I-PREGNO - prevention of unhealthy weight gain and psychosocial stress in families during pregnancy and postpartum using an mHealth enhanced intervention: a study protocol of two cluster randomized controlled trials.

BACKGROUND: The transition to parenthood represents a critical life period with psychosocial, and behavioral changes and challenges for parents. This often increases stress and leads to unhealthy weight gain in families, especially in psychosocially burdened families. Although universal and selective prevention programs are offered to families, specific support often fails to reach psychosocially burdened families. Digital technologies are a chance to overcome this problem by enabling a low-threshold access for parents in need. However, there is currently a lack of smartphone-based interventions that are tailored to the needs of psychosocially burdened families. AIMS: The research project I-PREGNO aims to develop and evaluate a self-guided, smartphone-based intervention in combination with face-to-face counseling delivered by healthcare professionals for the prevention of unhealthy weight gain and psychosocial problems. The intervention is specifically tailored to the needs of psychosocially burdened families during the pregnancy and postpartum period. METHODS: In two cluster randomized controlled trials in Germany and Austria (N = 400) psychosocially burdened families will be recruited and randomized to i) treatment as usual (TAU), or ii) I-PREGNO intervention (self-guided I-PREGNO app with counseling sessions) and TAU. We expect higher acceptance and better outcomes on parental weight gain and psychosocial stress in the intervention group. DISCUSSION: The intervention offers a low cost and low-threshold intervention and considers the life situation of psychosocially burdened families who are a neglected group in traditional prevention programs. After positive evaluation, the intervention may easily be implemented in existing perinatal care structures in European countries such as Germany and Austria. TRIAL REGISTRATION: Both trials were registered prospectively at the German Clinical Trials Register (Germany: DRKS00029673; Austria: DRKS00029934) in July and August 2022.

Gender and Emotional Representation Matter: Own Illness Beliefs and Their Relationship to Obesity.

BACKGROUND: Current treatments of obesity often fail to consider gender and psychological aspects, which are essential for weight loss and weight maintenance. The aim of our study was to analyze subjective illness representations (SIRs) of adults with obesity according to the Common-Sense Self-Regulation Model (CSM) by assessing their associations with weight-related variables and gender. METHODS: Data was collected via online self-assessment between April 2017 and March 2018. SIRs were operationalized by the revised Illness Perception Questionnaire (IPQ-R) and illness outcomes according to the CSM were defined as BMI, eating behaviour, physical wellbeing, bodyweight satisfaction, and shape concerns. The sample consisted of 427 adults (M = 42.2 years, SD = 10.9; 82% female) with obesity (BMI: M = 42.3 kg/m2, SD = 9.0). Student's t-tests and multiple hierarchical regression analyses were conducted with the control variables (age and BMI) and subjective illness representations and gender as independent variables. RESULTS: The explanation of outcome variances was moderate to high (21-43%) except for restraint eating behaviour (10%). Subjective illness representations showed several significant associations with weight-related variables, especially timeline and emotional representations. Female gender was significantly associated with more restraint eating behaviour [F (1, 400) = 4.19, p < 0.001] and females had unfavourable values of the weight-related variables as well as a more cyclic [t (425) = 3.68, p < 0.001], and more emotional representation [t (100) = 5.17, p < 0.001] of their obesity. CONCLUSION: The results of this study indicate that gender and subjective illness representations, especially the emotional representation, play an important role for weight-related variables. Therefore, the assessment of SIRs may constitute an economic tool to identify specific individual deficits of self-regulation.

Does Weight-Cycling Influence Illness Beliefs in Obesity? A Gender-Sensitive Approach.

Obesity is classified as a chronic disease. Women and men seem to face different obstacles in their attempts to overcome one of the most challenging tasks in the treatment of this disease, namely, weight reduction maintenance. The Common-Sense-Model (CSM) is mainly used to improve the understanding of self-regulation and health behaviour in chronic diseases but has yet to be explored for obesity. This paper applies the CSM to obesity, focussing on the construct of illness representations, which is the basis of health behaviour according to the CSM. A sample of n = 356 women and n = 77 men with obesity was investigated to assess the extent that illness representations in obesity are shaped by experiences of weight-cycling and the extent that gender influences their quality. Our results show that the representations of timeline and consequences as well as the emotional representation are particularly influenced by weight-cycling, especially in men. On average, women showed more maladaptive illness representations than men. These findings not only contribute to a better applicability of the CSM in obesity, but also emphasize the importance of gender in obesity research and interventions.