Formative Development of ClockWork for the Postpartum Period: A Theory-Based Intervention to Harness the Circadian Timing System to Address Cardiometabolic Health-Related Behaviors

• Published in: International journal of environmental research and public health Vol. 20; no. 4; p. 3669
• Main Authors: Conlon, Rachel P Kolko, Hu, Haomin, Saptono, Andi, Hawkins, Marquis S, Parmanto, Bambang, Levine, Michele D, Buysse, Daniel J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 18-02-2023; MDPI
• Subjects: Adult; Animal behavior; Animals; Behavior modification; Biological clocks; Body mass; Body mass index; Body size; Body weight loss; Cardiovascular Diseases; Circadian Clocks; Circadian rhythm; Circadian rhythms; Clockwork; Consumer goods industry; Eating behavior; Exercise; Feasibility; Female; Health Behavior; Health risks; Humans; Intervention; Light; Medical research; Medicine, Experimental; Metabolism; Obesity; Physical activity; Postpartum; Postpartum Period; Pregnancy; Pregnant women; Retention; Sleep; Weight control; Weight loss; United States; body weight; sleep; health behavior; circadian rhythms; eating; postpartum period
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph20043669

Individuals with body mass index (BMI) ≥ 25 kg/m
before pregnancy have greater difficulty losing the weight gained during pregnancy, and this postpartum weight retention predicts higher risk for cardiometabolic disease. The postpartum period involves substantial disruptions in circadian rhythms, including rhythms related to eating, physical activity, sleep, and light/dark exposure, each of which are linked to obesity and cardiometabolic disease in non-pregnant adult humans and animals. We posit that a multi-component, circadian timing system-based behavioral intervention that uses digital tools-
-will be feasible and acceptable to postpartum individuals and help promote weight- and cardiometabolic health-related behaviors. We provide data from stakeholder interviews with postpartum individuals (pre-pregnancy BMI ≥ 25;
= 7), which were conducted to obtain feedback on and improve the relevance and utility of digital self-monitoring tools for health behaviors and weight during the postpartum period. Participants perceived the ClockWork intervention and digital monitoring app to be helpful for management of postpartum weight-related health behaviors. They provided specific recommendations for increasing the feasibility intervention goals and improving app features for monitoring behaviors. Personalized, easily accessible interventions are needed to promote gestational weight loss after delivery; addressing circadian behaviors is an essential component of such interventions. Future studies will evaluate the efficacy of the ClockWork intervention and associated digital tools for improving cardiometabolic health-related behaviors linked to the circadian timing system during the postpartum period.