Fresh Start, a postpartum weight loss intervention for diverse low-income women: design and methods for a randomized clinical trial
Authors
Rosal, Milagros C.Haughton, Christina
Estabrook, Barbara
Wang, Monica L.
Chiriboga, German
Nguyen, Oahn H.T.
Person, Sharina D.
Lemon, Stephenie C.
UMass Chan Affiliations
Prevention Research CenterDepartment of Quantitative Health Sciences
Department of Medicine, Division of Preventive and Behavioral Medicine
Document Type
Journal ArticlePublication Date
2016-09-09Keywords
Health disparitiesNarrative interventions
Obesity
Postpartum weight loss
Randomized clinical trial
Women
Behavior and Behavior Mechanisms
Health Services Administration
Health Services Research
Maternal and Child Health
Obstetrics and Gynecology
Preventive Medicine
Women's Health
Metadata
Show full item recordAbstract
BACKGROUND: Overweight and obesity are prevalent among young women and are greater among minority and low-income women. The postpartum period is critical in women's weight trajectories as many women do not lose their pregnancy weight, and others lose some and then plateau or experience weight gain. Excess weight puts women at greater risk of chronic disease and thus weight loss in the postpartum period may be key to the long-term health of young women. This paper describes the design and methods of a randomized clinical trial of Fresh Start, an innovative narrative-based group intervention aimed at promoting postpartum weight loss among low-income, diverse women. METHODS/DESIGN: Study participants were recruited from the five sites of the Women, Infants and Children (WIC) program in central Massachusetts. Participants were English-speaking, age > /= 18 years, 6 weeks to 6 months postpartum, with a body mass index (BMI) > /= 27 kg/m(2). The Fresh Start postpartum weight loss intervention, adapted from the Diabetes Prevention Program (DPP) in collaboration with WIC staff and clients, consisted of an 8-week group-based curriculum followed by nine monthly telephone calls. It included a narrative component (i.e., storytelling), group discussions, print materials and access to exercise facilities. The study is a two-arm randomized controlled trial. The control condition included print materials and access to exercise facilities. In-person assessments were conducted at baseline and at 6 and 12 months following the eight-week intervention phase. DISCUSSION: The Fresh Start intervention translated key elements of an evidence-based weight loss protocol into a format that is hypothesized to be relevant, acceptable and effective for the target audience of low-SES postpartum women. This novel intervention was developed in collaboration with WIC to be sustainable within the context of its clinics, which reach approximately 9 million individuals per year across the U.S. via 10,000 clinics. TRIAL REGISTRATION: clinicaltrials.gov NCT02176915. Registered 25 June 2014.Source
BMC Public Health. 2016 Sep 9;16:953. doi: 10.1186/s12889-016-3520-0. Link to article on publisher's siteDOI
10.1186/s12889-016-3520-0Permanent Link to this Item
http://hdl.handle.net/20.500.14038/40155PubMed ID
27612615Related Resources
Link to Article in PubMedDistribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.1186/s12889-016-3520-0
Scopus Count
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by/4.0/
Related items
Showing items related by title, author, creator and subject.
-
Policy Brief: Addressing Social Determinants of Health through Community Health Workers: A Call to ActionLondon, Katharine; Damio, Grace; Ferrazo, Meredith; Perez-Escamalla, Rafael; Wiggins, Noelle (2018-01-30)This technical report was compiled by the Hispanic Health Council in partnership with Southwestern AHEC and a panel of Community Health Worker Policy Research Experts which included our Katharine London from the Center for Health Law and Economics. The report offers a number of policy recommendations for community health workers for communities that might benefit from community-based services. The report offers recommendations on; payment of community health workers; community health worker caseloads; community health worker recruitment; community health worker training; reflective and trauma-informed mentoring and supportive supervision of community health workers; integration of community health workers into care teams; documenting the effect of community heal worker services on social determination of health. The Hispanic Health Council believes a service design that effectively supports community health workers would incorporate the seven areas of policy recommendation included in this report.
-
A Public Health Framework for the State Mental Health Authority: A Call for Action by Massachusetts Consumers and Family MembersDelman, Jonathan (2006-01-01)During the Spring of 2006, Consumer Quality Initiatives (CQI) conducted 20 focus groups across the state, 12 with adults with mental illness, 3 with parents of youth with serious emotional disorder, 2 with youth with SED, 1 with family members of adult consumers, and 2 with youth in transition. Supported by a contract with Massachusetts Department of Mental Health (DMH), the goal was to assist DMH in framing the criteria for its upcoming reprocurement. Our findings reveal a frustration with an approach to health care delivery that focuses primarily on the provision of psychiatric care (egs, medication, therapy, hospitalization). We reviewed the focus group reports to identify the most significant themes, which clustered within eight broad categories.
-
Making the Case for Sustainable Funding for Community Health Worker Services: Talking to Payers and ProvidersLondon, Katharine (2018-01-27)In this presentation, Katharine London of the Center for Health Law and Economics makes her case for offering sustainable funding for community health worker services. Research has shown community health workers can have a distinct impact on health systems, helping them improve population health and contain costs, while also promoting health equity and community engagement. This presentation was designed to assist CHWs and other advocates in engaging with policymakers and payers to support CHW sustainability and develop a financial plan for their CHW work. It was presented as part of a CHW Sustainability event held at the Families USA’s annual conference, Health Action 2018: Staying Strong for America’s Families, in Washington, DC. See Katharine London's blog post on payment delivery methods for community health workers here.