JMIR Publications

ABSTRACT

Background:

The key to gestational weight management intervention involves health-related behaviors, including dietary and exercise management. Behavioral theory-based interventions are effective in improving health-related behaviors. However, evidence for mobile health interventions based on specific behavioral theories is insufficient and their effects have not been fully elucidated.

Objective:

To examine the effects of gestational mobile health intervention on psychological cognition and behavior for gestational weight management, using an integrated behavioral model as the theoretical framework.

Methods:

This study was conducted in Tertiary maternity hospital and conducted as a single-blind randomized controlled trial (RCT) in Changzhou, Jiangsu Province, China. Using the behavioral model, integrated with the protection motivation theory and information–motivation–behavioral skills model (PMT-IMB model), the intervention group received mobile health intervention using a self-developed app from 14 to 37 gestational weeks, whereas the control group received routine guidance. Psychological cognition and behaviors related to weight management during pregnancy were main outcomes, which measured at baseline, and at second and third trimesters of pregnancy using a self-designed questionnaire. Generalized estimation and regression equations were used to compare the outcome differences between the intervention and control groups.

Results:

In total, 302 participants (83.9%) underwent all measurements at three time points (intervention group: 150, control group: 152). Compared with the control group, the intervention group had significantly higher scores for information, perceived vulnerability, response cost, and exercise management in the second trimester, while their scores for perceived vulnerability, response cost, and diet management were significantly higher in the third trimester. Repeated measurement analysis results revealed that the time and group effects on information and response cost were statistically significant for psychological cognition, while only group effects were detected for perceived vulnerability (adjusted B=0.669, 95% CI: 0.050–1.288, p = 0.034). Moreover, the time and group effects on exercise management and total points were statistically significant for weight management behavior.

Conclusions:

The intervention program was effective in increasing psychological cognitions and healthy behaviors among Chinese pregnant women. This study provides new evidence supporting the effectiveness of mobile intervention based on behavioral science theory in gestational weight management. Clinical Trial: Chinese Clinical Trial Registration Center (ChiCTR2100043231)