Personal behaviors during pregnancy influence gestational weight gain, gestational diabetes mellitus and preeclampsia, in addition to developmental programming of the offspring. This application is designed to assess the technical merit, feasibility, usability and potential commercial application of a digital platform and wellness curriculum to reduce the health risks of the mother and child during pregnancy and after delivery. Currently, there are no evidence-based, scalable and holistic digital health programs for pregnant women during and post pregnancy, and the CDC's Diabetes Prevention Program is contraindicated for pregnant women. We propose to develop the initial eight sessions (6 during pregnancy, 2 post-pregnancy) of an 18-session digital wellness program implemented during pregnancy and 6-months post-partum when women are likely to be more receptive to engage in healthy behaviors. The program translates our prior research-tested, team-based intervention paradigm from a hardcopy curriculum with multiple in-person sessions to a digital format with interactive sessions administered by the participants via the digital platform, by videoconferencing. Participants will receive a digital scale, activity and sleep tracker and a sphygmomanometer that syncs wirelessly with the digital platform to each participant's personal Dashboard account. The wireless tracking and monitoring will occur across several metrics, tiers of social networking functionality, with time and behavior- based notifications to participants to ensure program adherence. The application will be accessible by mobile phone, smart devices and computer to facilitate participant interaction, motivation, peer support, and biometric and behavior monitoring. Between sessions, women participate in goals and engage in behavioral leaning activities related to the prior session's learning objectives. Messaging to women is based upon online platform utilization, reinforcing activities, long-term goals and social communication. Daily data derived from the digital scale, blood pressure, activity and sleep tracker, when outside recommended parameters, will immediately be seamlessly transferred to the woman's EMR and healthcare provider's secure and confidential fax or email. Curriculum sessions will focus on; a) weight gain and energy balance; b) nutrition during pregnancy; c)physical activity; d) stress reduction; e) sleep hygiene; and f) pregnancy physiology and fetal growth. Postpartum sessions include a) depression prevention; b) breast feeding; c) return to healthy pre-pregnancy weight via diet and physical activity; d) life balance and socialization. All team sessions are reinforced with activities between meetings, post-session goals, educational videogames and other digital resources including, exercise and cooking instruction videos, FAQs, meal and snack recipes and a pregnancy wellness guide. We will assess program feasibility, usability, resources, tools, tier support, relevance and satisfaction of the entire platform, tools and 8 sessions an accompanying weekly activities by six teams of 5 women/team with questionnaires, focus groups, and web analytics. In addition, we will specifically assess participant usage of various application components and monitoring devices. Healthcare providers will be queried about utility, satisfaction and recommendations regarding patient data uploads to the EMR, email or fax and perceptions of the intervention by survey.
Public Health Relevance Statement: A health promotion and wellness program that favorably modifies health behaviors and risk factors for excessive gestational weight gain, gestational diabetes, and preeclampsia, and promotes a return to a healthier weight, depression prevention and breast feeding after delivery, fills a need for women during and after pregnancy. This Phase I proposal aims to initiate a feasibility and usability assessment of a team-based, digital wellness platform, translating our prior relevant, evidence-based behavioral interventions. The program and resources target nutrition, physical activity, sleep, stress and depression, along with home biometric monitoring. This intervention should improve the health outcomes of women during and after pregnancy, benefitting the developing fetus and future of the mother and child.
Project Terms: Accelerometer; Accountability; Adherence; Award; base; Behavior; Behavior monitoring; Behavior Therapy; Behavioral; Biometry; Birth; Blood Pressure; Breast Feeding; Car Phone; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Child; Childhood; commercial application; Communities; Computers; cooking; curriculum enhancement; dashboard; Data; depression prevention; design; Development; Devices; diabetes prevention program; Diet; digital; Educational Curriculum; Electronic Mail; energy balance; Ensure; Equilibrium; evidence base; Exercise; Feedback; Fetal Growth; Fetus; Focus Groups; Future; Gestational Diabetes; gestational weight gain; Goals; Health; Health behavior; Health Personnel; Health Promotion; healthy weight; high risk population; Home environment; Hygiene; improved; Individual; Instruction; Internet; Intervention; Knowledge; laptop; Learning; Life; Life Style; Meditation; meetings; Mental Depression; mobile application; Monitor; monitoring device; Moods; Mothers; Motivation; National Institute of Child Health and Human Development; Notification; nutrition; offspring; online resource; Outcome; Participant; Patients; peer support; Perception; Perinatology; Personal Behavior; Persons; Phase; Physical activity; Physicians; Physiology; Polysomnography; Postpartum Period; Pre-Eclampsia; Pregnancy; pregnancy hypertension; pregnancy prevention; Pregnant Women; Prenatal Nutrition; programs; Provider; Questionnaires; Recipe; Recommendation; Research; Resources; Risk; Risk Factors; satisfaction; Secure; Self-Administered; Sleep; Small Business Innovation Research Grant; social communication; Social Network; social networking website; Socialization; Sphygmomanometers; Stress; stress management; stressor; Surveys; System; Telefacsimile; Testing; Thinness; Time; tool; Translating; uptake; usability; Videoconferencing; virtual reality; web site; Weight; Weight Gain; Wellness Program; Wireless Technology; Woman; Women's Group
