My Baby My Move A Community Wellness Intervention
My Baby My Move A Community Wellness Intervention
My Baby, My Move+ (2019-2021) is a peer-led wellness intervention which aims to reduce
 excessive gestational weight gain (EGWG) by targeting prenatal physical activity, mood, and
 sleep quality. Up to 50% of pregnant women in the U.S. gain weight in excess of the Institute
 of Medicine guidelines. EGWG leads to poor maternal and child outcomes. It also sets the
 stage for long-term overweight/obesity for both mother and child. The MBMM+ intervention is
 an example of a theoretically-based prenatal physical activity intervention that targets
 these outcomes.

 Up to 100 pregnant women (50 intervention arm, 50 control arm) will be recruited from the
 University of Colorado Clinics. Women in the intervention arm will participate in the 12-week
 MBMM+ intervention. Leiferman and her team propose to develop and test the feasibility and
 sustainability of the MBMM+ intervention to instill good healthy habits (e.g., prenatal
 physical activity, good sleep hygiene, stress management) during and beyond pregnancy.
 Findings from this study will be used to inform a future, large randomized trial.
Intervention Group:

 The MBMM+ intervention is designed to promote the engagement in physical activity and takes
 into account barriers among pregnant women cited in our formative work such as lack of
 knowledge and skills, body changes and discomfort, feeling limited, and lack of social
 support. Uniquely, the MBMM+ program also targets sleep hygiene and mood to further support
 regular physical activity engagement. Over the years of working with pregnant women, we have
 observed that once women notice how their regular physical activity helps their mood and
 sleep patterns they are often more likely to continue engaging in regular physical activity.
 During the first four weeks of the MBMM+ program, participants will receive electronic
 informational handouts covering topics on weight management (content will be based in part on
 Co-I Downs' Healthy Mom Zone intervention such as informing on benefits and guidelines of
 healthy GWG, tips on healthy eating, energy balance, and sleep quality) as well as the
 benefits and safety concerns related to prenatal physical activity. Starting week 5 of the
 12-week intervention, participants will attend two in-person, group physical activity
 sessions per week with each session lasting approximately 60 minutes and will be held at a
 local community center located close to the recruitment clinics. Sessions will be held on
 weekday evenings and weekend mornings as these times were preferred by pregnant women. Given
 that pregnant women often express a lack of knowledge about safe physical activities during
 pregnancy, preventing them from engaging in physical activity, each session will include both
 didactic and experiential components to increase knowledge and skill building. Sessions will
 begin with a didactic component covering overcoming barriers to physical activity, goal
 setting, self-monitoring, problem solving, topics related to mood (stress management,
 family/work balance, wellness wheel), sleep hygiene (setting routines, avoiding stimulants,
 environmental supports), and additional physical activity topics (e.g., managing physical
 activity in postpartum, overcoming relapses). Participants will be given educational
 materials in print and electronic form based on their preferences. The experiential component
 (i.e., physical activity) will be 30 minutes in duration and involve primarily walking, at a
 moderate intensity, based on national recommendations coupled with yoga. Our formative work
 suggests that mothers prefer walking and find it more enjoyable in the form of groups. We
 have chosen to also include yoga to provide options for ways to be active that also
 positively impact sleep and mood and pregnant women report desiring prenatal yoga. All
 walking sessions will be facilitated by the peer leaders. The yoga sessions will be taught by
 an experienced prenatal yoga instructor residing in Denver, CO.

 Each session will have 3-4 peer leaders to help facilitate and model the physical activity
 component (i.e., will accompany women during their walking and yoga sessions to provide
 support and ensure safety (e.g., correct postures during yoga, monitoring exercise intensity
 and symptoms during walking sessions). Our MBMM formative work and expertise in
 community-based physical activity interventions suggests participants prefer peer group
 leaders because they foster a sense of community and social support within the group setting.
 Peer leaders will be compensated for their time working with the MBMM+ program and will be
 peer mothers from the community who are recent mothers (< two years postpartum) who
 successfully engaged in regular physical activity during a previous pregnancy. Peer leaders
 will be identified by our research team, recreation center directors, and health care
 provider partners. At the end of every session, participants will check in with an assigned
 peer leader to discuss in small groups their weekly logs. Peer leaders will note the
 discussions that occurred amongst the participants in their group, describe barriers that
 were identified, problem-solving strategies that were suggested and used, and future
 goals/recommended action steps. This group work will help participants to learn ways to fit
 physical activity into their lifestyle and overcome barriers by receiving feedback from their
 peer leader and other group members. It will also ensure that the intervention is conducted
 and received in the way intended as the peer leaders and program manager/PI will review these
 small group progress notes each week and monitor intervention delivery.

 Peer leader training and fidelity: Weekly, the research team (PI/program manager) will have
 phone calls and/or in-person meetings with the group peer leaders to debrief and address any
 issues that may arise. The program manager and/or PI will be on-site for all sessions to
 ensure quality control of intervention delivery and data collection efforts by peer leaders.
 The PI will conduct a training session before the onset of the intervention with the peer
 group leaders to cover topics including how to engage in safe and effective physical activity
 during pregnancy, an overview of behavioral change theory and the behavioral skills that the
 intervention is targeting, ways to garner social support and leadership skills. The PI has
 been extensively trained by the Cooper Institute in Prenatal-Postnatal Physical Activity. The
 yoga instructor will have been extensively trained in prenatal yoga.

 Control Group:

 Women randomized to the control group will complete a similarly structured 12-week program;
 electronic materials related to various prenatal topics including preparation for birth,
 birthing options, and responsive parenting will be distributed twice a week for the first
 4-weeks of the program. Starting week 5 of the 12-week intervention, participants will attend
 two in-person, group sessions per week with each session lasting approximately 60 minutes and
 will be held at a local community center located close to the recruitment clinics. Sessions
 will be held on weekday evenings and weekend mornings as these times were preferred by
 pregnant women.
Inclusion Criteria:

 -  English-speaking

 -  pregnant (6-10 weeks) women

 -  aged 18-46 years

 -  reside in Denver, CO

 -  currently engaging in less than 120 minutes of moderate-intensity exercise per week

 -  have medical clearance to exercise during pregnancy.

 Exclusion Criteria:

 -having conditions that preclude exercise (i.e. HCP has restricted patient from engaging in
 exercise according to AGOG's absolute contraindications to exercise (e.g. haemodynamically
 significant heart disease, restrictive lung disease, incompetent cervix/cerclage,
 persistent second or third trimester bleeding, placenta previa after 26 weeks gestation,
 premature labor during the current pregnancy, ruptured membranes, and pregnancy induced
 hypertension)