Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to ...engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants and designing interventions for midlife women, although with suboptimal success, as increasing PA could meaningfully attenuate CVD risk. An updated approach to understanding PA among midlife women could improve upon existing resources by focusing on novel psychosocial influences on PA in this population (ie, body satisfaction, social interactions, social comparisons, mood state) and within-person relations between these influences and PA in the natural environment.
The overarching goal of Project WHADE (Women's Health And Daily Experiences) is to use an ecological momentary assessment (EMA) approach to capture ecologically valid relations between midlife women's psychosocial experiences and PA as they engage in their normal daily activities. The primary aim of the study is to identify within-person psychosocial predictors of variability in PA (ie, experiences associated with higher vs lower PA for a given individual).
Midlife women (aged 40-60 years) with one or more additional risk markers for CVD (eg, hypertension) will be recruited from primary care clinics and the general community (target n=100). Eligible women will complete an initial survey and a face-to-face baseline session before engaging in a 10-day EMA protocol. Psychosocial experiences will be assessed using a brief self-report via a smartphone 5 times per day, and PA will be assessed throughout waking hours using a research-grade monitor. Participants will return for a brief exit interview at the end of 10 days. Multilevel models that address the nested structure of EMA data will be used to evaluate the study aims.
Recruitment and enrollment are ongoing, and a total of 75 women have completed the protocol to date. Data collection is expected to be completed in Fall 2020.
Project WHADE is designed to identify naturally occurring psychosocial experiences that predict short-term variability in midlife women's PA. As such, the results of this study should advance the current understanding of PA among midlife women by providing further insight into within-person psychosocial influences on PA in this group. In the future, this information could help inform the design of interventions for this population.
DERR1-10.2196/19044.
Abstract Purpose To investigate the long-term (6- and 12-month) effects of the Strong Healthy Women intervention on health-related behaviors, weight and body mass index (BMI), and weight gain during ...pregnancy. Strong Healthy Women is a small-group behavioral intervention for pre- and interconceptional women designed to modify key risk factors for adverse pregnancy outcomes; pretest–posttest findings from a randomized, controlled trial have been previously reported. The following questions are addressed: 1) were significant pretest–posttest changes in health-related behaviors (previously reported) maintained over the 12-month follow-up period; 2) did the intervention impact weight and BMI over the 12-month follow-up period; and 3) did the intervention impact pregnancy weight gain for those who gave birth during the follow-up period? Methods Data are from 6- and 12-month follow-up telephone interviews of women in the original trial of the Strong Healthy Women intervention ( n = 362) and from birth records for singleton births ( n = 45) during the 12-month follow-up period. Repeated measures regression was used to evaluate intervention effects. Main Findings At the 12-month follow-up, participants in the Strong Healthy Women intervention were significantly more likely than controls to use a daily multivitamin with folic acid and to have lower weight and BMI. The intervention’s effect on reading food labels for nutritional values dropped off between the 6- and 12-month follow-up. Among those who gave birth to singletons during the follow-up period, women who participated in the intervention had lower average pregnancy weight gain compared with controls. Although the intervention effect was no longer significant when controlling for pre-pregnancy obesity, the adjusted means show a trend toward lower weight gain in the intervention group. Conclusion These findings provide important evidence that the Strong Healthy Women behavior change intervention is effective in modifying important risk factors for adverse pregnancy outcomes and may improve an important pregnancy outcome, weight gain during pregnancy. Because the intervention seems to help women manage their weight in the months after the intervention and during pregnancy, it may be an effective obesity prevention strategy for women before, during, and after the transition to motherhood.
Transitioning to parenthood is a major life event that may impact parents' personal lifestyles, yet there is an absence of theory-based research examining the impact of parenthood on motives for ...dietary behaviour. As a result, we are unaware of the social cognitive variables that predict eating behaviour among those transitioning to parenthood. The purpose of the study was to examine eating behaviour motives across 12 months within the framework of the theory of planned behavior (TPB) and compare these across groups of new parents, non-parents, and established parents.
Non-parents (n = 92), new parents (n = 135), and established parents (n = 71) completed TPB questionnaires assessing attitudes, subjective norms, perceived behavioral control (PBC), and intentions and three day food records at baseline, and 6- and 12-months post-delivery (for parents) and 6- and 12-months post-baseline (for non-parents).
Repeated measures ANOVAs revealed that among men, new- and established-parents had greater intentions to eat healthy compared to non-parents, F(2) = 3.59, p = .03. Among women, established parents had greater intentions than new- and non-parents, F(2) = 5.33, p = .01. Among both men and women during the first 6-months post-delivery, new-parents experienced decreased PBC, whereas established parents experienced increased PBC. Overall, affective attitudes were the strongest predictor of intentions for men (β = 0.55, p < .001) and women (β = 0.38, p < .01). PBC predicted changes in fruit and vegetable consumption for men (β = 0.45, p = .02), and changes in fat consumption for men (β = -0.25, p = .03) and women (β = -.24, p < .05), regardless of parent status.
