title: Improving women's preconceptional health: long-term effects of the Strong Healthy Women behavior change intervention in the central Pennsylvania Women's Health Study.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA. cweisman@psu.edu
authors.forename: Carol S
authors.initials: CS
authors.lastname: Weisman
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Hillemeier
authors.forename: Danielle Symons
authors.initials: DS
authors.lastname: Downs
authors.forename: Mark E
authors.initials: ME
authors.lastname: Feinberg
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Chuang
authors.forename: John J
authors.initials: JJ
authors.lastname: Botti
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dyer
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005492:Folic Acid; D005500:Follow-Up Studies; D005515:Food Labeling; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D010414:Pennsylvania; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012307:Risk Factors; D013995:Time; D016896:Treatment Outcome; D014815:Vitamins / Q000627:therapeutic use; D015430:Weight Gain; D016387:Women's Health; D055815:Young Adult
chemical_list: D014815:Vitamins; D005492:Folic Acid