Evaluating preconception health and behaviour change following a digital intervention: OptimalMe

BACKGROUND: Reproductive-aged women are a high-risk group for accelerated weight gain and obesity development. The objective of the current study was to assess the impact of a digital healthy lifestyle intervention for women planning a pregnancy, in optimising preconception health and lifestyle behaviours. METHODS: Australian women with the intention to conceive were invited to participate in OptimalMe. To be eligible women must be aged 18-44 years, not pregnant but wanting to conceive within 12 months of recruitment and have internet access. All participants receive the same digital lifestyle intervention, supported by health coaching and text messages during preconception. A parallel 2-arm design with sequential randomisation to compare telephone with videoconference delivery methods for health coaching was adopted. RESULTS: Overall, 298 women enrolled, with a mean ± (SD) age of 31.7 (4.6) years and BMI 25.5 (6.3) kg/m2. Suboptimal preconception behaviours were reported at baseline including alcohol consumption (57.0%), infrequent weighing (37.2%), and incomplete cervical cancer screening (15.8%) and prenatal supplementation (38.6%). The OptimalMe evaluation was completed by 217 women, 72.8% of the study population, an average of 4.5 months after commencing the intervention. At follow-up, a significant shift towards desired behaviours was reported for alcohol consumption (non-drinker) (z = 2.727, p = 0.00634), prenatal supplementation (taking supplement) (z=-11.082, p < 0.00001) and weighing behaviour (frequent weigher) (z=-5.291, p < 0.00001). CONCLUSIONS: Results indicate that women who are actively planning a pregnancy require support to optimise health and lifestyle in preparation for pregnancy. Post intervention outcomes suggest that remotely delivered preconception interventions improve lifestyle behaviours and engagement with clinical preconception care objectives. KEY MESSAGES: • Digital health interventions show positive change to important lifestyle behaviours. • Women planning a pregnancy demonstrate sub optional health and lifestyle behaviours therefore interventions are needed to improve this.