The transition to parenthood for new and established parents may impact motivation for healthy eating, especially PBC within the framework of TPB. However, regardless of parental status, affective attitudes and PBC are critical antecedents of intentions and eating behaviour. Interventions should target affective attitudes and PBC to motivate healthy eating and may need to be intensified during parenthood.
We examined preconception (prepregnancy) predictors of pregnancy weight gain and weight gain that exceeds the 2009 Institute of Medicine (IOM) recommendations based on pre-pregnancy body mass index ...(BMI), in a prospective study.
Data are from a population-based cohort study of 1,420 women who were interviewed at baseline and 2 years later. The analytic sample includes 103 women who were not pregnant at baseline and gave birth to full-term singletons during the follow-up period. Preconception maternal weight category as well as health behaviors, psychosocial stress, parity, and age were examined as predictors of pregnancy weight gain and of weight gain in excess of the IOM recommendations using multiple linear and logistic regression analysis.
Pregnancy weight gain averaged 33.01 pounds, with 51% of women gaining weight in excess of the 2009 IOM recommendations for their preconception weight category. Preconception overweight (BMI = 25-29.9) increased the odds of excessive pregnancy weight gain nearly threefold, whereas preconception physical activity levels meeting activity guidelines reduced the odds of excessive weight gain but was marginally statistically significant.
Although future research examining the role of physical activity in relation to pregnancy weight gain is needed, preconception overweight and physical activity levels are prime targets for interventions to avoid excessive pregnancy weight gain.
Maintaining adequate hydration over the course of pregnancy is critical for maternal and fetal health and reducing risks for adverse pregnancy outcomes (e.g., preeclampsia, low placental and amniotic ...fluid volume). Recent evidence suggests that women may be at risk for under-hydration in the second and third trimesters when water needs begin to increase. Scant research has examined pregnant women's knowledge of hydration recommendations, water intake behaviors, and willingness to use digital tools to promote water intake. This study aimed to: 1) describe hydration recommendation knowledge and behaviors by the overall sample and early vs late pregnancy, and 2) identify habits and barriers of using digital tools. Pregnant women (N = 137; M age = 30.9 years; M gestational age = 20.9) completed a one-time, 45-minute online survey. Descriptive statistics quantified women's knowledge of hydration recommendations, behaviors, and attitudes about utilizing digital tools to promote adequate intake, and Mann-Whitney U and chi-squared tests were used to determine group differences. Most women lacked knowledge of and were not meeting hydration recommendations (63%, 67%, respectively) and were not tracking their fluid consumption (59%). Knowledge of hydration recommendations differed by time of pregnancy, such that women in later pregnancy reported 82 ounces compared to women in early pregnancy (49 ounces). Common barriers included: forgetting to drink (47%), not feeling thirsty (47%), and increased urination (33%). Most were willing to use digital tools (69%) and believed a smart water bottle would help them achieve daily fluid recommendations (67%). These initial findings suggest that pregnant women may benefit from useful strategies to increase knowledge, decrease barriers, and maintain adequate hydration, specifically earlier in pregnancy. These findings will inform the design of a behavioral intervention incorporating smart connected water bottles, wearables for gesture detection, and behavior modification strategies to overcome barriers, promote proper hydration and examine its impact on maternal and infant health outcomes.
Perinatal overweight and obesity is a major public health and clinical care issue that requires deliberate and immediate attention. Preconception and prenatal assessment and counseling should address ...the risks associated with obesity, recommendations for weight gain, proper nutrition and dietary intake, and physical activity. Nutrition and exercise guidance should be offered to all perinatal overweight and obese women with an emphasis on effective strategies to overcome barriers. All women should be encouraged to adopt a healthy lifestyle and achieve a healthy weight before becoming pregnant.
Body-worn inertial measurement unit (IMU) sensors have been widely used in postural stability and balance studies because of their low cost and convenience. In most of these studies, a single IMU ...sensor is attached to a waist belt near the body’s center of mass. Some populations such as pregnant women, however, may find a waist belt challenging in terms of fit and comfort. For this reason it may be useful to identify an alternative location for placement of an IMU and a more comfortable means for attaching the sensor to the body.
Research question
Does placing an IMU sensor in a pendant worn around the neck permit discrimination between conditions with varying postural stability?
Twenty-six healthy participants performed three standing tasks (double-leg, tandem, and single-leg standing) under eyes-open and eyes-closed vision conditions to preliminarily assess the ability of the pendant sensor to discriminate between balance conditions. Discrimination based upon data from a belt-mounted IMU was assessed in the same trials. Differences in standard deviation of acceleration components, sway area, and jerkiness due to trial condition and sensor were evaluated using analysis of variance followed by post hoc comparisons. These data were also incorporated into receiver-operator characteristic (ROC) curve analysis to assess the effectiveness of each sensor at discriminating between conditions.
