Efficacy of an mHealth-delivered behavioral intervention on weight loss and cardiometabolic risk in African American postpartum people with overweight or obesity: the SnapBack randomized controlled trial

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2024-07-23 DOI:10.1002/oby.24091

Sharon J. Herring, Daohai Yu, Niesha Darden, Brooke Bailer, Jane Cruice, Jessica J. Albert, Christine Santoro, Veronica Bersani, Chantelle N. Hart, Eric A. Finkelstein, Linda M. Kilby, Xiaoning Lu, Gary B. Bennett, Gary D. Foster

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引用次数: 0

Abstract

Objective

The objective of this study was to evaluate the efficacy of a mobile health (mHealth)-delivered behavioral intervention on changes in postpartum weight and cardiometabolic risk factors (blood pressure [BP], lipids, and hemoglobin A1c) over 12 months.

Methods

A randomized controlled trial of 300 African American postpartum people with overweight and obesity enrolled in Philadelphia Women, Infants, and Children (WIC) clinics was conducted. Participants were randomized to usual WIC care (n = 151) or a 12-month mHealth-delivered intervention (n = 149) comprising behavior change goals, interactive self-monitoring text messages, and counseling support.

Results

Intervention and usual-care participants did not significantly differ in 12-month mean postpartum weight change (1.1 vs. 1.6 kg, p = 0.5; difference −0.6 kg, 95% CI: −2.3 to 1.2). However, high intervention engagement led to weight loss compared with weight gain among those who were less engaged (−0.6 vs. 2.4 kg, p = 0.01; difference −3.0 kg, 95% CI: −5.4 to −0.6). The intervention reduced systolic BP relative to usual care (−1.6 vs. 2.4 mm Hg, p = 0.02; difference −4.0 mm Hg, 95% CI: −7.5 to −0.5), but this effect did not extend to other cardiometabolic risk factors.

Conclusions

Among African American postpartum people enrolled in WIC, an mHealth-delivered intervention reduced systolic BP but not additional cardiometabolic risk factors or weight. Intervention participants with high engagement had significantly better postpartum weight outcomes, and thus, next steps include addressing barriers to engagement.

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针对超重或肥胖的非裔美国人产后减肥和心脏代谢风险的移动医疗行为干预效果：SnapBack 随机对照试验。

研究目的本研究旨在评估移动医疗（mHealth）提供的行为干预在 12 个月内对产后体重和心脏代谢风险因素（血压、血脂和血红蛋白 A1c）变化的影响：对费城妇女、婴儿和儿童（WIC）诊所登记的 300 名超重和肥胖的非裔美国人产后妇女进行了随机对照试验。参与者被随机分配到 WIC 的常规护理（151 人）或为期 12 个月的移动医疗干预（149 人），其中包括行为改变目标、互动式自我监测短信和咨询支持：干预参与者和常规护理参与者在产后 12 个月的平均体重变化上没有明显差异（1.1 对 1.6 千克，P = 0.5；差异 -0.6 千克，95% CI：-2.3 对 1.2）。然而，干预参与度高的产妇体重下降，而干预参与度低的产妇体重增加（-0.6 kg vs. 2.4 kg，p = 0.01；差异-3.0 kg，95% CI：-5.4 to -0.6）。与常规护理相比，干预措施降低了收缩压（-1.6 vs. 2.4 mm Hg，p = 0.02；差异-4.0 mm Hg，95% CI：-7.5 to -0.5），但这一效果并未延伸至其他心脏代谢风险因素：在参加 WIC 的非裔美国人产后人群中，移动医疗提供的干预措施降低了收缩压，但没有降低其他心脏代谢风险因素或体重。参与度高的干预参与者的产后体重结果明显更好，因此，下一步工作包括消除参与障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.