Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 14, 2025
Date Accepted: Aug 27, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Examining the Impact of a Co-Developed Multicomponent e-Health Lifestyle Intervention on Physical Activity and its Association with Gestational Weight Gain in Underserved Women: A State-Wide Randomized Controlled Trial
ABSTRACT
Background:
Over two-thirds of women experience inappropriate gestational weight gain (GWG) during pregnancy which can detrimentally impact the long-term health of both mother and child. Physical activity can assist with appropriate GWG attainment. However, pregnant women facing economic disadvantages are particularly at risk for inappropriate GWG and often lack resources that would allow for adoption of healthy lifestyle behaviors.
Objective:
This report describes the effects of a state-wide randomized controlled trial testing the effectiveness of a multicomponent e-Health lifestyle intervention on change in physical activity and sedentary time across pregnancy and its association with GWG in underserved women.
Methods:
Pregnant women enrolled in the Louisiana Special Supplemental Nutrition program for Women, Infants, and Children (WIC) were randomly assigned to a multicomponent e-Health intervention for GWG management or Usual Care (standard WIC care) prior to 16 weeks gestation. Physical activity, including movement duration and context, and sedentary time were assessed at baseline (early pregnancy) and at the end of the intervention (late pregnancy) using accelerometry (N=294) and the pregnancy physical activity questionnaire (PPAQ) (N=315). GWG was determined based on weight collected at study visits in early and late pregnancy. Linear mixed models were used to assess intervention effects within and between groups and to assess associations between changes in physical activity and GWG.
Results:
A decrease in physical activity duration was observed in both groups across pregnancy. The Intervention Group reported an increase in sports participation across pregnancy compared to the Usual Care Group (adjusted effect estimate [95% confidence interval]: +4 MET-hours/week [2; 7], p=0.002). There were no associations between physical activity or sedentary time measures and GWG.
Conclusions:
An e-Health multicomponent behavioral lifestyle intervention that included guidance to increase physical activity towards national guidelines did not meaningfully impact physical activity outcomes or GWG in pregnant women who were enrolled in Louisiana WIC. Clinical Trial: ClinicalTrials.gov NCT04028843
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