title: 'Fit Moms/Mamás Activas' internet-based weight control program with group support to reduce postpartum weight retention in low-income women: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  High postpartum weight retention is a strong independent risk factor for lifetime obesity, cardiovascular disease, and type 2 diabetes in women. Interventions to promote postpartum weight loss have met with some success but have been limited by high attrition. Internet-based treatment has the potential to overcome this barrier and reduce postpartum weight retention, but no study has evaluated the effects of an internet-based program to prevent high postpartum weight retention in women.
  
  
  METHODS
  Fit Moms/Mamás Activas targets recruitment of 12 Women, Infants and Children (WIC) Supplemental Nutrition Program clinics with a total of 408 adult (>18 years), postpartum (<1 year) women with 14.5 kg or more weight retention or a body mass index of 25.0 kg/m(2) or higher. Clinics are matched on size and randomly assigned within county to either a 12-month standard WIC intervention or to a 12-month WIC enhanced plus internet-based weight loss intervention. The intervention includes: monthly face-to-face group sessions; access to a website with weekly lessons, a web diary, instructional videos, and computer-tailored feedback; four weekly text messages; and brief reinforcement from WIC counselors. Participants are assessed at baseline, six months, and 12 months. The primary outcome is weight loss over six and 12 months; secondary outcomes include diet and physical activity behaviors, and psychosocial measures.
  
  
  CONCLUSIONS
  Fit Moms/Mamás Activas is the first study to empirically examine the effects of an internet-based treatment program, coupled with monthly group contact at the WIC program, designed to prevent sustained postpartum weight retention in low-income women at high risk for weight gain, obesity, and related comorbidities.
  
  
  BACKGROUND
  This trial was registered with Clinicaltrials.gov (identifier: NCT01408147 ) on 29 July 2011.
authors.affiliation: Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. sphelan@calpoly.edu.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phelan
authors.affiliation: Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. acbranne@calpoly.edu.
authors.forename: Anna
authors.initials: A
authors.lastname: Brannen
authors.affiliation: Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, 318 Rosenau Hall, Campus Box 7400, Chapel Hill, NC, 27599-7440, USA. keericks@email.unc.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Erickson
authors.affiliation: Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, 318 Rosenau Hall, Campus Box 7400, Chapel Hill, NC, 27599-7440, USA. mdiamond@unc.edu.
authors.forename: Molly
authors.initials: M
authors.lastname: Diamond
authors.affiliation: Statistics Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. aschaffn@calpoly.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Schaffner
authors.affiliation: Department of Modern Languages, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. kschrist@calpoly.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Muñoz-Christian
authors.affiliation: Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. abstewar@calpoly.edu.
authors.forename: Ana
authors.initials: A
authors.lastname: Stewart
authors.affiliation: Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. mtsanche@calpoly.edu.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sanchez
authors.affiliation: Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. vcrodrig@calpoly.edu.
authors.forename: Vanessa C
authors.initials: VC
authors.lastname: Rodriguez
authors.affiliation: Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA. diramos@calpoly.edu.
authors.forename: Dalila I
authors.initials: DI
authors.lastname: Ramos
authors.affiliation: San Luis Obispo County Women, Infants, and Children Supplemental Nutrition Program, 2191 Johnson Ave, San Luis Obispo, CA, 93401, USA. lmcclure@co.slo.ca.us.
authors.forename: Linda
authors.initials: L
authors.lastname: McClure
authors.affiliation: Santa Barbara County Women, Infants, and Children Supplemental Nutrition Program, 315 Camino del Remedio, Santa Barbara, CA, 93110, USA. caro.stinson@sbcphd.org.
authors.forename: Caro
authors.initials: C
authors.lastname: Stinson
authors.affiliation: Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, 318 Rosenau Hall, Campus Box 7400, Chapel Hill, NC, 27599-7440, USA. dtate@unc.edu.
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Tate
mesh_terms: D000293:Adolescent; D000328:Adult; D031204:Caloric Restriction; D002985:Clinical Protocols; D015444:Exercise; D005260:Female; D006801:Humans; D020407:Internet; D017063:Outcome Assessment, Health Care; D049590:Postpartum Period / Q000378:metabolism*; D011203:Poverty; D018401:Sample Size; D055105:Waist Circumference; D015431:Weight Loss