Satisfaction Clinical Trial
Official title:
Supporting Healthful Lifestyles During Pregnancy: A Health Coach Intervention Pilot Study
In this mixed methods study, the investigators assessed the feasibility and acceptability of a remote health coach intervention to promote healthful lifestyle behaviors among overweight pregnant women. At one northeastern US clinic, the investigators enrolled 30 overweight (pre-pregnancy BMI≥25 kg/m2) pregnant women at a median gestation of 12.5 weeks (IQR: 11-15) into a one arm intervention trial. The investigators connected participants with a health coach to provide behavioral support to help participants adopt or maintain healthy lifestyle goals during pregnancy. Health coaches contacted participants by phone every 2-3 weeks to monitor goals, and sent emails and text messages to check-in between calls. To assess the intervention, participants completed baseline (N=30) and follow-up surveys at the end of the intervention (N=26), as well as follow-up phone interviews (N=18).
<Health Coach Intervention > The investigators connected participants at enrollment (median
gestation of 12.5 weeks, IQR: 11-15) with a trained health coach who called participants
every 2-3 weeks until 36 weeks of gestation. During these phone calls, health coaches helped
participants adopt and maintain new healthful lifestyle behaviors that were evidence-based,
simple, and easy to track. Goals aimed to promote appropriate gestational weight gain and
covered several domains including diet, physical activity, screen time, and sleep.
During the first call, health coaches invited participants to prioritize these goals
according to their level of self-efficacy, readiness to change, preferences, and values.
Throughout the intervention, health coaches used principles of motivational interviewing
that relied on a patient-centered approach to enhance readiness to change by exploring
ambivalence and resistance to change. In addition to setting personal goals, health coaches
also presented optimal goals for ideal cardiovascular health.
During follow-up calls, health coaches monitored progress and helped adjust goals when
necessary (e.g. too many goals, or the goal was too ambitious). Health coaches also
addressed barriers and potential solutions with participants, and helped them target higher
goal settings or select novel goals when participants attained them. Health coaches sent
emails or text messages depending on participant preferences to check-in about progress
toward goals or clinical appointments between calls. Research staff (including an MD) met
weekly with health coaches to review their conversations with participants, and to address
any medical issues to ensure that it would be reported to the primary care provider
obstetric team if appropriate.
<Study Design and Sample> Participants completed baseline (N=30) and follow-up (N=26)
surveys at the end of the intervention as well as follow-up phone interviews (N=18). Surveys
collected information on demographics, attitudes related to weight status and pregnancy,
opinions about the intervention, and included food frequency questions . Interviews followed
a guide of open-ended questions to determine insights on what helped achieve goals,
motivation, opinions of the health coach intervention, and areas for improvement. One study
staff member, who has experience with qualitative data collection, conducted all of the
individual interviews. This study was approved by the Harvard Pilgrim Health Care Human
Studies Committee.
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