Teen Mom 2: A Multicomponent Digital Health Intervention to Improve Black Maternal Cardiometabolic Health in Mississippi’s WIC Community
Abigail Gamble, Ph.D.
University of Mississippi Medical Center
Teen Mom 2 will assess the feasibility, acceptability, and effectiveness of a 24-week multi-component digital health intervention, #BabyLetsMove. The intervention will be delivered in a telehealth setting in partnership with the Special Supplemental Nutritional Program for Women, Infants, and Children (WIC) and the Telehealth Center of Excellence at the University of Mississippi Medical Center to increase physical activity (PA) and reduce sedentary behavior (SB) in pregnant, Black adolescents in the Mississippi Delta.
Our digital health innovation is based on preliminary data from the original Teen Mom Study and uses a theory-based, multi-level systems-change approach. At the systems level, racially concordant young adult (18 to 25 years) WIC moms (n=8) will be trained to deliver peer health coaching in a telehealth setting to address social needs and support self-directed behavior changes in pregnant adolescents. At the individual level, pregnant, Black adolescent (15 to 19 years) WIC clients (n=20) will be given three empirically supported behavior goals to (1) watch 2 hours or less of TV per day, (2) take 10,000 steps or more per day, and (3) engage in 20 minutes or more of organized exercise like prenatal yoga or dance videos per day.
The intervention is designed to build social cognition, affect, and skills using four intervention components: a Fitbit activity tracker, interactive self-monitoring text messages with automated feedback, tailored skills training text messages linked to digital materials, and peer health coaching. The central hypothesis is that augmenting usual WIC care with the #BabyLetsMove intervention will improve WIC’s ability to serve rural families and provide support for empowering pregnant, Black teens to prioritize and improve their health.
The specific aims are to 1) Assess the impact of #BabyLetsMove on objectively measured moderate-to-vigorous PA and SB from baseline (<16 weeks’ gestation) to 26- and 36-weeks’ gestation in pregnant, Black adolescents. 2) Utilize remote patient monitoring and wearable sensors to objectively measure and explore patterns of weight gain, glucose variability, and mean arterial pressure from baseline to 26 and 36 weeks’ gestation. 3) Utilize a mix-methods design guided by the PRISM framework to evaluate the implementation of #BabyLetsMove in partnership with WIC and telehealth.
This is the first digital health intervention study designed with and for a historically marginalized pregnant adolescent population. This study will add to our understanding of optimal mHealth and health coaching interventions in pregnant, Black teens in rural locales. It will add to the implementation science literature by focusing on a scalable and sustainable intervention in a novel setting and understudied and vulnerable perinatal adolescent population. Finally, it will contribute to the urgent national agenda to improve Black maternal health through an innovative partnership and delivery mechanism.
