Date of Award

Fall 12-14-2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Dr. Susan Kelley

Second Advisor

Dr. Regena Spratling

Third Advisor

Dr. Sarah Henes

Abstract

Overweight and obese women who lose weight prior to pregnancy have fewer pregnancy complications than those who do not (Forsum, Brantsaeter, Olafsdottir, Olsen, & Thorsdottir, 2013; Schummers, Hutcheon, Bodnar, Lieverman, & Himes, 2015). Research findings suggest there are missed opportunities to provide diet and physical activity counseling during preventive care visits. Providers cite a lack of time and resources as barriers (Morgan et al., 2006; Yamamoto et al., 2014).

This was a two-group, randomized, pilot-study of 19 overweight or obese women in Central Georgia. Participants completed surveys related to their perception of risk for obesity-related pregnancy complications, readiness to change nutrition and physical activity behaviors, nutrition and physical activity self-efficacy, actual physical activity, and dietary history at baseline, after completion of the study, and at follow-up. Those in the intervention group participated in one face-to-face meeting, reviewed eight online education modules, and received weekly booster messages. The control group participated in a similar protocol; however, information was limited to general women’s health topics.

Nineteen women (intervention = 11, control = 8) completed all instruments related to primary outcomes—perception of risk, readiness to change, and self-efficacy. The average age of participants was 28.7 years (SD = 6.35). The average body mass index was 36.54 kg/m2 (SD = 5.52). Women were predominately Caucasian (68.4%) and married (52.6%) with children (57.9%). Most had a college degree (42.1%) or higher (15.8%), and a yearly income between $25,000 and $75,000 (42.1%). Evaluation of completion data, resources, and intervention management indicated that the intervention may be feasible during preventative care visits. Participant responses to exit interview questions demonstrated the intervention may be acceptable for women of childbearing age. Effect sizes ranged from small (ƞp2= .00, p = .88) to large (ƞp2= .27, p = .08) indicating the intervention may be effective in an adequately powered sample.

Future research should focus on the further development and implementation of programs that assist with pre-conception weight loss. Providing women with information regarding the complications associated with being overweight and obese, as well as the information or tools necessary to reduce weight prior to pregnancy, may be instrumental for improving short and long-term pregnancy outcomes for both mothers and their offspring.

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