The impact of a randomized controlled trial of a lifestyle intervention on postpartum physical activity among predominantly Puerto Rican women with overweight and obesity: Proyecto Mamá

Engaging in physical activity during pregnancy decreases the risk of gestational diabetes and excessive weight gain, thereby reducing postpartum risk of type 2 diabetes and postpartum weight retention. Such long-term adverse health outcomes disproportionately affect Hispanic women and women with overweight or obesity. However, few interventions have been tailored for these at-risk groups. Therefore, we assessed the impact of a culturally modified, motivationally targeted, individually-tailored intervention on postpartum PA and PA self-efficacy among predominantly Puerto Rican women with overweight and obesity. Proyecto Mamá was a randomized controlled trial among predominantly Puerto Rican women with overweight or obese pre-pregnancy BMI in Western Massachusetts (data collected 2014–2020, analyzed 2021–2022, n = 123). Women were randomized at < 20 weeks gestation to a Lifestyle Intervention (LI, n = 57) focusing on healthy exercise and diet or to a comparison Health and Wellness Intervention (HW, n = 66). Active intervention occurred from early pregnancy through 6 months postpartum with follow-up continuing to one year postpartum. PA and self-efficacy were secondary outcomes of the trial and were assessed via the Pregnancy PA Questionnaire (PPAQ) and the Self-Efficacy for PA Questionnaire, respectively at baseline, and at 6-weeks, 6-months, and 12-months postpartum. An intent-to-treat analysis was conducted using generalized linear mixed effects models. In intent-to-treat analyses, women in the LI arm performed significantly more sports/exercise (3.4 MET-hrs/wk, 95% CI: 0.3, 6.4), household/caregiving (31.3 MET-hrs/wk, 95% CI: 4.0, 58.6), and light intensity PA (22.7 MET-hrs/wk, 95% CI: 0.3, 45.1) from early pregnancy through one year postpartum, compared to women in the HW arm. Women in the LI were 2.2 times more likely to meet American College of Obstetricians and Gynecologists (ACOG) PA guidelines from early pregnancy through one year postpartum, compared to women in the HW (OR = 2.2, 95% CI: 1.3, 3.6). There were no differences in occupational, transportation, sedentary, moderate, vigorous, and combined moderate-vigorous PA or PA self-efficacy over time between intervention groups. In this randomized trial among pregnant predominantly Puerto Rican women with overweight or obese pre-pregnancy BMI, we found that a culturally modified, individually tailored intervention had a beneficial impact on several PA domains from early pregnancy through one year postpartum. This study is registered at www.clinicaltrials.gov NCT01868230; registration date: 5/29/2013.