title: Use of a DVD to provide dietary and lifestyle information to pregnant women who are overweight or obese: a nested randomised trial.
abstract: BACKGROUND
  We conducted a nested randomised trial to evaluate the effect of an educational DVD, providing information about healthy food choices and exercise during pregnancy, on diet and physical activity, among pregnant women who were overweight or obese.
  
  
  METHODS
  We conducted a nested randomised trial within the context of the LIMIT randomised trial. Women were eligible with a singleton pregnancy between 10 and 20 weeks gestation, and body mass index at the time of their first antenatal appointment of ≥25 kg/m(2). All women who were randomised to the Lifestyle Advice Group of the LIMIT trial received a series of consultations with both research dieticians and research assistants, in addition to standard written dietary and exercise materials (Standard Materials Group). Women randomised to the DVD Group received the same consultations and written materials, and additionally received an educational DVD (DVD Group). The primary study outcome was the Healthy Eating Index. Other study outcomes included physical activity, and gestational weight gain. Women completed a qualitative evaluation of all the materials provided.
  
  
  RESULTS
  1,108 women in the LIMIT Lifestyle Advice Group participated in the nested trial, with 543 women randomised to the DVD Group, and 565 women to the Standard Materials Group. Women who received the DVD compared with those who did not, had a higher mean Healthy Eating Index at 36 weeks gestation (73.6 vs 72.3; adjusted mean difference 1.2; 95% CI 0.2 to 2.3; p = 0.02), but not at 28 weeks gestation (73.2 vs 73.5; adjusted mean difference -0.1; 95% CI -1.1 to 0.9; p = 0.82). There were no statistically significant differences in physical activity or total gestational weight gain. While most women evaluated the materials positively, frequency of utilisation was poor.
  
  
  CONCLUSIONS
  Ongoing attention to the delivery of information is required, particularly with the increased use and availability of digital and multi-media interactive technologies.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trials Registry ACTRN12607000161426.
authors.affiliation: The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. gosiaszmeja@gmail.com.
authors.forename: Malgorzata A
authors.initials: MA
authors.lastname: Szmeja
authors.affiliation: The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. courtney.cramp@adelaide.edu.au.
authors.forename: Courtney
authors.initials: C
authors.lastname: Cramp
authors.affiliation: The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. rosalie.grivell@adelaide.edu.au.|Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia. rosalie.grivell@adelaide.edu.au.
authors.forename: Rosalie M
authors.initials: RM
authors.lastname: Grivell
authors.affiliation: The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. andrea.deussen@adelaide.edu.au.
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Deussen
authors.affiliation: Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia. lisa.yelland@adelaide.edu.au.|The University of Adelaide, School of Population Health, Adelaide, South Australia, Australia. lisa.yelland@adelaide.edu.au.
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Yelland
authors.affiliation: The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. jodie.dodd@adelaide.edu.au.|Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia. jodie.dodd@adelaide.edu.au.
authors.forename: Jodie M
authors.initials: JM
authors.lastname: Dodd
mesh_terms: D000328:Adult; D001315:Australia; D015992:Body Mass Index; D004505:Education, Nonprofessional / Q000379:methods*; D015444:Exercise; D005260:Female; D005865:Gestational Age; D006801:Humans; D008019:Life Style; D009520:New Zealand; D064686:Nutritionists; D009765:Obesity / Q000178:diet therapy*; D050177:Overweight / Q000178:diet therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000178:diet therapy*; D037841:Pregnant People; D057566:Self Report; D011795:Surveys and Questionnaires; D014742:Videodisc Recording / Q000706:statistics & numerical data*; D015430:Weight Gain; D055815:Young Adult