title: Potential for a stress reduction intervention to promote healthy gestational weight gain: focus groups with low-income pregnant women.
abstract: BACKGROUND
  Prepregnancy body mass index and excessive gestational weight gain (GWG) are associated with adverse maternal and infant outcomes. Because stress contributes to obesity and eating behaviors, stress reduction interventions during pregnancy may be a novel way to influence GWG, positively affect maternal and infant outcomes, and address the obesity epidemic intergenerationally.
  
  
  METHODS
  Our research team is developing a mindfulness-based stress reduction and nutrition intervention for low-income, overweight and obese pregnant women, with healthy GWG as the primary outcome measure. To inform development of the intervention, we conducted focus groups with our target population. Focus group transcripts were analyzed for themes related to sources and importance of stress, relationship between stress and eating, and motivation for a stress reduction pregnancy intervention.
  
  
  RESULTS
  Fifty-nine low-income pregnant women from the San Francisco Bay Area participated in focus groups and completed a questionnaire. The vast majority of women (80%) reported experiencing significant stress from a variety of sources and most recognized a relationship between stress and eating in their lives.
  
  
  CONCLUSIONS
  This at-risk population seems to be extremely interested in a stress reduction intervention to support healthy GWG during pregnancy. The women in our groups described high levels of stress and a desire for programs beyond basic dietary recommendations. These findings inform practitioners and policymakers interested in pregnancy as a "window of opportunity" for behavior change that can affect the metabolic and weight trajectory both for women and their offspring.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California. Electronic address: Melanie.Thomas@ucsf.edu.
authors.forename: Melanie
authors.initials: M
authors.lastname: Thomas
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, California.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Vieten
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California.
authors.forename: Nancy
authors.initials: N
authors.lastname: Adler
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, California.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Ammondson
authors.affiliation: Center for Health and Community, University of California, San Francisco, California.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Coleman-Phox
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California.
authors.forename: Elissa
authors.initials: E
authors.lastname: Epel
authors.affiliation: School of Public Health, University of California, Berkeley, California.
authors.forename: Barbara
authors.initials: B
authors.lastname: Laraia
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D064866:Mindfulness; D011203:Poverty; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D016730:Program Development; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult