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Improving Women’s Preconceptional Health: Long-Term Effects of the Strong Healthy Women Behavior Change Intervention in the Central Pennsylvania Women’s Health Study

      Abstract

      Purpose

      To investigate the long-term (6- and 12-month) effects of the Strong Healthy Women intervention on health-related behaviors, weight and body mass index (BMI), and weight gain during pregnancy. Strong Healthy Women is a small-group behavioral intervention for pre- and interconceptional women designed to modify key risk factors for adverse pregnancy outcomes; pretest–posttest findings from a randomized, controlled trial have been previously reported. The following questions are addressed: 1) were significant pretest–posttest changes in health-related behaviors (previously reported) maintained over the 12-month follow-up period; 2) did the intervention impact weight and BMI over the 12-month follow-up period; and 3) did the intervention impact pregnancy weight gain for those who gave birth during the follow-up period?

      Methods

      Data are from 6- and 12-month follow-up telephone interviews of women in the original trial of the Strong Healthy Women intervention (n = 362) and from birth records for singleton births (n = 45) during the 12-month follow-up period. Repeated measures regression was used to evaluate intervention effects.

      Main Findings

      At the 12-month follow-up, participants in the Strong Healthy Women intervention were significantly more likely than controls to use a daily multivitamin with folic acid and to have lower weight and BMI. The intervention’s effect on reading food labels for nutritional values dropped off between the 6- and 12-month follow-up. Among those who gave birth to singletons during the follow-up period, women who participated in the intervention had lower average pregnancy weight gain compared with controls. Although the intervention effect was no longer significant when controlling for pre-pregnancy obesity, the adjusted means show a trend toward lower weight gain in the intervention group.

      Conclusion

      These findings provide important evidence that the Strong Healthy Women behavior change intervention is effective in modifying important risk factors for adverse pregnancy outcomes and may improve an important pregnancy outcome, weight gain during pregnancy. Because the intervention seems to help women manage their weight in the months after the intervention and during pregnancy, it may be an effective obesity prevention strategy for women before, during, and after the transition to motherhood.
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      Biography

      Carol S. Weisman, PhD, is a sociologist and health services researcher with a principal interest in women’s health care.

      Biography

      Marianne M. Hillemeier, PhD, MPH, is a sociologist/demographer with research interests in maternal and child health disparities.

      Biography

      Danielle Symons Downs, PhD, is an exercise psychology researcher whose expertise is in understanding the psychosocial and behavioral correlates of exercise in women and children.

      Biography

      Mark E. Feinberg, PhD, is a psychologist whose research focuses on family and community prevention programs.

      Biography

      Cynthia H. Chuang, MD, is a general internist with research interests in reproductive health care for women with chronic medical conditions.

      Biography

      John J. Botti, MD, is a maternal-fetal medicine specialist who cares for women with increased risks for adverse pregnancy outcomes.

      Biography

      Anne-Marie Dyer, MS, is a biostatistician and the data manager and chief data analyst for the Central Pennsylvania Women’s Health Study.