Smartphone-based lifestyle coaching modifies behaviours in women with subfertility or recurrent miscarriage: a randomized controlled trial: a randomized controlled trial
Smartphone-based lifestyle coaching modifies behaviours in women with subfertility or recurrent miscarriage: a randomized controlled trial: a randomized controlled trial
Research question: is an online lifestyle coaching platform more effective at modifying periconceptional behaviours than standard advice offered by the UK National Health Service (NHS)?
Design: women with subfertility or recurrent miscarriage were recruited to a two-centre randomized controlled trial. They were randomized to either the online lifestyle coaching platform Smarter Pregnancy (intervention) or periconceptional advice provided by NHS websites (control). Participants completed a lifestyle questionnaire at baseline, 6, 12, 18 and 24 weeks, and the results were used to tailor lifestyle coaching in the intervention group. At baseline, 12 and 24 weeks, composite risk scores (CRS) were calculated. A lower CRS corresponds to a healthier lifestyle.
Results: of the 400 women recruited, 262 women were randomized (131 in each arm). At 12 weeks, a reduction in CRS (includes risk score for intake of folic acid, vegetables and fruits, smoking and alcohol) was observed in the intervention versus control arms. After correcting for baseline, the difference in the CRS between intervention and control was –0.47 (95% CI –0.97 to 0.02) at 12 weeks and –0.32 (95% CI –0.82 to 0.15) at 24 weeks. A statistically significant reduction in lifestyle risk scores was found in women with a body mass index (BMI) of 25 kg/m2 or above compared with those with a BMI below 25kg/m2. The odds of being pregnant at 24 weeks was increased in the intervention versus control (OR 2.83, 95% CI 0.35 to 57.76).
Conclusions: the Smarter Pregnancy coaching platform is more effective in delivering lifestyle advice and modulating behaviours to support women with a history of subfertility or recurrent miscarriage than standard online NHS advice.
Ehealth, Lifestyle, Lifestyle coaching, Online, Periconception, Smartphone
111-119
Ng, Ka Ying Bonnie
869b3b2d-dd7c-407d-88aa-5db399e02b3a
Steegers-Theunissen, Régine
134c5e64-5b09-41f7-92fc-ae591a1c5527
Willemsen, Sten
9be37793-9fc5-4522-ac69-163981d162a6
Wellstead, Susan
2264823e-ae68-4976-bbf2-92da4ba21e59
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Macklon, Nick
d08e4844-96cf-4333-aa84-aec9b8febb42
July 2021
Ng, Ka Ying Bonnie
869b3b2d-dd7c-407d-88aa-5db399e02b3a
Steegers-Theunissen, Régine
134c5e64-5b09-41f7-92fc-ae591a1c5527
Willemsen, Sten
9be37793-9fc5-4522-ac69-163981d162a6
Wellstead, Susan
2264823e-ae68-4976-bbf2-92da4ba21e59
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Macklon, Nick
d08e4844-96cf-4333-aa84-aec9b8febb42
Ng, Ka Ying Bonnie, Steegers-Theunissen, Régine, Willemsen, Sten, Wellstead, Susan, Cheong, Ying and Macklon, Nick
(2021)
Smartphone-based lifestyle coaching modifies behaviours in women with subfertility or recurrent miscarriage: a randomized controlled trial: a randomized controlled trial.
Reproductive BioMedicine Online, 43 (1), .
(doi:10.1016/j.rbmo.2021.04.003).
Abstract
Research question: is an online lifestyle coaching platform more effective at modifying periconceptional behaviours than standard advice offered by the UK National Health Service (NHS)?
Design: women with subfertility or recurrent miscarriage were recruited to a two-centre randomized controlled trial. They were randomized to either the online lifestyle coaching platform Smarter Pregnancy (intervention) or periconceptional advice provided by NHS websites (control). Participants completed a lifestyle questionnaire at baseline, 6, 12, 18 and 24 weeks, and the results were used to tailor lifestyle coaching in the intervention group. At baseline, 12 and 24 weeks, composite risk scores (CRS) were calculated. A lower CRS corresponds to a healthier lifestyle.
Results: of the 400 women recruited, 262 women were randomized (131 in each arm). At 12 weeks, a reduction in CRS (includes risk score for intake of folic acid, vegetables and fruits, smoking and alcohol) was observed in the intervention versus control arms. After correcting for baseline, the difference in the CRS between intervention and control was –0.47 (95% CI –0.97 to 0.02) at 12 weeks and –0.32 (95% CI –0.82 to 0.15) at 24 weeks. A statistically significant reduction in lifestyle risk scores was found in women with a body mass index (BMI) of 25 kg/m2 or above compared with those with a BMI below 25kg/m2. The odds of being pregnant at 24 weeks was increased in the intervention versus control (OR 2.83, 95% CI 0.35 to 57.76).
Conclusions: the Smarter Pregnancy coaching platform is more effective in delivering lifestyle advice and modulating behaviours to support women with a history of subfertility or recurrent miscarriage than standard online NHS advice.
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Accepted/In Press date: 6 April 2021
e-pub ahead of print date: 11 April 2021
Published date: July 2021
Additional Information:
Funding Information:
The authors thank all the women who have participated in this randomized controlled trial. This study was funded by NIHR Southampton Biomedical Research Centre (Nutrition) and the Department of Obstetrics and Gynaecology at the Erasmus MC University Medical Center in Rotterdam, The Netherlands. Smarter Pregnancy is a commercial product and licenses to use the software under trial were purchased. The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author.
Publisher Copyright:
© 2021 Reproductive Healthcare Ltd.
Keywords:
Ehealth, Lifestyle, Lifestyle coaching, Online, Periconception, Smartphone
Identifiers
Local EPrints ID: 449963
URI: http://eprints.soton.ac.uk/id/eprint/449963
ISSN: 1472-6483
PURE UUID: e0e0d34f-afa2-43c3-8ffe-2ecfed898ebb
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Date deposited: 30 Jun 2021 16:30
Last modified: 17 Mar 2024 06:40
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Contributors
Author:
Ka Ying Bonnie Ng
Author:
Régine Steegers-Theunissen
Author:
Sten Willemsen
Author:
Susan Wellstead
Author:
Nick Macklon
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