Study Results
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Basic Information
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COMPLETED
NA
202 participants
INTERVENTIONAL
2011-08-31
2015-12-31
Brief Summary
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Detailed Description
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In the first phase of this study, the investigators conducted in-depth focus groups with over 60 overweight, low to middle-income, pregnant women to learn more about what they might be looking for in such an intervention. In the second phase, which began in fall 2010, 48 low- to middle-income overweight pregnant women were randomly assigned to one of the interventions. Based on the knowledge gained from Phase 2, we refined the MIND intervention and are conducting an efficacy trial in Phase 3.
During Phase 3, we will enroll 220 overweight, low to middle-income, pregnant women in a trial of MIND to test feasibility and to examine changes in hypothesized mechanisms (stress, opioid tone), non-homeostatic eating, and in health outcomes (abdominal fat, insulin sensitivity, weight change) in the intervention group (n=110). Intervention participants will complete a battery of psychological and clinical measures (weight, BMI, waist/hip ratio, body composition) at baseline, post-intervention, 32-34 weeks gestation, and 3 and 9 months postpartum. Control participants (n=110) will complete the same battery of psychological measures at baseline and 8-10 weeks after baseline. All study participants will complete brief psychological, weight and waist/hip ratio measures at 6 months postpartum. Additionally, we will obtain prenatal and labor/delivery medical records for all study participants.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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Mindful Moms
Based on the Mindful Motherhood Training (developed by Cassandra Vieten, PhD), Mindfulness-Based-Eating and Awareness Training (MB-EAT) (developed by Jean Kristeller, PhD), and other mindfulness- and acceptance-based interventions
Mindful Moms
8 weekly 2-hour sessions, 2 "booster" telephone sessions, and 1 postpartum "booster" session
Comparison Group
Usual prenatal care
No interventions assigned to this group
Interventions
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Mindful Moms
8 weekly 2-hour sessions, 2 "booster" telephone sessions, and 1 postpartum "booster" session
Eligibility Criteria
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Inclusion Criteria
* Currently pregnant, target 8-19 weeks gestation (intervention starts at 12-19 weeks gestation)
* Singleton gestation
* Age 18 to 45 years
* Pre-pregnancy BMI 25-41 and \< 300 pounds
* Income to poverty ratio ≤ 500% specific to family size
Exclusion Criteria
* Needle phobic or fainting in response to blood draw
* Substance abuse, mental health, or medical condition that, in the opinion of investigators, will make it difficult for the potential participant to participate in the group intervention and/or affects baseline metabolism or body composition (e.g., hypertension, asthma, arthritis, severe food allergies, HIV).
* Eating disorder which would make it difficult for the potential participant to follow the exercise, diet, and mind-body training guidelines.
* Polycystic ovarian syndrome treated with Metformin since this is indicative of insulin resistance and makes long term weight loss difficult, which are relevant outcomes in this study
* Diabetes or positive early diabetes screening test in the current pregnancy (weight loss is affected by insulin resistance)
* Previous or current mindfulness meditation practice with a typically sitting meditation of 20 or more minutes two or more times per week
* Recent weight loss (more than 5% within past 6 months). In addition, women with a history of known coronary artery disease (CAD), or typical or atypical anginal chest pain will require a letter from the participant's physician that he or she has been adequately evaluated and that a moderate exercise program is appropriate. A study physician must review the case and agree. Study participation involves a moderate exercise program. Although moderate exercise is recommended for persons with CAD, we want to ensure that steps have been taken to limit the risks of the exercise component.
* Chronic use of systemic (oral or IV) corticosteroids in the 6 months prior to enrollment (steroid use may reduce the efficacy of the intervention)
* History of gastric bypass surgery
* Multiple gestation
18 Years
45 Years
FEMALE
Yes
Sponsors
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California Pacific Medical Center Research Institute
OTHER
University of California, San Francisco
OTHER
Responsible Party
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Principal Investigators
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Elissa Epel, PhD
Role: PRINCIPAL_INVESTIGATOR
University of California, San Francisco
Locations
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University California San Francisco
San Francisco, California, United States
Countries
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References
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Epel E, Laraia B, Coleman-Phox K, Leung C, Vieten C, Mellin L, Kristeller JL, Thomas M, Stotland N, Bush N, Lustig RH, Dallman M, Hecht FM, Adler N. Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model. Int J Behav Med. 2019 Oct;26(5):461-473. doi: 10.1007/s12529-019-09779-2.
Roubinov DS, Epel ES, Coccia M, Coleman-Phox K, Vieten C, Adler NE, Laraia B, Bush NR. Long-term effects of a prenatal mindfulness intervention on depressive symptoms in a diverse sample of women. J Consult Clin Psychol. 2022 Dec;90(12):942-949. doi: 10.1037/ccp0000776. Epub 2022 Nov 28.
Parikh NI, Laria B, Nah G, Singhal M, Vittinghoff E, Vieten C, Stotland N, Coleman-Phox K, Adler N, Albert MA, Epel E. Cardiovascular Disease-Related Pregnancy Complications Are Associated with Increased Maternal Levels and Trajectories of Cardiovascular Disease Biomarkers During and After Pregnancy. J Womens Health (Larchmt). 2020 Oct;29(10):1283-1291. doi: 10.1089/jwh.2018.7560. Epub 2020 Jan 14.
Vieten C, Laraia BA, Kristeller J, Adler N, Coleman-Phox K, Bush NR, Wahbeh H, Duncan LG, Epel E. The mindful moms training: development of a mindfulness-based intervention to reduce stress and overeating during pregnancy. BMC Pregnancy Childbirth. 2018 Jun 1;18(1):201. doi: 10.1186/s12884-018-1757-6.
Related Links
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University of California, San Francisco Center for Obesity Assessment, Study and Treatment
Other Identifiers
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