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Use of a DVD to provide dietary and lifestyle information to pregnant women who are overweight or obese: a nested randomised trial
Szmeja MA, Cramp C, Grivell RM, Deussen AR, Yelland LN, Dodd JM
BMC Pregnancy and Childbirth 2014 Dec 12;14(409):Epub
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: We conducted a nested randomised trial to evaluate the effect of an educational DVD, providing information about healthy food choices and exercise during pregnancy, on diet and physical activity, among pregnant women who were overweight or obese. METHODS: We conducted a nested randomised trial within the context of the LIMIT randomised trial. Women were eligible with a singleton pregnancy between 10 and 20 weeks gestation, and body mass index at the time of their first antenatal appointment of >= 25 kg/m2. All women who were randomised to the lifestyle advice group of the LIMIT trial received a series of consultations with both research dieticians and research assistants, in addition to standard written dietary and exercise materials (standard materials group). Women randomised to the DVD group received the same consultations and written materials, and additionally received an educational DVD (DVD group). The primary study outcome was the Healthy Eating Index. Other study outcomes included physical activity, and gestational weight gain. Women completed a qualitative evaluation of all the materials provided. RESULTS: 1,108 women in the LIMIT lifestyle advice group participated in the nested trial, with 543 women randomised to the DVD group, and 565 women to the standard materials group. Women who received the DVD compared with those who did not, had a higher mean Healthy Eating Index at 36 weeks gestation (73.6 versus 72.3; adjusted mean difference 1.2; 95% CI 0.2 to 2.3; p = 0.02), but not at 28 weeks gestation (73.2 versus 73.5; adjusted mean difference -0.1; 95% CI -1.1 to 0.9; p = 0.82). There were no statistically significant differences in physical activity or total gestational weight gain. While most women evaluated the materials positively, frequency of utilisation was poor. CONCLUSIONS: Ongoing attention to the delivery of information is required, particularly with the increased use and availability of digital and multi-media interactive technologies. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12607000161426.

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