Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning

BackgroundHalf of women begin pregnancy above the healthy weight range, increasing the risk of complications and adversely affecting the lifelong health of their babies. Maternal obesity remains the strongest risk factor for offspring obesity across childhood, adolescence, an...

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Main Authors: Jodie Scott, Melissa Oxlad, Jodie Dodd, Claudia Szabo, Andrea Deussen, Deborah Turnbull
Format: Article
Language:English
Published: JMIR Publications 2022-04-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2022/4/e35108
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author Jodie Scott
Melissa Oxlad
Jodie Dodd
Claudia Szabo
Andrea Deussen
Deborah Turnbull
author_facet Jodie Scott
Melissa Oxlad
Jodie Dodd
Claudia Szabo
Andrea Deussen
Deborah Turnbull
author_sort Jodie Scott
collection DOAJ
description BackgroundHalf of women begin pregnancy above the healthy weight range, increasing the risk of complications and adversely affecting the lifelong health of their babies. Maternal obesity remains the strongest risk factor for offspring obesity across childhood, adolescence, and adulthood. Previous research suggests that women should be encouraged to be within a healthy weight range before conception to improve health outcomes. ObjectiveWe outlined the intervention planning and design process to develop an evidence-informed eHealth intervention to promote weight management. The intervention, based on psychological theories and behavior change techniques, has been developed for women affected by overweight or obesity who intend to become pregnant. The Begin Better web application is part of an integrated program being evaluated in a clinical trial to assess if weight management before pregnancy can influence clinical outcomes for mothers and babies. MethodsOur intervention development process was guided by intervention mapping and person-based methods. This study documents steps 2 to 4 of a 6-step iterative intervention mapping approach informed by the Information-Motivation-Behavioral Skills model and the findings of a previous interview study. We defined behavior change objectives for each of the Information-Motivation-Behavioral Skills behavioral determinants as well as theory-based behavior change techniques and practical strategies. We also used persuasive system design principles to assist in translating these strategies into a digital environment. ResultsThe resultant intervention comprises nutritional and physical activity content along with psychological strategies, which are notably absent from mainstream weight management programs. Strategies to increase motivation, garner social support, and promote self-care are integral to maintaining engagement with the intervention, which aims to improve lifestyle behaviors and enhance well-being. Important elements include tracking mechanisms for percentage progress toward goals to enable feedback on behaviors and outcomes; in-application messages of praise on entry of goals or habits; and strategies to prompt habit formation and action planning via small, easily achievable steps toward positive change. ConclusionsDesign decisions and processes for idea generation about intervention content, format, and delivery are often not reported. In this study, we respond to this gap in the literature and outline a process that is potentially transferable to the development of other interventions.
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spelling doaj.art-f381f9299a6d457a82a2c0c23f72eee02023-08-28T21:31:03ZengJMIR PublicationsJMIR Formative Research2561-326X2022-04-0164e3510810.2196/35108Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention PlanningJodie Scotthttps://orcid.org/0000-0002-5616-8916Melissa Oxladhttps://orcid.org/0000-0001-9067-6706Jodie Doddhttps://orcid.org/0000-0002-6363-4874Claudia Szabohttps://orcid.org/0000-0003-2501-1155Andrea Deussenhttps://orcid.org/0000-0001-6210-1876Deborah Turnbullhttps://orcid.org/0000-0002-7116-7073 BackgroundHalf of women begin pregnancy above the healthy weight range, increasing the risk of complications and adversely affecting the lifelong health of their babies. Maternal obesity remains the strongest risk factor for offspring obesity across childhood, adolescence, and adulthood. Previous research suggests that women should be encouraged to be within a healthy weight range before conception to improve health outcomes. ObjectiveWe outlined the intervention planning and design process to develop an evidence-informed eHealth intervention to promote weight management. The intervention, based on psychological theories and behavior change techniques, has been developed for women affected by overweight or obesity who intend to become pregnant. The Begin Better web application is part of an integrated program being evaluated in a clinical trial to assess if weight management before pregnancy can influence clinical outcomes for mothers and babies. MethodsOur intervention development process was guided by intervention mapping and person-based methods. This study documents steps 2 to 4 of a 6-step iterative intervention mapping approach informed by the Information-Motivation-Behavioral Skills model and the findings of a previous interview study. We defined behavior change objectives for each of the Information-Motivation-Behavioral Skills behavioral determinants as well as theory-based behavior change techniques and practical strategies. We also used persuasive system design principles to assist in translating these strategies into a digital environment. ResultsThe resultant intervention comprises nutritional and physical activity content along with psychological strategies, which are notably absent from mainstream weight management programs. Strategies to increase motivation, garner social support, and promote self-care are integral to maintaining engagement with the intervention, which aims to improve lifestyle behaviors and enhance well-being. Important elements include tracking mechanisms for percentage progress toward goals to enable feedback on behaviors and outcomes; in-application messages of praise on entry of goals or habits; and strategies to prompt habit formation and action planning via small, easily achievable steps toward positive change. ConclusionsDesign decisions and processes for idea generation about intervention content, format, and delivery are often not reported. In this study, we respond to this gap in the literature and outline a process that is potentially transferable to the development of other interventions.https://formative.jmir.org/2022/4/e35108
spellingShingle Jodie Scott
Melissa Oxlad
Jodie Dodd
Claudia Szabo
Andrea Deussen
Deborah Turnbull
Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning
JMIR Formative Research
title Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning
title_full Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning
title_fullStr Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning
title_full_unstemmed Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning
title_short Promoting Health Behavior Change in the Preconception Period: Combined Approach to Intervention Planning
title_sort promoting health behavior change in the preconception period combined approach to intervention planning
url https://formative.jmir.org/2022/4/e35108
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