Stability was found to vary across conditions, but there was no interaction between stability and sensor location (all p ≥ 0.323). ROC curve analysis showed that sensors in both locations were good discriminators between conditions.
Significance
Placing an IMU in a pendant may be feasible for studying and monitoring postural instability. This approach may be especially valuable when considering populations for which wearing a belt is uncomfortable.
•Inertial measurement unit sensors are usually firmly attached to the body.•Wearing such sensors on a belt is not comfortable or feasible for some populations.•Discrimination between conditions was tested for sensors on a belt and in a pendant.•Similar discrimination effectiveness was demonstrated for both sensor locations.
A dynamical systems model of intrauterine fetal growth Freigoun, Mohammad T.; Rivera, Daniel E.; Guo, Penghong ...
Mathematical and computer modelling of dynamical systems,
11/2018, Letnik:
24, Številka:
6
Journal Article
Recenzirano
Odprti dostop
The underlying mechanisms for how maternal perinatal obesity and intrauterine environment influence foetal development are not well understood and thus require further understanding. In this paper, ...energy balance concepts are used to develop a comprehensive dynamical systems model for foetal growth that illustrates how maternal factors (energy intake and physical activity) influence foetal weight and related components (fat mass, fat-free mass, and placental volume) over time. The model is estimated from intensive measurements of foetal weight and placental volume obtained as part of Healthy Mom Zone (HMZ), a novel intervention for managing gestational weight gain in obese/overweight women. The overall result of the modelling procedure is a parsimonious system of equations that reliably predicts foetal weight gain and birth weight based on a sensible number of assessments. This model can inform clinical care recommendations as well as how adaptive interventions, such as HMZ, can influence foetal growth and birth outcomes.
Objective: The onset of parenthood has been identified as a critical risk period for physical inactivity, yet limited research has examined the correlates of physical activity (PA) using theoretical ...models in longitudinal designs with comparison groups of couples without children. The purpose of this study was to predict PA across 12 months among cohorts of couples with and without children using the theory of planned behavior (TPB). Method: Participants were 314 adults (102 not expecting a child, 136 expecting first child, and 76 expecting second child) who completed baseline demographics, measures of the TPB, and 7-day accelerometry, followed by assessments at six and 12 months. Results: Hierarchical linear modeling showed some TPB relationships were moderated by parental status and gender. Most notable, time-varying covariate analyses showed perceived behavioral control and intention decreased for new mothers compared to women without children across time. PA was predicted by intention for all cohorts, and intention was predicted by affective and instrumental attitudes and perceived behavioral control for husbands and wives, whereas subjective norm predicted intention only in husbands. For wives, the relationship between intention and instrumental attitudes and perception of behavioral control varied by parental status, and was larger for couples without children compared to second-time parents. Overall, there was considerable coordination in slopes and intercepts among couples, yet individual cognitions were better predictors than partner cognitions. Conclusion: The findings provide helpful information for targeting PA interventions among young adults, and suggest that interventions for new mothers may require greater effort to raise the absolute values of control when compared to women without children.
Parents play an important role in the development of children's health behaviors, but less is known about the role of parental encouragement for physical activity (PA) on youth PA behavior and body ...image satisfaction. The purposes of this study were to: (1) longitudinally assess whether adolescent PA at age 15 mediates the effect of perceived parental encouragement for PA at age 15 for predicting adolescent body satisfaction at age 16, while controlling for body mass index (BMI), and (2) examine the extent to which adolescent sex moderates this association.
Participants were 379 boys and girls assessed at 15 and 16 years of age, who completed surveys as part of a larger longitudinal study in their health/physical education classes in a school district in Central Pennsylvania. Participants completed measures of their perception of parental encouragement for PA, PA behavior, body satisfaction, and height and weight to calculate BMI at age 15 and 16 (i.e., 10th and 11th grades). Pearson correlations were used to examine the association among the study variables and hierarchical regression analyses were used to predict body satisfaction at age 16.
Perceived encouragement for PA from fathers, but not mothers, at age 15, was significantly associated with adolescent PA at age 15 and body satisfaction scores at age 16. Adolescents reporting higher PA behavior and perceived encouragement for PA from fathers at age 15 had higher body satisfaction scores at age 16. Moreover, adolescent PA at age 15 mediated the association between perceived fathers' encouragement for PA at age 15 and adolescent body satisfaction at age 16, when controlling for BMI. Examining the moderating effect of adolescent sex on this association revealed that adolescent PA no longer mediated the association between perceived encouragement for PA from fathers and adolescent body satisfaction, and sex moderated this association.
These findings suggest that, regardless of adolescent BMI, fathers may play an instrumental role in adolescents' body image satisfaction by positively influencing PA behavior. However, the influence of perceived encouragement for PA from fathers on adolescent body satisfaction and PA behavior may differ for boys and girls.
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