80 Research Summary: Goal Setting Among Women with BMI ?25 Planning a Pregnancy Involved in MAPS Coaching

Faculty Mentor: Sara Simonsen (Nursing, University of Utah)

The purpose of this thesis was to describe the goals that women with overweight/obese BMIs who were planning a pregnancy made while participating in Motivation and Problem Solving (MAPS) counseling focused on enrollment and engagement in the Diabetes Prevention Program (DPP), a 12-month program designed to reduce the risk of Type II diabetes in those with diabetes risk factors. Identifying the types of goals that women set while participating in MAPS coaching can help us to understand how to increase enrollment and participation of reproductive-age women in the DPP. Obesity is strongly associated with developing Type II diabetes, and preventing obesity in women prior to pregnancy is particularly important because there are unique risks to both maternal and fetal outcomes. Previous studies have shown that women struggle to adhere to lifestyle interventions, but motivational interventions and goal setting can enhance the effectiveness of these interventions.. The participants in this study were women across the Wasatch front who were 18-40 years old, had an overweight or obese BMI, and were planning a pregnancy within the next 24 months. MAPS counselors contacted participants via telephone to identify each woman’s strengths and unique situations, and assist them in developing a “wellness plan” with goals set relating to enrolling and participating in DPP. Women received up to five MAPS calls over a16 week span. An analysis of the goals that the women set with their counselors showed that the goals made could be divided into two categories, DPP program participation-related goals and lifestyle goals. A total of 47 out of 48 women set a goal at their first MAPS Session. The most common goals at the first MAPS session were related to enrollment in the DPP program (64.6%) and nutrition (41.2%). A total of 46 out of 47 and 38 out of 41 women set goals at their second and third MAPS sessions, respectively. The most common goals for MAPS session 2 were engagement with the DPP program (51.1%) and goals related to nutrition (42.6%), while the most common goals for MAPS session 3 were engagement with the DPP program (36.6%), nutrition (29.3%), and using the HealthSlate app provided by the DPP(29.3%). A total of 20 out of 34 women set goals during MAPS call four and the most common goals were related to exercise (32.4%), nutrition (23.5%), and meeting with a DPP facilitator for assistance (23.5%). One woman out of four made goals during MAPS call five, and her goals related to nutrition (25.0%) and meeting with a MAPS facilitator for support (25.0%). Overall, the most common DPP program participation goals were enrollment and engagement while the most common lifestyle goals were related to nutrition, exercise, weight-based goals. Identifying where reproductive-age women commonly sought assistance with their goals during this study can help distinguish where this under-researched population can be supported as they strive to prevent obesity and Type II diabetes.