JMIR Publications

ABSTRACT

Background:

Half of women begin pregnancy above the healthy weight range, increasing the risk of complications and adversely affecting the lifelong health of their baby. Maternal obesity remains the strongest risk factor for offspring obesity across childhood, adolescence and adulthood. Previous research suggests that women should be encouraged to be within a healthy weight range before conception in order to improve health outcomes.

Objective:

We outline the application of the Intervention Mapping (IM) approach in developing an evidence-informed eHealth intervention to promote weight management. The intervention, based on psychological theories and behaviour change techniques, was developed for women with overweight or obesity who intend to become pregnant. The “Begin Better” eHealth intervention is part of an integrated program being evaluated in a clinical trial to assess if weight management before pregnancy can influence clinical outcomes for mother and baby.

Methods:

The current study documents steps 2 to 5 of a 6-step iterative intervention mapping approach informed by the Information-Motivation-Behavioural Skills (IMB) model and the findings of a previous interview study. We defined behaviour change objectives for each of the IMB behavioural determinants as well as theory-based behaviour change techniques (BCT) and practical strategies. We also utilised Persuasive Systems Design (PSD) principles to assist in translating these strategies to a digital environment.

Results:

The resultant intervention comprises nutrition and physical activity content, along with psychological strategies, which are notably absent from mainstream weight management programs. Strategies to increase motivation, garner social support and promote self-care are integral to maintaining engagement with the intervention, which aims to improve lifestyle behaviours and enhance wellbeing. Important elements include: tracking mechanisms for percentage progress towards goals to enable feedback on behaviours and outcomes; in-app messages of praise on entry of goals or habits; strategies to prompt habit formation and action planning via small, easily achievable steps toward positive change.

Conclusions:

Design decisions and processes for idea generation about intervention content, format and delivery are often not reported. This study we respond to this gap in the literature and outline a process that is potentially transferable to the development of other interventions.