0197 Sleep Goal-Focused Online Access to Lifestyle Support (GOALS) Trial: An Integrated Postpartum Sleep, Diet, and Physical Activity Intervention

Abstract Introduction Postpartum weight retention contributes to long-term cardiometabolic risk. Postpartum diet and physical activity interventions yield modest effects on weight, with sleep, an essential determinant of weight, often overlooked. This study evaluated the feasibility, acceptability, and preliminary efficacy of Sleep GOALS, an online postpartum intervention integrating strategies to address sleep, diet, and physical activity. Methods This two-arm, 16-week pilot trial randomized participants (2–7 months postpartum; BMI 25–40 kg/m²) to Sleep GOALS or an educational brochure. Feasibility benchmarks were: enrollment of 40 participants over 1 year, ≥30% from racially diverse backgrounds, 80% retention at follow-up, and 80% of participants completing ≥70% of 16 modules. Acceptability benchmarks were mean scores ≥4/5 on a survey assessing understanding, implementation, and barriers. Secondary outcomes included changes in weight, sleep, physical activity, diet, and maternal psychosocial functioning. Analyses included descriptive statistics and linear mixed-effects models. Mean differences (MD) were calculated as intervention minus control. Results Forty individuals were enrolled, with 20% from racially diverse backgrounds. Study retention was 70%. On average, participants completed 72% modules. Acceptability was high, with most lessons rated >4 for ease of understanding, implementation, and minimal barriers. The intervention resulted in a greater proportion achieving ≥5% weight loss (36% vs. 23%). Between-group differences favored the intervention for total active time (MD = -44.22 min/day; d = -0.46) and light-intensity activity (MD = -28.64 min/day; d = -0.32). Sleep continuity (improvement favored the intervention, including wake after sleep onset MD = 0.52 hr/day; d = 0.59; number of awakenings MD = 3.17; d = 0.82), and improved sleep regularity (MD = -5.54 points; d = -0.35). The control included larger increases in total duration (MD = 0.56 hr/day; d = 0.33) and greater reductions in perceived stress (MD = 4.45 points; d = -0.31). Depressive symptoms, functioning, and diet quality improved similarly across groups. Conclusion Sleep GOALS demonstrated strong acceptability and produced encouraging signals of efficacy for physical activity and sleep continuity indicators. Recruitment and retention did not meet a priori benchmarks, highlighting opportunities to strengthen trial procedures before testing in a fully powered RCT. Support (if any) NHLBI 1K01 HL161439-01 (PI: Hawkins)