Supporting postpartum weight loss in women living in deprived communities: design implications for a randomised control trial

• Published in: European journal of clinical nutrition Vol. 65; no. 8; pp. 952 - 958
• Main Authors: Craigie, A M, Macleod, M, Barton, K L, Treweek, S, Anderson, A S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-08-2011; Nature Publishing Group
• Subjects: 631/443/494; 692/699/2743/393; 692/700/478; Adolescent; Adult; Biological and medical sciences; Body Mass Index; Body size; Body Weight; Body weight gain; Body weight loss; Clinical Nutrition; Counseling - methods; Deprivation; Diet; Epidemiology; Feasibility Studies; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Health aspects; Humans; Internal Medicine; Intervention; Interviews as Topic; Low income groups; Management; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Methods; Obesity; original-article; Physical activity; Physiological aspects; Pilot Projects; Postpartum; Postpartum Period; Pregnancy; Primary care; Public Health; Puerperium; Recruitment; Retention; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight control; Weight Loss; Weight Reduction Programs - methods; Women; Womens health; Young Adult; United Kingdom; United Kingdom > UK; weight loss; feasibility trial; postpartum; obesity; pregnancy; Human; Obesity; Nutrition disorder; Weight loss; Metabolic diseases; Puerperium; Pregnancy; Randomization; Female; Feasibility; Woman; Community; Nutritional status
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2011.56

Background/Objectives:
Pregnancy is a life stage where excess weight gain may occur and the postpartum period is often characterised by weight retention. The aim of the current study was to evaluate the feasibility of undertaking a randomised controlled trial of a weight loss intervention (WeighWell) in postpartum women living in areas of social disadvantage.
Subjects/Methods:
The study aimed to recruit 60 women who were not pregnant, 6–18 months postpartum with a body mass index >25 kg/m
2
living in areas of deprivation within Tayside, UK. Recruitment strategies focused on visits to community groups; writing directly to postpartum women living in areas of deprivation and primary care teams who covered the most deprived 15% of the population and advertising in community settings. The 12-week intervention used motivational interviewing techniques to promote an energy deficit diet and increased physical activity, delivered by three face-to-face consultations plus three structured telephone calls.
Results:
Of 142 women screened, 63 were eligible and 52 (83%) were recruited and randomised to an intervention (
n
=29) or comparison group (
n
=23). Over the 12-week intervention, body weight changed significantly by −1.6±2.0 kg in the intervention group compared with +0.2±2.2 kg in the comparison group, indicating the potential efficacy of the intervention. Loss to follow-up was 24% in the intervention group and 39% for the comparison group.
Conclusions:
The findings support the development of a definitive trial that embraces personalised recruitment strategies and the development of approaches to improve retention over a clinically relevant intervention period.