Hypertensive disorders of pregnancy (HDP) are now well-recognized risk factors for adverse outcomes in the postpartum period and for development of future cardiovascular disease (CVD). Postpartum BMI has emerged as a strong predictor of both short- and long-term blood pressure (BP) control in observational studies suggesting that earlier postpartum lifestyle modifications may be instrumental in future CVD risk reduction in women with HDP. While such lifestyle modifications are recognized as critical for postpartum health, implementation and engagement of postpartum women remains a challenge as new mothers face greater barriers to in-person care given childcare responsibilities. The proposed study will investigate the acceptability of a virtual cardiac wellness program and its impact on weight, lifestyle modifications, cardiometabolic health, patient engagement, and outcomes following HDP as compared to the standard of care for postpartum women at Massachusetts General Hospital.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
100
Participants assigned to this arm will participate in the experimental intervention.
Participants assigned to this arm will participate in a placebo intervention.
Massachusetts General Hospital
Boston, Massachusetts, United States
Postpartum weight loss at 6 months postpartum
Postpartum weight loss (Last prenatal visit weight- weight at 6 months postpartum) as a proportion of weight gained during pregnancy (Last prenatal visit weight- either 1st prenatal weight or pre-pregnancy weight within 1 year)
Time frame: 1 year
Postpartum weight loss at 1 year postpartum
Postpartum weight loss (from last prenatal visit weight) at 1 year postpartum as a proportion of weight gained during pregnancy
Time frame: 1 year
Return to pre-pregnancy weight
Proportion of women who return to pre-pregnancy weight at 6 months postpartum
Time frame: 6 months
Return to pre-pregnancy weight
Proportion of women who return to pre-pregnancy weight at 1 year postpartum
Time frame: 1 year
Changes in blood pressure
Systolic and diastolic blood pressure at 6 months postpartum
Time frame: 6 months
Changes in blood pressure
Systolic and diastolic blood pressure at 1 year postpartum
Time frame: 1 year
Change in sedentary time
Change in self-reported sedentary time from study enrollment and study completion (completion of the study intervention). Decreased sedentary time means better outcomes.
Time frame: 6 months
Change in physical activity as assessed by self-reported physical activity survey
Change in self-reported physical activity from study enrollment and study completion as assessed by self-reported physical activity survey (Days per week exercised, length of exercise sessions). Increased physical activity means a better outcome.
Time frame: 6 months
Change in physical activity as assessed by modified Duke Activity Status Index
Change in self-reported physical activity from study enrollment and study completion as assessed by modified Duke Activity Status Index (6 question yes/no survey, score ranges from 0-31.5). A higher score means a higher functional status.
Time frame: 6 months
Change in stress as assessed by self-reported stress survey
Change in self-reported stress from study enrollment and study completion as assessed by self-reported stress survey (3 questions on scale of 0-4 \[0= Never experience stress, 4= Constant stress\], Max score=12). A lower score means a better outcome.
Time frame: 6 months
Change in stress as assessed by American Heart Association Cardiovascular Disease Go Red Questionnaire
Change in self-reported stress from study enrollment and study completion as assessed by American Heart Association Cardiovascular Disease Go Red Questionnaire (11 questions on scale of 0-4 \[0= None of the Time, 4= All of the Time\], Max score=44). A lower score means a better outcome.
Time frame: 6 months
Change in self efficacy for diet
Change in self efficacy to eat a healthy diet from study enrollment and study completion assessed by an 8-question survey rating confidence for motivating oneself to do tasks relating to eating healthy consistently for at least 6 months (Range 1 \[I could not do it\] to 5 \[I could do it\], Max score= 40). A higher score means a better outcome.
Time frame: 6 months
Change in self efficacy for physical activity assessed by questionnaire
Change in self efficacy toward achieving and maintaining a healthy level of physical activity assessed by an 8-question survey rating confidence for motivating oneself to do tasks related to physical activity consistently for at least 6 months (Range 1 \[I could not do it\] to 5 \[I could do it\], Max score= 40). A higher score means a better outcome.
Time frame: 6 months
Change in cardiovascular disease knowledge assessed by American Heart Association Cardiovascular Disease Go Red Questionnaire
Change in knowledge on the American Heart Association Cardiovascular Disease Go Red Questionnaire (modified for the postpartum population) from study enrollment and study completion (5 questions total: 4 questions on scale of 0-4 \[0= Very well informed, 4= Not at all informed\], Max score=16, 16-part question about the causes of heart disease \[1= Yes, 2 =No\], Max score = 32). A lower score means a better outcome.
Time frame: 6 months
Change in quality of diet assessed by Dietary Approaches to Stop Hypertension (DASH) score
Change in quality of diet assessed by Dietary Approaches to Stop Hypertension (DASH) score from study enrollment and study completion (DASH score range 0 \[no targets met\] to 9 \[all targets met\]). A higher score means a better outcome.
Time frame: 6 months
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