Study of the Validity of Using the MEQ to Measure Mindful Eating in Pregnant Women
Condition: Pregnancy
Study type: Observational

Summary: 
      The Specific Aim of this supplemental project is to evaluate the Mindful Eating Questionnaire
      (MEQ) to determine if it is a valid instrument for pregnant women. During this project, the
      MEQ will be qualitatively evaluated in a sample of pregnant women who are similar in age,
      ethnicity, education, and marital status to the women targeted for recruitment in the parent
      study. The qualitative evaluation will include a focus group with 10 participants followed by
      30 individual cognitive interviews. Comments from the interviews will be summarized and
      analyzed systematically for each of the 28 questions of the MEQ and the interviewer will use
      findings from initial interviews to inform subsequent interviews. Content validity will be
      evaluated based on responses from the focus group and cognitive interviews, and MEQ items
      will be evaluated for comprehension, retrieval, judgment, and response. Strengths,
      weaknesses, relevance, comprehensiveness, and interpretations will be reported for each of
      the MEQ questions. We will also have some of the more traditional validation parameters (the
      inclusion of other questionnaires) in the study to collect data on convergent and
      discriminant validity. The resulting publication will provide readers with a thorough report
      on the utility and appropriateness of using the MEQ to quantify mindful eating in pregnant
      women.
    

Detailed description: 
      Pre-pregnancy maternal overweight/obesity and excess weight gain during pregnancy are
      associated with metabolic abnormalities in mothers and their offspring. Despite guidelines
      developed by the Institute of Medicine (IOM) for appropriate levels of gestational weight
      gain, more than 50% of overweight and obese pregnant women exceed the recommended amount of
      weight gain during pregnancy (CDC 2009). Updated guidelines from the Institute of Medicine
      (IOM) in 2009 suggest that individualized dietary counseling and regular physical activity
      are necessary for pregnant women to achieve appropriate levels of gestational weight gain
      (IOM and NRC 2009), yet few studies have examined weight management in overweight pregnant
      women and none were successful at increasing adherence to the IOM guidelines (Polley, Wing et
      al. 2002; Olson, Strawderman et al. 2004; Asbee, Jenkins et al. 2009; Shirazian, Monteith et
      al. 2010; Phelan, Phipps et al. 2011).

      This project is a supplement to a parent study called Expecting Success: Personalized
      management of body weight during pregnancy (U01 DK094418-01 PIs: Leanne M. Redman, Ph.D. &
      Corby K. Martin, Ph.D.). The parent study will test the efficacy of two interventions at
      promoting appropriate levels of weight gain during pregnancy compared to each other and to a
      usual care control group. Appropriate levels of weight gain during pregnancy will be defined
      by the 2009 IOM gestational weight gain guidelines (CDC 2009). The two interventions include
      training on mindfulness surrounding eating, hunger, and satiety; hence, it is logical to test
      if changes in mindfulness differ between the two intervention groups and the usual care
      group. Moreover, it is possible that change in mindfulness will be associated with the
      study's outcome or different levels of gestational weight gain between the usual care group
      and the two intervention groups. Finally, changes in mindfulness could mediate the effect of
      the two interventions on gestational weight gain.

      Despite the possible importance of mindfulness to the eating behavior and weight management
      of pregnant women, no measure has been validated to measure mindfulness in pregnant women.
      The Mindful Eating Questionnaire (MEQ) is a 28-item self-report instrument that measures five
      domains of mindful eating: disinhibition, awareness, external cues, emotional response, and
      distraction. Mindful eating refers to an unbiased awareness of sensations surrounding eating
      and although a preliminary study found the MEQ to be a valid measure of mindful eating in
      healthy adults, it has not been validated in pregnant women. A valid measure of mindful
      eating is required when an intervention is used to increase mindful eating in pregnant women
      and evaluate if the increase results in healthier eating habits and effective weight
      management. Indeed, effectively measuring mindful eating is central to evaluating: 1) if an
      intervention had the anticipated effect on mindful eating, 2) if increasing mindful eating
      resulted in changes to eating habits and body mass, and 3) if changes in mindful eating
      mediated treatment effects.

      Relationship of the supplement to the parent grant: Mindfulness training is effective at
      helping people manage their eating habits, making mindfulness training a viable strategy to
      use with special populations who struggle with eating and weight management, including
      pregnant women. During the parent study, two personal weight-management interventions
      designed to meet the unique needs of pregnant women will be deployed and mindful eating
      techniques are part of these interventions. Although a preliminary study found the Mindful
      Eating Questionnaire (MEQ) to be valid in a convenience sample of generally healthy adults,
      it is not known if the MEQ is an appropriate and valid instrument for use with pregnant
      women, and the proposed project will answer this question. If the MEQ is valid for use with
      pregnant women, it can be used in the parent study, as well as other studies, to determine if
      the interventions are effectively at training participant to mindfully eat and if changes in
      mindful eating mediate intervention effects.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Forty pregnant women (11 will participate in the focus group and 29 will complete
        individual cognitive interviews) will be recruited who are similar in age, ethnicity,
        education, and marital status to the women who will be recruited for the parent study.