App-based support for healthy pregnancy weight gain and lifestyle: preliminary Canadian data

Abstract

Aim: Evaluate the associations between usage of the standalone SmartMoms Canada mHealth intervention, and gestational weight gain (GWG) guideline adherence and lifestyle improvements in pregnant individuals in the context of a pragmatic study.

Methods: Participants (18–40 years, BMI 18.5–39.9 kg/m²) were recruited into a single-arm trial conducted in Winnipeg and Ottawa, Canada. All participants were provided with the app, a Fitbit^® tracker, and a smart scale. Participants were assessed in early, mid-, and late pregnancy. Physical activity was measured with the Godin Leisure Time Exercise score, and the Fitbit^® tracker (steps and time in physical activity). Fitbit^® app was used to measure dietary intake. App usage and GWG were monitored. GWG guideline adherence was compared with data from the Statistics Canada Maternal Experiences Survey (MES). GWG adherence and lifestyle changes were compared between app usage groups (≥ median weekly app usage vs. < median) with multinomial logistic regressions or t tests. Trajectories in lifestyle changes were compared between groups with repeated measure analyses.

Results: Of the 75 participants recruited in early pregnancy, 51 were followed through pregnancy (32% drop out). Overall app usage was low (median 1.30 min/wk). Adequate GWG was achieved by 35.7% (95% CI: 23.2–48.2) of participants vs. 32.6% in the MES; while excessive GWG occurred in 50.0% (95% CI: 36.9–63.1) vs. 48.7%. GWG adherence was not different between usage groups (P = 0.399), but a higher mean weekly app usage (continuous) was associated with lower odds of insufficient GWG (OR = 0.01,P = 0.035). There were no significant associations between app usage and changes in physical activity, but a lower increase in carbohydrate intake was observed in the higher usage group.

Conclusions: Few associations were found between app usage and GWG or lifestyle outcomes. Lack of significant results could relate to low protocol and intervention adherence (Trial registration: http://www.isrctn.com/ISRCTN16254958).

Keywords

mHealth / gestational weight gain / pregnancy / lifestyle / patient education / nutrition / physical activity

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