Weight Management in Obese Pregnant Underserved African American Women
Condition: Obesity; Pregnancy; Weight Gain
MeSH terms: Body Weight; Weight Gain
Study type: Interventional

Summary: 
      This project will test a novel lifestyle intervention to help overweight and obese
      socioeconomically disadvantaged African American women achieve healthy weight control during
      and after pregnancy and improve the health of their offspring. The treatment will be given
      through an existing national home visiting program, Parents As Teachers (PAT), which will
      facilitate sustainability and nationwide dissemination, if effective. We hypothesize that
      compared with standard PAT monitoring and counseling (PAT), women randomized to the lifestyle
      intervention program (PAT+) will have a lower percentage who exceed Institute of Medicine
      recommendations for gestational weight gain.
    

Detailed description: 
      Maternal overweight/obesity and inappropriate gestational weight gain increase both maternal
      and neonatal morbidity and mortality. In addition, offspring of overweight/obese women are at
      increased risk for neurodevelopmental delay, becoming obese, and developing metabolic
      diseases. Women who are socioeconomically disadvantaged (SED), especially from African
      American populations, are particularly susceptible to adverse pregnancy-related outcomes
      because of their high prevalence rates of obesity. Therefore, successful weight management
      during pregnancy in SED, African American women has considerable public health implications.
      We have experience in testing lifestyle interventions among SED nonpregnant women that have
      been implemented and sustained within community organizations such as Parents As Teachers
      (PAT), a national home visiting program that provides parent-child education and services
      free-of-charge to high-needs women, prenatally and post-partum, with up to 25 home visits per
      year until kindergarten. We propose to conduct a 24-month (6-month prenatal and 18-month
      post-partum) randomized, controlled trial in overweight and obese SED African American women
      to evaluate the ability of an innovative lifestyle intervention program (PAT+), delivered by
      PAT parent educators during prenatal and post-partum home visits, to improve maternal and
      neonatal/infant weight, metabolic and health outcomes, relative to the standard PAT program
      (PAT). A programmatic evaluation will determine the applicability of the PAT+ intervention in
      real world settings by measuring programmatic reach, implementation, acceptability, and
      sustainability. If effective, PAT+ can be disseminated through this national organization,
      which currently reaches over 249,000 mothers and 319,000 children participating in 2,173 PAT
      programs across all 50 states.
    

Intervention name(s): Standard Parents As Teachers (PAT); Parents As Teachers Plus (PAT+)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants will receive visits by Parent Educators, who will deliver the standard PAT curriculum. Participants will receive 28 total visits over the course of approximately 2 years.; Participants will receive the standard PAT curriculum, plus lifestyle intervention focusing on healthy diet and exercise, through 28 home visits over the course of approximately 2 years.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Obesity; Pregnancy; Body Weight Changes; Diet Therapy