title: Testing the feasibility of a mobile technology intervention promoting healthy gestational weight gain in pregnant women (txt4two) - study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Overweight, obesity and excess gestational weight gain (GWG) are associated with negative health outcomes for mother and child in pregnancy and across the life course. Interventions promoting GWG within guidelines report mixed results. Most are time and cost intensive, which limits scalability. Mobile technologies (mHealth) offer low cost, ready access and individually-tailored support. We aim to test the feasibility of an mHealth intervention promoting healthy nutrition, physical activity and GWG in women who begin pregnancy overweight or obese.
  
  
  METHODS
  txt4two is a parallel randomised control trial pilot recruiting women with a singleton, live gestation between 10(+0) and 17(+6) weeks at the first hospital antenatal clinic visit. Inclusion criteria are pre-pregnancy BMI > 25 kg/m(2) and mobile phone ownership. One hundred consenting women will be randomised to intervention or control groups at a 1:1 ratio. All participants will receive standard antenatal care. In addition, the txt4two intervention will be delivered from baseline to 36 weeks gestation and consists of a tailored suite of theoretically-grounded, evidence-based intervention strategies focusing on healthy nutrition, physical activity and GWG. This includes: mobile phone interactive text messages promoting positive health behaviours, goal setting and self-monitoring; video messages; an information website; and a private moderated Facebook® chat forum. The primary outcome is the feasibility of the intervention. Secondary outcomes include GWG and participants' knowledge and behaviour regarding diet and physical activity during pregnancy.
  
  
  CONCLUSIONS
  Findings will inform the development of larger-scale mHealth programmes to improve the delivery of healthy pregnancy nutrition, physical activity and GWG, that could be widely translated and disseminated.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry: ACTRNU111111544397 . Date of registration: 19 March 2014.
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Victoria, Australia. jwillcox@deakin.edu.au.
authors.forename: Jane Catherine
authors.initials: JC
authors.lastname: Willcox
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Victoria, Australia. karen.campbell@deakin.edu.au.
authors.forename: Karen Jane
authors.initials: KJ
authors.lastname: Campbell
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia. eamcca@unimelb.edu.au.|Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia. eamcca@unimelb.edu.au.
authors.forename: Elizabeth Anne
authors.initials: EA
authors.lastname: McCarthy
authors.affiliation: Mater Mothers Hospital/Mater Research, Queensland, Australia. shelley.wilkinson@mater.org.au.
authors.forename: Shelley Ann
authors.initials: SA
authors.lastname: Wilkinson
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia. mlappas@unimelb.edu.au.|Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia. mlappas@unimelb.edu.au.
authors.forename: Martha
authors.initials: M
authors.lastname: Lappas
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Victoria, Australia. kylie.ball@deakin.edu.au.
authors.forename: Kylie
authors.initials: K
authors.lastname: Ball
authors.affiliation: Cancer Prevention Research Centre, School of Population Health, University of Queensland, Queensland, Australia. b.fjeldsoe@sph.uq.edu.au.
authors.forename: Brianna
authors.initials: B
authors.lastname: Fjeldsoe
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Victoria, Australia. anne.griffiths@deakin.edu.au.
authors.forename: Anne
authors.initials: A
authors.lastname: Griffiths
authors.affiliation: National Institute for Health Innovation, University of Auckland, Auckland, New Zealand. r.whittaker@nihi.auckland.ac.nz.
authors.forename: Robyn
authors.initials: R
authors.lastname: Whittaker
authors.affiliation: National Institute for Health Innovation, University of Auckland, Auckland, New Zealand. r.maddison@nihi.auckland.ac.nz.
authors.forename: Ralph
authors.initials: R
authors.lastname: Maddison
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia. ashub@internode.on.net.|Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia. ashub@internode.on.net.
authors.forename: Alexis
authors.initials: A
authors.lastname: Shub
authors.affiliation: Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia. DPidd@mercy.com.au.
authors.forename: Deborah
authors.initials: D
authors.lastname: Pidd
authors.affiliation: Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia. EFraser@mercy.com.au.
authors.forename: Elise
authors.initials: E
authors.lastname: Fraser
authors.affiliation: Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia. NMoshonas@mercy.com.au.
authors.forename: Nelly
authors.initials: N
authors.lastname: Moshonas
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Victoria, Australia. david.crawford@deakin.edu.au.
authors.forename: David Andrew
authors.initials: DA
authors.lastname: Crawford
mesh_terms: D040421:Cell Phone; D002985:Clinical Protocols; D004032:Diet / Q000009:adverse effects; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D000068097:Maternal Health; D063731:Mobile Applications; D009765:Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010353:Patient Education as Topic; D018743:Perinatal Care / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D012107:Research Design; D012648:Self Care; D061108:Social Media; D017216:Telemedicine / Q000379:methods*; D060145:Text Messaging; D016896:Treatment Outcome; D014739:Victoria; D014741:Video Recording; D015430:Weight Gain