title: Evaluation of the 'healthy start to pregnancy' early antenatal health promotion workshop:  a randomized controlled trial.
abstract: BACKGROUND
  Pregnancy is an ideal time to encourage healthy lifestyles as most women access health services and are more receptive to health messages; however few effective interventions exist. The aim of this research was to deliver a low-intensity, dietitian-led behavior change workshop at a Maternity Hospital to influence behaviors with demonstrated health outcomes.
  
  
  METHODS
  Workshop effectiveness was evaluated using an RCT; 'usual care' women (n = 182) received a nutrition resource at their first antenatal visit and 'intervention' women also attended a one-hour 'Healthy Start to Pregnancy' workshop (n = 178). Dietary intake, physical activity levels, gestational weight gain knowledge, smoking cessation, and intention to breastfeed were assessed at service-entry and 12 weeks later. Intention-to-treat (ITT) and per-protocol (PP) analyses examined change over time between groups.
  
  
  RESULTS
  Approximately half (48.3%) the intervention women attended the workshop and overall response rate at time 2 was 67.2%. Significantly more women in the intervention met pregnancy fruit guidelines at time 2 (+4.3%, p = 0.011) and had a clinically-relevant increase in physical activity (+27 minutes/week) compared with women who only received the resource (ITT). Women who attended the workshop increased their consumption of serves of fruit (+0.4 serves/day, p = 0.004), vegetables (+0.4 serves/day, p = 0.006), met fruit guidelines (+11.9%, p < 0.001), had a higher diet quality score (p = 0.027) and clinically-relevant increases in physical activity (+21.3 minutes/week) compared with those who only received the resource (PP).
  
  
  CONCLUSIONS
  The Healthy Start to Pregnancy workshop attendance facilitates improvements in important health behaviors. Service changes and accessibility issues are required to assist women's workshop attendance to allow more women to benefit from the workshop's effects.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12611000867998.
authors.affiliation: Mater Medical Research Institute, Mothers and Babies Theme, Raymond Terrace, South Brisbane, Queensland, 4101, Australia. shelley.wilkinson@mater.org.au
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Wilkinson
authors.forename: H David
authors.initials: HD
authors.lastname: McIntyre
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001521:Behavior Therapy / Q000379:methods*; D001942:Breast Feeding; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D015397:Program Evaluation; D016540:Smoking Cessation; D014675:Vegetables; D055815:Young Adult