- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04449432
Goals for Reaching Optimal Wellness: GROWell
November 15, 2023 updated by: University of California, Davis
Despite the negative consequences to maternal-child health from women gaining too much weight during pregnancy, up to 62% of overweight and obese women gain more pregnancy weight than is recommended.
This project will establish the efficacy of Goals for Reaching Optimal Wellness (GROWell), an mHealth tool for achieving appropriate pregnancy weight gain and promoting postpartum weight loss among women who enter pregnancy overweight or obese.
GROWell will fill a gap in research and clinical care by providing a validated, standalone mHealth tool for weight control during pregnancy and postpartum, which is a currently lacking resource.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
Research attempts to prevent excess gestational weight gain, defined as gaining more weight during pregnancy than Institute of Medicine (IOM) guidelines for prepregnancy body mass index (BMI), have largely been unsuccessful.
Roughly 62% of overweight and 45% of obese women still gain more weight than recommended, increasing risk for postpartum weight retention.
Few mobile health (mHealth) interventions have been trialed to address pregnancy-associated weight gain, which is a missed opportunity.
Adult women are high users of technology for general and pregnancy-specific health information seeking and sharing.
To fill this gap, the long-term goal of this research is to disseminate into clinical practice a standalone mHealth tool that is effective for overweight and obese pregnant women to achieve gestational weight gain within IOM recommendations and return to prepregnancy weight after childbirth.
The goal of this application is to test GROWell: Goals for Reaching Optimal Wellness, an innovative, mHealth tool based on Self-regulation Theory that investigators designed in pilot work to achieve appropriate gestational weight gain and safe postpartum weight loss.
The investigators propose a blinded, randomized controlled trial to test the efficacy of GROWell compared to an attention control also developed in a pilot.
Investigators will recruit 480 women ages 18-44 with prepregnancy BMI 25-<40 and 10-16 weeks gestation of a singleton, uncomplicated pregnancy.
Block randomization based on BMI, race, and recruitment clinic will be used to assign participants equally to arm 1, GROWell (n=240), or arm 2, the attention control (n=240).
Upon study enrollment and through 6 months postpartum, GROWell participants will receive daily text messages that provide tailored education, problem-solving skills, and support to aid their personalized dietary goals.
Once weekly, participants self-monitor overall adherence to their goals using text messages that prompt them to report on how they did in the past week.
When users respond to this prompt, they immediately receive a text with tailored feedback on their adherence and long-term progress toward their goals.
Control participants will receive weekly texts that provide personalized self-care, pregnancy, labor, delivery, and early infancy education.
The specific aims are to: (1) Compare the efficacy of GROWell to the attention control in reducing the proportion of women who gain excess gestational weight based on IOM guidelines (>25 lbs for overweight and >20 lbs for obese) controlling for demographics, parity, physical activity, diet quality, and depression/anxiety; and (2) Compare the efficacy of GROWell to the attention control in reducing postpartum weight retention at 6 months post-birth as measured by the proportion of women who are within 5% of their prepregnancy weight, controlling for demographics, parity, physical activity, diet quality, breastfeeding, and depression/anxiety.
This research addresses PA 18-135 (Maternal Nutrition and Pre-pregnancy Obesity) and will provide an innovative, evidence-based, standalone mHealth tool to reduce excess gestational weight gain and postpartum weight retention among overweight and obese women, currently an unavailable resource.
Study Type
Interventional
Enrollment (Estimated)
480
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: William Pacuilla
- Phone Number: (530) 754-8280
- Email: bpacuilla@ucdavis.edu
Study Contact Backup
- Name: Grace Liu
- Phone Number: (530) 754-8323
- Email: proposals@ucdavis.edu
Study Locations
-
-
California
-
Davis, California, United States, 95616
- UC Davis
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 44 years (Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- 10-16 weeks gestation of a confirmed pregnancy (i.e., ultrasound/heartbeat detected)
- Nulliparous or >12 months since previous birth
- Receive care at one of eight UC Davis Obstetric Clinics and plan to deliver at UC Davis Medical Center
- BMI >25 and <40 who are willing to receive and respond to texts using their own cell phone or a study-provided phone
Exclusion Criteria:
- Known pregnancy or fetal complications/high-risk status
- Multiple gestation
- Unable to read/write English
- BMI >40
- Current smokers
- Quit smoking <6 months prior to enrollment
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: GROWell (Interactive Obesity Treatment Approach)
With Self-regulation Theory as the framework, the Interactive Obesity Treatment Approach Adapted for Pregnancy/Postpartum includes four components: (1) personalized goal setting, (2) daily support and educational messages, (3) self-monitoring of behavior with tailored feedback, and (4) skills training.
