Development and feasibility of a web-based gestational weight gain intervention for women with pre-pregnancy overweight or obesity

Background: Excessive gestational weight gain is associated with negative maternal and infant health outcomes. Digital health approaches may help overcome barriers to participating in lifestyle interventions requiring in-person visits. The purpose of this study was to develop and examine the feasibility of a web based gestational weight gain intervention.Methods: Intervention development included feedback and input from pregnant women. We conducted a 12-week one-arm pilot study during which participants engaged in an online discussion board with coaches and other pregnant women, tracked their weight gain with an interactive graph, and accessed a list of online resources for pregnancy health. Feasibility outcomes were recruitment, retention, engagement and sustained participation, intervention acceptability, and website usability. Gestational weight gain was an exploratory outcome.Results: Participants (n=12) were on average 16.8 (SD: 2.0) weeks gestation with average pre-pregnancy body mass index of 30.5 (SD: 4.8) kg/m2. Participant retention was 92% (n=11). Participants logged into the website a median of 21 times (IQR, 8-37; range, 2-98) over 12 weeks, and 58% (n=7) logged into the website during the last week of the intervention. All participants said they would be very likely or likely to participate again, and 100% said they would be very likely or likely to recommend the intervention to a pregnant friend. In post-intervention interviews, 64% (n=7) explicitly said that the website was easy to use, but 100% (n=11) mentioned usability issues. When asked their preferred intervention platform, 18% (n=2) somewhat or strongly preferred a private website, 18% (n=2) had no preference, and 64% (n=7) somewhat or strongly preferred Facebook. Seventy percent (n=7) had excessive gestational weight gain, 10% (n=1) inadequate gestational weight gain, and 20% (n=2) gained within recommended ranges.Conclusions: Additional development work is needed before moving to efficacy testing. Most notably, usability issues with the investigator-developed website and participant preference suggest a switch to a commercial social media platform.