<0.01). Moreover, the intervention group had higher scores for perceived competence for diet in late pregnancy (p = 0.0185) and perceived competence for PA in mid- and late-pregnancy (p = 0.0033 and p = 0.0019) compared to UC. Intervention group self-efficacy for diet increased from baseline to late-pregnancy (p = 0.0145) and was higher at two months post partum (p = 0.0041). Self-efficacy for exercise also increased in the intervention group from baseline to mid-pregnancy (p = 0.0362).

These findings support that GWG interventions can be effective at preventing EGWG and lays the foundation for future intervention research. Future work should identify how to conduct an intensive, comprehensive behavior change intervention in the clinical setting.

DOI

https://doi.org/10.31274/etd-180810-5708

Copyright Owner

Lyndi Marie Buckingham-Schutt

Language

en

File Format

application/pdf

File Size

264 pages

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