Remote Lifestyle Intervention to Reduce Postpartum Weight Retention: Protocol for a Community-Engaged Hybrid Type I...

Area of Science:

• Public Health
• Maternal Health
• Health Disparities

Background:

• Maternal obesity disproportionately affects non-Hispanic Black and Latinx individuals, increasing risks for hypertension and postpartum weight retention.
• Remote lifestyle interventions show promise but often lack cultural adaptation and focus on community-level factors.
• Integrating interventions into community-based programs can enhance trust, engagement, and scalability.

Purpose of the Study:

• To evaluate the effectiveness of a culturally adapted remote lifestyle intervention (Healthy for Two-Home Visiting) compared to usual home visiting services.
• To assess the intervention's impact on postpartum weight retention in pregnant or postpartum individuals, particularly non-Hispanic Black and Latinx populations.
• To identify facilitators and barriers to implementing the intervention within home visiting services.

Main Methods:

• A hybrid type I effectiveness-implementation randomized controlled trial involving 360 pregnant individuals with overweight or obesity.
• Participants randomized 1:1 to receive "Healthy for Two-Home Visiting" or usual home visiting services.
• Primary outcome: weight retention at 6 months postpartum. Implementation measures include feasibility, acceptability, reach, adoption, and fidelity.

Main Results:

• Study funded June 2021, recruitment began April 2023.
• As of November 2024, 90 participants enrolled.
• Data collection for effectiveness expected to end June 2026; implementation evaluation by December 2026.

Conclusions:

• This trial integrates a culturally adapted remote lifestyle intervention into home visiting to reduce postpartum weight retention.
• Understanding implementation drivers is key for sustainability and dissemination to reduce long-term obesity and maternal health disparities.
• Community engagement is central to improving intervention effectiveness and promoting maternal health equity.