Promoting health during pregnancy: Outcomes of an iPad delivered multiple behavior change intervention

background: Healthy Pregnancy is a multiple behavior change intervention that offers tailored guidance based on the Transtheoretical Model of Change for fruit and vegetable consumption, smoking cessation and relapse prevention, and stress management. The intervention, available in English and Spanish, is delivered on iPads and focuses on adopting these key health behaviors during pregnancy and into the postpartum using best practices of behavior change science.

methods: Pregnant women (n=335) from six federally funded community health centers (65.1% Hispanic; 20.9% White, 9% Black) were recruited into a randomized clinical trial. Women completed up to 3 sessions during pregnancy and 2 assessments at 1 and 4 months postpartum. Special attention to retention of an underserved population produced 70.7% retention.

results: The treatment group significantly reduced their overall behavior risks compared to the usual care group at 1 month (0.85 vs. 1.2 risks; OR=.70) and 4 months (0.72 vs. 0.91 risks; OR=.81) postpartum. The treatment group significantly increased their fruit and vegetable consumption at 1 month (4.3 vs. 3.3 cups; OR=2.7) and 4 months (4.4 vs. 3.7 cups; OR=2.2) and were more likely to progress to eating at least 4.5 cups per day at 1 month (38.1% vs. 20.0%) and 4 months (43.2% vs. 26.4%). Analyses also demonstrated 43% of those who were at-risk at baseline moved to action or maintenance at the second postpartum assessment.

conclusions: Healthy Pregnancy is an evidence-based, engaging, and flexible means by which to engage pregnant women in decreasing behavior risks and sustaining healthy behaviors.