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Measuring Adherence to a Nutrition and Exercise Lifestyle Intervention: Is Program Adherence Related to Excessive Gestational Weight Gain?

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Abstract

To identify adherence required to achieve target health outcome(s) in nutrition and/or exercise interventions, a measurement tool that tracks objective and self-reported measures of adherence is necessary. The purpose of this study was to design an adherence measurement tool and test it retrospectively on the Nutrition and Exercise Lifestyle Intervention Program (NELIP; Ruchat et al., Medicine and Science in Sports and Exercise, 44(8), 1419–1426, 2012; Mottola et al., Medicine and Science in Sports and Exercise, 42(2), 265–272, 2010), designed to prevent excessive gestational weight gain (EGWG). The tool was based on the goals of the NELIP and included a grading system for each behavior (exercise and nutrition). It was used to determine whether adherence scores could differentiate excessive versus acceptable weight gain during pregnancy across pre-pregnancy body mass index (BMI) categories. Results showed irrespective of pre-pregnancy BMI, women with acceptable weight gain had significantly higher adherence (p < 0.05) than women with excessive weight gain. It is recommended that this adherence tool be included in future prospective lifestyle intervention studies.

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Acknowledgements

The original Nutrition and Exercise Lifestyle Intervention Program was funded by the Canadian Institute of Health Research-IAPH and Rx&D HRF Canada.

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Authors and Affiliations

  1. R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, University of Western Ontario, London, ON, N6A 3K7, Canada

    Taniya S. Nagpal & Michelle F. Mottola

  2. School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Canada

    Taniya S. Nagpal, Harry Prapavessis & Michelle F. Mottola

  3. Exercise and Health Psychology Laboratory, London, ON, Canada

    Harry Prapavessis

  4. Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA

    Christina Campbell

  5. Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada

    Michelle F. Mottola

  6. Children’s Health Research Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada

    Michelle F. Mottola

Authors
  1. Taniya S. Nagpal
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  2. Harry Prapavessis
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  3. Christina Campbell
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  4. Michelle F. Mottola
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Correspondence to Michelle F. Mottola.

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The authors declare that they have no conflict of interest.

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Summary

• Adherence to lifestyle interventions including a nutrition and exercise behavior change is necessary to evaluate and report because a lack of adherence can decrease the effectiveness of an intervention.

• By identifying the goals of an intervention and scoring participants throughout the intervention in meeting those goals, adherence can be measured and reported.

• Excessive gestational weight gain can be prevented by following a nutrition and exercise program during pregnancy; however, studies have yielded inconsistent results in women with a pre-pregnancy BMI of overweight or obese.

• By retrospectively measuring adherence to the NELIP, it was identified that greater adherence will result in the prevention of excessive gestational weight gain across all BMI categories.

• Future behavior change interventions targeting pregnant women should focus on increasing program adherence to increase the likelihood of preventing excessive gestational weight gain.

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Nagpal, T.S., Prapavessis, H., Campbell, C. et al. Measuring Adherence to a Nutrition and Exercise Lifestyle Intervention: Is Program Adherence Related to Excessive Gestational Weight Gain?. Behav Analysis Practice 10, 347–354 (2017). https://doi.org/10.1007/s40617-017-0189-5

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  • DOI: https://doi.org/10.1007/s40617-017-0189-5

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