Protocol for a two-arm feasibility RCT to support postnatal maternal weight management and positive lifestyle behaviour in women from an ethnically diverse inner city population: The SWAN feasibility trial

Citation

Bick D, Taylor C, Avery A, Bhavnani V, Craig V, Healey A, Khazaezadeh N, McMullen S, Oki B, Oteng-Ntim E, O'Connor S, Poston L, Seed P, Roberts S & Ussher M (2019) Protocol for a two-arm feasibility RCT to support postnatal maternal weight management and positive lifestyle behaviour in women from an ethnically diverse inner city population: The SWAN feasibility trial. Pilot and Feasibility Studies, 5 (1), Art. No.: 117. https://doi.org/10.1186/s40814-019-0497-3

Abstract
Introduction: A high BMI during and after pregnancy is linked to poor pregnancy outcomes and contributes to long-term maternal obesity, hypertension, and diabetes. Evidence of feasible, effective postnatal interventions is lacking. This randomised controlled trial will assess the feasibility of conducting a future definitive trial to determine effectiveness and cost-effectiveness of lifestyle information and access to Slimming World® (Alfreton, UK) groups for 12 weeks commencing from 8 to 16 weeks postnatally, in relation to supporting longer-term postnatal weight management in women in an ethnically diverse inner city population. Methods/analysis: Women will be recruited from one maternity unit in London. To be eligible, women will be overweight (BMI 25-29.9 kg/m2) or obese (BMI ≥ 30 kg/m2) as identified at their first antenatal contact, or have a normal BMI (18.5-24.9 kg/m2) at booking but gain excessive gestational weight as assessed at 36 weeks gestation. Women will be aged 18 and over, can speak and read English, expecting a single baby, and will not have accessed weight management groups in this pregnancy. Women will be randomly allocated to standard care plus lifestyle information and access to Slimming World® (Alfreton, UK) groups or standard care only. A sample of 130 women is required. Feasibility trial objectives reflect those considered most important inform a decision about undertaking a definitive future trial. These include estimation of impact of lifestyle information and postnatal access to Slimming World® (Alfreton, UK) on maternal weight change between antenatal booking weight and weight at 12 months postbirth, recruitment rate and time to recruitment, retention rate, influence of lifestyle information and Slimming World® (Alfreton, UK) groups on weight management, diet, physical activity, breastfeeding, smoking cessation, alcohol intake, physical and mental health, infant health, and health-related quality of life 6 and 12 months postnatally. An embedded process evaluation will assess acceptability of study processes and procedures to women. Ethics/dissemination: London-Camberwell St Giles Research Ethics Committee, reference: 16/LO/1422. Outcomes will be disseminated in peer-reviewed journals and presentations at national and international conferences.

Keywords
alcohol consumption; Article; behavior change; body image; body weight change; body weight gain; breast feeding; child health; confidentiality; controlled study; cost effectiveness analysis; diet; dietary intake; England; ethnicity; female; health economics; human; lifestyle modification; maternal obesity; mental health; obesity; perinatal period; physical activity; pregnancy; quality of life; randomized controlled trial; self esteem; sleep pattern; smoking; smoking cessation; support group; urban population; weight loss program

Journal
Pilot and Feasibility Studies: Volume 5, Issue 1

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Professor Michael Ussher

Professor of Behavioural Medicine, Institute for Social Marketing