Acceptability of a novel text message delivered intervention for weight loss and maintenance of weight loss in the postpartum period: the Supporting Mums study

Introduction: Pregnancy and postpartum are risky periods for the development of obesity. Postpartum behaviour change is challenging due to the demands of parenthood. Mobile technologies could offer a low intensity, flexible and individualised approach to behaviour change during this time. This study examined the acceptability of a 12 month, theory‐based, tailored, SMS‐delivered intervention supporting weight loss and maintenance of weight loss in women with overweight and obesity in the postpartum period versus an active control delivering child development messages. Methods: Two‐arm pilot RCT which recruited UK women, within two years of giving birth, with a BMI ≥25 kg/m2. The intervention was delivered by automated text messages. Acceptability outcomes, according to pre‐defined progression criteria, were examined using study records, questionnaires at 3, 6, 9 and 12 months and interviews at 3 and 12 months. Acceptability of the intervention was assessed through group‐specific retention rates at 12 months, satisfaction ratings, and women's views on the intervention content and the perceived benefits of the intervention (thematic analysis). Results: Of the 100 women recruited to the pilot RCT, 51 women were randomised to the intervention group. During the follow‐up period, 9/51 (17.6%) women became pregnant and had to withdraw for that reason. Excluding pregnancies, 36/ 42 (85.7%) women in the intervention group were retained at the 12 month follow‐up. Of those completing follow‐up at 12 months, mean text message satisfaction score was 91.7% very/ mostly satisfied. Interviews at 3 months (n = 35) and 12 months (n = 12) found that women viewed the intervention positively in terms of text content. There were individual preferences for content types e.g. practical vs. motivational, but the variety of messages delivered allowed women to utilise their preferred advice. Some women said the timing of delivery was not always convenient, especially as their lifestyle patterns changed across the course of the 12‐month intervention delivery. However, using this mode of delivery allowed the information provided to be retained and accessed at women's convenience, and participants valued the salience of the messages which acted as a constant reminder, motivation and support to adopt healthier behaviours. Some women reported weight loss and dietary and activity behaviour changes as a result of the intervention. All women interviewed at 12 months said that they would recommend the intervention to other mothers and they highlighted the need for women to receive weight management support in the postpartum period. Conclusion: The intervention was acceptable to postpartum women. This evidence supports the decision to proceed to testing this intervention in a full trial.