Each component aligns with the self- regulatory processes shown in previous studies to be necessary for behavior change.
All interactions with participants are via text using a cell phone.
|
Personalized messaging via cell phone to support healthy eating behaviors during pregnancy and through 6 months postpartum
|
Active Comparator: Attention Support Control
The attention control will be delivered using text messaging to reduce the potential placebo effect that interacting with our mHealth system may have on pregnancy weight gain and postpartum weight loss.
Information will be provided to control group participants that is specific to pregnancy, labor, delivery, and early infancy, but not to diet.
Texts are specific to the participant's partner, pregnancy, employment, and breastfeeding plans/status.
|
Personalized messaging via cell phone to support healthy behaviors during pregnancy and through 6 months postpartum
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gestational Weight Gain
Time Frame: Mid-study (25-30 weeks)
|
Gestational weight gain will be calculated as: [weight(delivery) - weight(preconception)]. Women will be categorized as gaining excess gestational weight if they started pregnancy as overweight and gained more than 25 pounds or started pregnancy as obese and gained more than 20 pounds.
|
Mid-study (25-30 weeks)
|
Postpartum Weight Retention
Time Frame: End of study (50-55 weeks)
|
Postpartum weight retention will be calculated as: [weight(6 months postpartum) - weight(preconception)]. Women will be categorized as experiencing postpartum weight retention if postpartum weight at 6 months is greater than 1.05*preconception weight.
|
End of study (50-55 weeks)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adherence to text-based self- monitoring
Time Frame: mid-study (25-30 weeks) and post-study (50-55 weeks)
|
Measured cumulatively by week as the number of times a participant responds to weekly prompts to report on her progress to the number of times she was prompted, calculated to a percent separately for prenatal and postnatal periods.
|
mid-study (25-30 weeks) and post-study (50-55 weeks)
|
Adherence to prescribed goals
Time Frame: mid-study (25-30 weeks) and post-study (50-55 weeks)
|
Measured cumulatively by week as the proportion of goals for which a participant has "good adherence" during the previous week, defined as adhering to the goal 5/7 days, or >70%, calculated to a percent and separately for prenatal and postpartum periods.
|
mid-study (25-30 weeks) and post-study (50-55 weeks)
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Delivery type
Time Frame: mid-study (25-30 weeks)
|
Categorical as cesarean or vaginal delivery
|
mid-study (25-30 weeks)
|
Fetal growth abnormalities
Time Frame: mid-study (25-30 weeks)
|
categorical as small-for-gestational age, large-for- gestational-age, macrosomia, or none.
|
mid-study (25-30 weeks)
|
Pregnancy complications
Time Frame: mid-study (25-30 weeks)
|
categorical as gestational diabetes, hypertension, preeclampsia/eclampsia, placental abruption, fetal death, antepartum admission, preterm birth with and without NICU admission, none
|
mid-study (25-30 weeks)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Leigh Ann Simmons, PhD, University of California, Davis
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Simmons LA, Phipps JE, Whipps M, Smith P, Carbajal KA, Overstreet C, McLaughlin J, De Lombaert K, Noonan D. From hybrid to fully remote clinical trial amidst the COVID-19 pandemic: Strategies to promote recruitment, retention, and engagement in a randomized mHealth trial. Digit Health. 2022 Sep 25;8:20552076221129065. doi: 10.1177/20552076221129065. eCollection 2022 Jan-Dec.
- Simmons LA, Phipps JE, Overstreet C, Smith PM, Bechard E, Liu S, Walker C, Noonan D. Goals for Reaching Optimal Wellness (GROWell): A clinical trial protocol of a digital dietary intervention for pregnant and postpartum people with prenatal overweight or obesity. Contemp Clin Trials. 2022 Feb;113:106627. doi: 10.1016/j.cct.2021.106627. Epub 2021 Nov 20.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
December 14, 2020
Primary Completion (Estimated)
January 31, 2024
Study Completion (Estimated)
March 31, 2024
Study Registration Dates
First Submitted
June 23, 2020
First Submitted That Met QC Criteria
June 23, 2020
First Posted (Actual)
June 26, 2020
Study Record Updates
Last Update Posted (Estimated)
November 17, 2023
Last Update Submitted That Met QC Criteria
November 15, 2023
Last Verified
November 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1399548
- 1R01NR017659-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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