momHealth: A Feasibility Study of a Multibehavioral Health Intervention for Pregnant and Parenting Adolescent Mothers.

INTRODUCTION: In 2016, 209,809 babies were born to mothers 15 - 19 years of age, for a live birth rate of 20.3 per 1,000 in this age group. Many health issues surround adolescent mothers and their infants, many of which can be addressed through behavioral change. The main purpose of this study was to examine the feasibility, acceptability, usability, and relevance of momHealth, an innovative multiple health behavior change (MHBC) education and support mHealth intervention, focused on breastfeeding, healthy eating and active living, and depression prevention among pregnant and parenting adolescents. We also evaluated the proposed online surveys and physical outcome measures for feasibility and acceptability (burden, time, ease of use). METHODS: A one-group quasi-experimental longitudinal design was used to examine the intervention components and the breastfeeding, diet/activity, and depression outcome measures. Nine iPad-delivered education modules, text messaging, and virtual individual and group support were provided for 12 weeks, beginning at 32 weeks of pregnancy, with follow-up to three months postpartum. Data on the main behaviors and outcomes were collected at three in-home visits, one telephone call soon after birth, and ten postpartum weekly and biweekly online surveys. RESULTS: Although recruitment and attrition presented challenges, six participants enrolled in the study during prenatal clinic visits; all were pregnant with their first child, single, and had a mean age of 17.7 years (SD = 1.4). Intervention participation ranged from 59% to 91% for educational module completion, text message reading, and individual virtual support meetings and three virtual peer support groups were held. Intervention acceptability, relevance, and delivery was supported by reports of clear and relevant content, reasonable time burden, iPad ease of use, and acceptable intervention length. Data collection was reported as convenient and non-burdensome, but the diet recall method and activity monitoring challenged some. CONCLUSIONS: This was the first MHBC research in adolescent pregnant women designed to improve breastfeeding outcomes, healthy eating/active living, and depression prevention. Findings demonstrated strengths and challenges of the interventions and methods, support feasibility and acceptability of momHealth, and informed the recruitment and intervention protocols of our pilot randomized trial.

RAC1 regulates actin arrays during polarity establishment in the brown alga, Silvetia compressa.

Multicellular development has evolved independently on numerous occasions and there is great interest in the developmental mechanisms utilized by each of the divergent lineages. Fucoid algae, in the stramenopile lineage (distinct from metazoans, fungi and green plants) have long been used as a model for early development based on unique life cycle characteristics. The initially symmetric fucoid zygote generates a developmental axis that determines not only the site of growth, but also the orientation of the first cell division, whose products have distinct developmental fates. Establishment and maintenance of this growth axis is dependent on formation of a filamentous actin array that directs vesicular movement, depositing new membrane and wall material for development of the rhizoid. What is not well known, is how formation and placement of the actin array is regulated in fucoid algae. A candidate for this function is Rac1, a small GTPase of the highly conserved Rho family, which has been implicated in controlling the formation of actin arrays in diverse eukaryotes. We demonstrate that Rac1 is not only present during formation of the filamentous actin array, but that its localization overlaps with the array in polarizing zygotes. Pharmacologically inhibiting Rac1 activity was shown to impede formation and maintenance of the actin array, and ultimately polar growth. Evidence is provided that a requirement of Rac1 function is its ability to associate with membranes via a post-translationally added lipid tail. Taken together, the data indicate that Rac1 is a necessary participant in establishment of the growth pole, presumably by regulating the placement and formation of the actin array. A role for Rac1 and related proteins in regulating actin is shared by animals, plants, fungi and with this work, brown algae, thus a conserved mechanism for generating polarity is in operation in unique eukaryotic lineages.

Rac1 function during fucoid development.

Morphogenesis in fucoid algae begins with adhesive secretion and rhizoid germination, developmental events that secure the alga within the intertidal zone. The importance of the actin cytoskeleton during these processes has been well established; but in general, little is known about actin regulation within the stramenopile lineage. Based on conserved strategies for regulation of actin in other lineages, co-localization of the Arp2/3 complex with actin structures that are essential for rhizoid formation may implicate members of the Rho family of small GTPases in the signaling pathway(s) regulating actin polymerization during fucoid development. Our lab recently demonstrated Rac1 dependent regulation of endomembrane polarization, polarization of adhesive secretion, germination and tip growth in the fucoid brown alga Silvetia compressa. We also present new evidence revealing Rac1 localization during germination in S. compressa, and show that membrane localization is essential for proper Rac1 function.