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Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care.

Kinnunen TI, Aittasalo M, Koponen P, Ojala K, Mansikkamäki K, Weiderpass E, Fogelholm M, Luoto R - BMC Pregnancy Childbirth (2008)

Bottom Line: The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study.The control clinics continued their usual care.The components of the feasibility evaluation were 1) recruitment and participation, 2) completion of data collection, 3) realization of the intervention and 4) the public health nurses' experiences. 1) The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months.

View Article: PubMed Central - HTML - PubMed

Affiliation: UKK Institute for Health Promotion Research, Tampere, Finland. tarja.i.kinnunen@uta.fi

ABSTRACT

Background: Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study.

Methods: A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN) participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1) recruitment and participation, 2) completion of data collection, 3) realization of the intervention and 4) the public health nurses' experiences.

Results: 1) The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrollment was 77% and the drop-out rate 15%. 2) In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3) In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4) The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study.

Conclusion: The study protocol was mostly feasible to implement, which encourages conducting large trials in comparable settings.

Trial registration: Current Controlled Trials ISRCTN21512277.

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Related in: MedlinePlus

Participant flow.
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Figure 2: Participant flow.

Mentions: As only 113 participants were enrolled within the three months allocated, the recruitment period was prolonged to six months (Table 2). Finally, of all potential 327 women with no earlier deliveries, 277 women were eligible and 224 women participated in the study (Figure 2). The participation rate was lower in the intervention than in the control clinics (Table 2). The drop-out rate was low (≤ 11%) in all clinics except for the intervention MCs (29%). Figure 2 presents the reasons for dropping out. Of the reasons related to this study, some drop-outs in the intervention clinics were unwilling to fill in more questionnaires, food records or the follow-up notebook. Other reasons, reported mostly in the control clinics, were reluctance to give the blood samples or difficulties to find the time for this.


Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care.

Kinnunen TI, Aittasalo M, Koponen P, Ojala K, Mansikkamäki K, Weiderpass E, Fogelholm M, Luoto R - BMC Pregnancy Childbirth (2008)

Participant flow.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2526978&req=5

Figure 2: Participant flow.
Mentions: As only 113 participants were enrolled within the three months allocated, the recruitment period was prolonged to six months (Table 2). Finally, of all potential 327 women with no earlier deliveries, 277 women were eligible and 224 women participated in the study (Figure 2). The participation rate was lower in the intervention than in the control clinics (Table 2). The drop-out rate was low (≤ 11%) in all clinics except for the intervention MCs (29%). Figure 2 presents the reasons for dropping out. Of the reasons related to this study, some drop-outs in the intervention clinics were unwilling to fill in more questionnaires, food records or the follow-up notebook. Other reasons, reported mostly in the control clinics, were reluctance to give the blood samples or difficulties to find the time for this.

Bottom Line: The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study.The control clinics continued their usual care.The components of the feasibility evaluation were 1) recruitment and participation, 2) completion of data collection, 3) realization of the intervention and 4) the public health nurses' experiences. 1) The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months.

View Article: PubMed Central - HTML - PubMed

Affiliation: UKK Institute for Health Promotion Research, Tampere, Finland. tarja.i.kinnunen@uta.fi

ABSTRACT

Background: Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study.

Methods: A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN) participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1) recruitment and participation, 2) completion of data collection, 3) realization of the intervention and 4) the public health nurses' experiences.

Results: 1) The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrollment was 77% and the drop-out rate 15%. 2) In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3) In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4) The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study.

Conclusion: The study protocol was mostly feasible to implement, which encourages conducting large trials in comparable settings.

Trial registration: Current Controlled Trials ISRCTN21512277.

Show MeSH
Related in: MedlinePlus