Original article| Volume 24, ISSUE 3, e305-e311, May 2014

Potential for a Stress Reduction Intervention to Promote Healthy Gestational Weight Gain: Focus Groups with Low-Income Pregnant Women



      Prepregnancy body mass index and excessive gestational weight gain (GWG) are associated with adverse maternal and infant outcomes. Because stress contributes to obesity and eating behaviors, stress reduction interventions during pregnancy may be a novel way to influence GWG, positively affect maternal and infant outcomes, and address the obesity epidemic intergenerationally.


      Our research team is developing a mindfulness-based stress reduction and nutrition intervention for low-income, overweight and obese pregnant women, with healthy GWG as the primary outcome measure. To inform development of the intervention, we conducted focus groups with our target population. Focus group transcripts were analyzed for themes related to sources and importance of stress, relationship between stress and eating, and motivation for a stress reduction pregnancy intervention.


      Fifty-nine low-income pregnant women from the San Francisco Bay Area participated in focus groups and completed a questionnaire. The vast majority of women (80%) reported experiencing significant stress from a variety of sources and most recognized a relationship between stress and eating in their lives.


      This at-risk population seems to be extremely interested in a stress reduction intervention to support healthy GWG during pregnancy. The women in our groups described high levels of stress and a desire for programs beyond basic dietary recommendations. These findings inform practitioners and policymakers interested in pregnancy as a “window of opportunity” for behavior change that can affect the metabolic and weight trajectory both for women and their offspring.
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      Melanie Thomas, MD, MS, is a clinical researcher and psychiatrist at UCSF, San Francisco General Hospital. Her research focuses on interventions targeting the intersection of mental health, health-related behavior, and chronic disease among low-income women of reproductive age.


      Cassandra Vieten, PhD, is a licensed clinical psychologist, Scientist at California Pacific Medical Center Research Institute, and President/CEO of the Institute of Noetic Sciences.


      Ingrid Ammondson, PhD, is a psychologist who works currently as a researcher, instructor, and consultant in the topics of wellness, somatic and affect psychology, stress management, and meditation.


      Nancy E. Adler, PhD, is the Vice-Chair of the Department of Psychiatry, and Director of the Center for Health and Community. Her current research examines social, psychological and biological mechanisms by which SES influences health.


      Elissa Epel, PhD, is a health psychologist studying stress pathways and how stress processes may lead to early disease precursors, overeating, abdominal obesity, and immune cell aging. She also examines how maternal stress, weight, and health behaviors may affect offspring.


      Kimberly Coleman-Phox, MPH, is project director of the MAMAS study at the UCSF Center for Health and Community. She is also currently pursuing her public health doctoral degree at the UCB School of Public Health.


      Barbara Laraia, PhD, MPH, RD, is Associate Professor at the UCB School of Public Health. Her research program focuses on the influence of contextual level effects on dietary intake, cardiometabolic risk factors and pregnancy outcomes, especially among vulnerable populations.