Feasibility and Lessons Learned from the FIRST WIND (Weight loss Interventions after Delivery) Intervention for Urban-based, Postpartum African American Women

Abstract

Objective: Rates of overweight, obesity and glucose intolerance of pregnancy are rapidly increasing among pregnant women, and particularly among women of color. We developed and pilot-tested an evidenced-based behavioral weight-loss intervention, tailored for urban-based, postpartum African America women.

Methods: We conducted a feasibility trial among 32 overweight or obese postpartum, urban-based African American women (15 in intervention group; 17 in the usual care group), who had recently delivered at a community- based hospital in Baltimore city. Participants were randomized to the active intervention or the self-directed arm of the study. Both groups received an initial 1-hour session with a behavioral interventionist. The 24-week intervention included five individual sessions and 10 group classes on weight management, mental wellness and exercise. Group sessions consisted of 60 minutes of lessons on behavioral strategies and 30 minutes of organized physical activity (e.g. walking, aerobics). The primary outcome was weight change from enrollment to the end of the intervention.

Results: A total of 64% of those potentially eligible at the in-person screen were enrolled in the study. Participants in the active intervention group were slightly younger with lower income levels, compared to those in the self- directed group. In total, 23 (82%) participants completed the study. Average attendance across all individual sessions was 50%(70% if contact made via email or phone) and 60% for group classes. Average weight loss at 6 months in the active intervention group was 0.49 kgs (4) compared to an average weight gain of 4 kgs (7) in the self- directed group. From a baseline of 80.8 (12.5), mental functioning scores in the active group remained stable at 84 (15) at 6 months. Average scores in the self-directed group decreased from 83 (15) to 68 (17). In post-intervention focus groups, women verbalized the need for group session, but advocated for alternative methods of individual contacts, including phone calls, emails and text messaging.

Conclusion: This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in postpartum, urban-based African American women with perinatal obesity. Study participants favorably received the intervention. The results may have implications for integrating weight-loss interventions into the early postpartum period in other urban-based communities.