Weight Loss Clinical Trial
Official title:
Breastfeeding Support and Weight Management for Black Women: A Dual Intervention
This study, in African American mothers in Detroit, will test an intervention that combines home visiting by experienced peer counselors with a smart phone-based weight control program. The investigators are trying to help mothers breastfeed their babies longer, and also help them get back to the weight they were before they were pregnant. This trial will help the investigators to guide policies in the state of Michigan and has the potential to improve the health of both mothers and babies everywhere.
Excessive pregnancy-related weight retention is an important determinant of obesity and is
more common among African American women. At the same time, breastfeeding, which has been
recommended as a strategy to decrease weight retention is lowest among African American
women. This racial disparity in breastfeeding may partly explain the disparity in obesity,
but even if the two are not causally related, a dual intervention designed to increase
breastfeeding duration and decrease postpartum weight retention makes practical sense because
both are associated with the same critical postpartum time window.
For this study, the investigators will incorporate a postpartum weight management component
into an effective breastfeeding support program. This dual intervention will use a
combination of in-person, telephone, and interactive web/mobile-based health counseling to
provide education and support for breastfeeding difficulties and postpartum weight
management. The intervention will be delivered by peer counselors who will be trained to
provide support using motivational interviewing techniques with consultation by experts. The
investigators have designed the dual intervention to provide encouragement, information, and
problem-solving assistance at the appropriate pre or postpartum stage for both breastfeeding
support and maternal weight management. The mixed delivery mode has proven effective in other
settings and is important to build a trusting relationship while allowing frequent and
flexible methods for communicating during this vulnerable time in a new mom's life. The
overall goal of this developmental/exploratory R21 proposal is to gather pilot data to
effectively refine the intervention so that it can be tested in a larger, longer study using
a factorial design in a future R01 phase. The investigators will recruit, in one large
inner-city prenatal care clinic (Henry Ford Health System, Detroit, MI), pregnant African
American women (32-36 weeks gestation) who are considering breastfeeding (n=80), randomize
them to the intervention or to a usual care group, and follow all participants to 20 weeks
postpartum. The specific aims are to: 1) test feasibility; 2) assess acceptability; and 3)
estimate the effect size of the intervention at 20 weeks postpartum relative to the usual
care group on (1) breastfeeding duration and (2) postpartum weight retention. This project is
significant because the combined intervention is designed to work synergistically on two
interrelated, highly prevalent problems that disproportionately disadvantage African American
families.
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