Lifestyle modification intervention for overweight and obese Hispanic pregnant women: development, implementation, lessons learned and future applications.
OBJECTIVE
To describe the development, implementation and lessons learned of lifestyle intervention to promote appropriate gestational weight gain among Hispanic pregnant women.


METHODS
The intervention was informed by an empowerment oriented theoretical framework, and targeted women in the Pregnancy and Early Life Improvement Study.


METHODS
The nutrition component consisted of recommendations for total calories, food quantity and improving carbohydrate and fat quality. We provided brown rice, omega-3 rich vegetable oil and spread, and water monthly. The physical activity focused on limiting sedentary behavior and promoting regular movement. The intervention was delivered through individual and group sessions and phone calls. Participants set their own goals, which were closely monitored. The intervention was evaluated extracting data from participant's record (attendance, goals, and challenges) and using a questionnaire.


RESULTS
Participants were from underserved communities with economic, time, cultural and social barriers for engaging in lifestyle interventions. Modifications were done to facilitate participation, such as coordinating sessions with prenatal appointments and reducing group size and duration of sessions. Weekly text messages were added to reinforce the intervention. The main goal chosen by participants was reduction of sweetened beverages. The greatest challenges were replacing white rice with brown rice and improving physical activity. Participants suggested conducting sessions near their community and using social media as a motivation tool. Main outcomes results will be published elsewhere.


CONCLUSIONS
We identified barriers to delivering the lifestyle intervention, mainly related to group session's participation. Sessions should be conducted in the community, using text messages and social media as reinforcement.
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Roxana
R
Torres
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Sandra
S
Soltero
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Maria Angelica
MA
Trak
Department of Psychology, University of Florida, Gainesville, FL.
Carolyn M
CM
Tucker
Department of Gynecology and Obstetrician, University Hospital, Medical Sciences Campus, University of Puerto Rico.
Keimari
K
Mendez
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Maribel
M
Campos
Department of Nutrition, Harvard Public Health School, Harvard University, Boston, MA.
Walter
W
Willett
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Marytere
M
Melendez
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
Mathew W
MW
Gillman
Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital Malmö, Malmö, Sweden.
Paul W
PW
Franks
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Kaumudi
K
Joshipura
Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Marshfield Clinic Health System, Marshfield, WI.
Jeremy
J
Pomeroy
Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico.
Cristina
C
Palacios
Hispanics; lifestyle intervention; nutrition; obesity; physical activity; pregnancy