Community-based Obesity Treatment in African American Women After Childbirth
Maneno muhimu
Kikemikali
Maelezo
The investigators propose to randomize overweight or obese, African American postpartum WIC participants (n=300) to either usual care (UC) or a community-based obesity treatment (PP) arm. Recruitment will occur in 6 of Philadelphia Women Infants Children's (WIC) clinic sites in the early postpartum period (≤ 6 months after birth). Once enrolled, participants will complete surveys and baseline assessments of their weight, waist circumference, blood pressure, and height at The Center for Obesity Research and Education (CORE). Participants will also have a fasting blood sample taken. Study staff will administer a number of questionnaires assessing demographics, psychosocial factors, contextual factors, and behavioral targets via questionnaires prior to randomization. Participants will then be randomized to the 12-month postpartum weight loss intervention (PP) or usual care (UC). Additional assessments will be conducted at 6 and 12 months post baseline. The PP arm includes expanded obesogenic behavior change goals, tailored skills training materials, interactive self-monitoring text messages, video testimonials, and interpersonal counseling support through health coach calls and Facebook. Data will be analyzed using an intent-to-treat (ITT) approach where subjects are analyzed according to their treatment assignment at randomization, regardless of level of engagement. The primary outcome is weight loss at 12 months. If successful, the expected results could provide a sustainable, low-cost, postpartum weight loss intervention model for widespread dissemination to reduce disparities in obesity and cardiometabolic comorbidities.
Tarehe
| Imethibitishwa Mwisho: | 09/30/2019 |
| Iliyowasilishwa Kwanza: | 01/27/2016 |
| Uandikishaji uliokadiriwa Uliwasilishwa: | 07/06/2016 |
| Iliyotumwa Kwanza: | 07/11/2016 |
| Sasisho la Mwisho Liliwasilishwa: | 10/14/2019 |
| Sasisho la Mwisho Lilichapishwa: | 10/16/2019 |
| Tarehe halisi ya kuanza kwa masomo: | 08/31/2016 |
| Tarehe ya Kukamilisha Msingi iliyokadiriwa: | 05/31/2020 |
| Tarehe ya Kukamilisha Utafiti: | 11/30/2020 |
Hali au ugonjwa
Uingiliaji / matibabu
Behavioral: Community-based obesity treatment (PP)
Awamu
Vikundi vya Arm
| Mkono | Uingiliaji / matibabu |
|---|---|
| No Intervention: Usual care (UC) Usual postpartum WIC care | |
| Experimental: Community-based obesity treatment (PP) The PP arm includes expanded obesogenic behavior change goals, tailored skills training materials, interactive self-monitoring text messages, video testimonials, and interpersonal counseling support through health coach calls and Facebook. | Behavioral: Community-based obesity treatment (PP) Participants in the treatment (PP) arm will receive a 5-component intervention: 1)Behavior change goals; 2)Self-monitoring; 3)Tailored skills training; 4)Video testimonials & 5)Interpersonal counseling. Both treatment and usual care arms will receive the current standard of care offered to postpartum mothers at WIC. |
Vigezo vya Kustahiki
| Zama zinazostahiki Kujifunza | 18 Years Kwa 18 Years |
| Jinsia Inastahiki Kujifunza | Female |
| Hupokea Wajitolea wa Afya | Ndio |
| Vigezo | Inclusion Criteria: 1. Self-identification as African American 2. Self-report pre-pregnancy BMI between 25-49.9 kg/m2 3. Measured BMI at baseline between 25-49.9 kg/m2 4. Philadelphia WIC participant 5. Singleton birth 6. Between 1 and 6 months postpartum 7. Own a cell phone with an unlimited text messaging plan 8. Able to participate in light physical activity (walking) 9. Participants must be willing to comply with all study-related procedures 10. Participants must be able to read and write fluently in English Exclusion Criteria: 1. BMI ≤ 24.9 or ≥ 50.0 kg/m2 2. Uncontrolled hypertension (systolic blood pressure > 160 or diastolic blood pressure > 95 mmHg). Participants with controlled hypertension on medication for at least three months are allowable. 3. Known atherosclerotic cardiovascular disease 4. Known congestive heart failure 5. Known diabetes mellitus (type 1 or type 2) 6. Known thyroid disease 7. Any major active rheumatologic, pulmonary, hepatic, dermatologic disease or inflammatory condition requiring steroids or immune modulating medications 8. History of testing HIV positive 9. Current smoker or tobacco user. Participants with < 5 cigarettes daily are allowable 10. Current or recent history (past 6 months) of drug or alcohol abuse or dependence 11. Participation in any weight control or investigational drug study within 6 weeks of screening 12. Current consumption of any of the following medications: appetite suppressants, anti-psychotics, lipase inhibitors 13. Serious or unstable medical or psychological conditions that, in the opinion of the investigator, would compromise the subject's safety for successful participation in the study 14. Gastrointestinal Disorders (gallbladder disease, Crohn's disease, etc) 15. Previous weight loss surgery 16. History of bulimia or anorexia |
Matokeo
Hatua za Matokeo ya Msingi
1. Weight loss (kilograms) [At baseline and 12 months]
Hatua za Matokeo ya Sekondari
1. Obesogenic dietary behaviors [At baseline and 12 months]
2. Insulin Resistance [At baseline and 12 months]
3. Health-related quality of life [At baseline and 12 months]
4. Physical Activity [At baseline and 12 months]
5. Physical Activity [At baseline and 12 months]
6. Sleep [At baseline and 12 months]
7. Sleep [At baseline and 12 months]
8. Sleep [At baseline and 12 months]
9. Hemoglobin A1c (HbA1c) [At baseline and 12 months]
10. Lipids [At baseline and 12 months]
Hatua Nyingine za Matokeo
1. Utilize Reach Effectiveness Adoption Implementation (RE-AIM) to evaluate the intervention's dissemination potential [12 months]
