title: The feasibility phase of a community antenatal lifestyle programme [The Lifestyle Course (TLC)] for women with a body mass index (BMI)≥ 30 kg/m(2.).
abstract: BACKGROUND
  maternal obesity [body mass index (BMI)≥30kg/m(2)] is a cause for concern because of increasing rates and risk of associated complications. However, little is known about how to improve the health of women with a BMI≥30kg/m(2).
  
  
  OBJECTIVE
  a 10-week antenatal lifestyle programme (The Lifestyle Course - TLC), underpinned by behaviour change theory, was developed in a programme of research which included a prospective, multicentred, feasibility phase (n=227). Participants had a BMI≥30kg/m(2) at the start of their pregnancy, planned to deliver in two areas of Greater Manchester and were aged 18 or over. The objectives were to (1) assess the feasibility of the intervention and (2) to pilot the trial processes and outcome measures.
  
  
  RESULTS
  (1) Trial intervention: only 22% of women in the feasibility phase had received gestational weight advice prior to the study. One or more TLC sessions were attended by 79% of women and 97% said they would recommend TLC to a friend due to the content suitability, perceived personal gains and extra care received. Changes to the TLC were suggested and implemented in the pilot phase. (2) Trial processes: recruitment rates (36%), retention rates (100%) and questionnaire completion rates up to one year (33%) were found. Daily general 'lifestyle' diaries and pedometers were not acceptable data collection tools (response rates of 32% and 16% respectively). However, specific food diaries were acceptable (response rates of 80-81%). The major challenge was the collection of maternal weight data at the follow-up points.
  
  
  CONCLUSIONS
  the antenatal intervention (TLC) designed for this programme of work appears to suit the needs of women with a BMI≥30kg/m(2). The need for an antenatal intervention is clear from this study and also highlights reflections on effective communication with pregnant women with a BMI≥30kg/m(2). Lessons learnt for designing a future trial include effective ways to communicate with pregnant women with a BMI≥30kg/m(2).
  
  
  BACKGROUND
  ISRCTN29860479.
authors.affiliation: The School of Psychological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9PL, UK. Electronic address: Debbie.Smith-2@manchester.ac.uk.
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Smith
authors.affiliation: Maternal & Fetal Health Research Centre, Institute of Human Development, The University of Manchester, Manchester Academic Health Science Centre, St Mary׳s Hospital, Manchester, Central Manchester University Hospitals NS Foundation Trust, UK. Electronic address: Wendy.Taylor@manchester.ac.uk.
authors.forename: Wendy
authors.initials: W
authors.lastname: Taylor
authors.affiliation: Maternal & Fetal Health Research Centre, Institute of Human Development, The University of Manchester, Manchester Academic Health Science Centre, St Mary׳s Hospital, Manchester, Central Manchester University Hospitals NS Foundation Trust, UK. Electronic address: Melissa.Whitworth@cmft.nhs.uk.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Whitworth
authors.affiliation: Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, Jean MacFarlane Building, Oxford Road, Manchester M13 9PL, UK. Electronic address: Stephen.Roberts@manchester.ac.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: Roberts
authors.affiliation: Maternal & Fetal Health Research Centre, Institute of Human Development, The University of Manchester, Manchester Academic Health Science Centre, St Mary׳s Hospital, Manchester, Central Manchester University Hospitals NS Foundation Trust, UK. Electronic address: Colin.sibley@manchester.ac.uk.
authors.forename: Colin
authors.initials: C
authors.lastname: Sibley
authors.affiliation: The School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester Academic Health Science Centre Jean MacFarlane Building, Oxford Road, Manchester M13 9PL, UK. Electronic address: Tina.lavender@manchester.ac.uk.
authors.forename: Tina
authors.initials: T
authors.lastname: Lavender
mesh_terms: D015992:Body Mass Index; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000150:complications / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: Behaviour change theory; Feasibility; Health care; Intervention; Lifestyle; Maternal obesity