Where We've Been

We’ve led several longitudinal cohort and qualitative studies over the past decade that identified behavioral, social-contextual, and structural predictors of peripartum weight change and cardiovascular (CVD) risk factors (e.g., short sleep duration, depression, physical inactivity, food insecurity) – predictors that serve as important targets for intervention.

We’ve developed and tested a perinatal obesity treatment approach that includes:
  • simple, empirically-supported behavior change goals that directly/indirectly modify energy balance, tailored to our target population of Black and Latina mothers
  • mobile technologies that incorporate interactive self-monitoring text messages, social media, and video testimonials
  • health coaching by staff trained in behavioral weight control strategies

This approach has demonstrated efficacy in several studies for reducing body weight and cardiometabolic risk factors (see publications).

Where We’re Headed

There is a clear and compelling opportunity to strategically intervene on CVD risk factors using a social-ecological approach.

Treatment options to date, including our own previous research, have led to incremental improvements but have not yet translated to optimal perinatal cardiovascular health for Black women. The complex context of Black birthing people demands comprehensive strategies that address root causes of racial disparities and systematically intervene at multiple levels of CVD risk, but major treatment gaps exist.

Few studies
  • Have been directly informed by the lived experience and expertise of Black women
  • Seek to address and repair the harms from structural and interpersonal racism
  • Include intervention targets such as chronic stress, trauma, and depression along with diet and physical activity that have the potential to produce more marked and sustained blood pressure and weight effects
  • Provide support in pregnancy through the end of the first postpartum year—the full duration of increased CVD risk
Through a partnership with Maternal Wellness Village, we are addressing treatment gaps by combining and evaluating
  • PMHE’s individual-level, perinatal obesity treatment approach
  • Maternal Wellness Village’s triadic interpersonal support for Black women by Black women (community doula care, mental health services, and lactation consultation)
  • Institutional-level interventions to address and repair harms from racism
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PMHE and Maternal Wellness Village received PCORI funding to do this work in 2021!
For more information CLICK HERE

Our Current and Prior Funded Projects

7/1/23-6/30/25

PaTH MOMS (Establishing a PaTH Clinical Research Network Maternal Morbidity and Mortality Stakeholder Council) will create a diverse council of patient, community and healthcare stakeholders embedded in the PaTH Clinical Research Network, one of the PCORnet research networks. The PaTH MOMS council will establish PaTH network research priorities to improve maternal health through the lens of lived experiences.

Funder: PCORI
11/10/21–12/10/27

Philadelphia’s Maternal Wellness Village and Temple have teamed up to study two approaches that treat multiple factors leading to heart disease among Black birthing people. Both approaches address individual behaviors through nutrition and physical activity text messages and home blood pressure self-monitoring as well as provide training to medical care providers in order to reduce patients’ experiences of racism or mistreatment. But only one of the approaches being studied also adds supports for Black women by Black women (community doula care, mental health services, and lactation consultation) during their pregnancy, birth, and postpartum in order to learn if these supports lead to lower blood pressure and also treat social isolation, depression, and increase experiences of respectful maternity care.

Funder: PCORI
01/01/21-12/31/24

PaTH is a Clinical Research Network that includes Boston Medical Center, Geisinger, Johns Hopkins University, Johns Hopkins Health System, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, RUSH, Temple Health System, Lewis Katz School of Medicine at Temple University, the University of Pittsburgh, UPMC and UPMC Health Plan, The Ohio State University, The Ohio State University Wexner Medical Center, University of Michigan, and Michigan Medicine. PaTH utilizes Patient Empowered Research to address the questions and concerns that matter most to our communities in order to make better health decisions.

Funder: PCORI
01/03/21–06/30/23

This proposal aims to optimize early postpartum care for Black birthing people with HDP and create a toolkit of best practices for dissemination among Essential Hospitals.

funder: AMERICA’S ESSENTIAL HOSPITALS
09/01/18–06/30/23

In this pragmatic trial, we are randomizing 438 Black and Latina, Philadelphia County WIC program participants with obesity in early pregnancy to either standard WIC care or an antenatal obesity treatment arm. As part of this effort, we piloted an antiracism training for WIC nutrition professionals as a means of improving attitudes, awareness, and confidence in identifying and addressing interactions that perpetuate individual, interpersonal and systemic racism.

funder: NIH/NIDDK
01/15/16–12/31/21

This project aims evaluate a mHealth-delivered behavioral weight loss intervention in Black WIC-recipients during the first postpartum year.

funder: NIH/NHLBI
07/01/19–03/31/22

Our Temple-Maternity Care Coalition proposal, grounded in a reproductive and racial justice framework, aims to prepare and produce a highly qualified workforce of community-based perinatal health workers to improve health for black and brown pregnant women and their families, while providing meaningful careers for mothers in North Philadelphia who face exceedingly high levels of poverty and un/underemployment.

funder: Lenfest North Philadelphia Workforce Initiative
04/01/14–03/31/18

This study aims to evaluate the efficacy of an excessive gestational weight gain prevention intervention as an adjunct to usual obstetric care at Temple in African American women.

funder: HRSA
07/01/12–06/30/16

This research uses observational epidemiology to examine the influence of postpartum sleep duration on adiposity and cardiometabolic risk factors in urban, low-income mothers.

funder: Doris Duke Charitable Foundation
01/11/11–11/30/15

This study aims to minimize postpartum weight retention among low-income, Black mothers by developing, implementing, and then evaluating a technology-based behavioral intervention.

funder: NIH/NHLBI

Affiliated Projects and Initiatives

Village Connect

One

SACRED Birth Study

Enhancing children’s sleep to decrease obesity and diabetes risk

Currently Enrolling

Change of HEART

This research study is designed to provide Black birthing people with nutrition and heart health education to support a joyful and healthy experience throughout your pregnancy, birth, & first year postpartum!

You may be eligible if:

• Over 18 years of age
• Black or African American
• Less than 7 months pregnant
• Own a mobile phone

Compensation is provided. Call or text us at 484-532-3181 to learn more.

Relevant Publications

Preventing excessive gestational weight gain among African American women: A randomized clinical trial.
2016

OBESITY

Intervening during and after pregnancy to prevent weight retention among African American women.
2017

Preventative Medicine Reports

Feasibility of using a peer coach to deliver a behavioral intervention for promoting postpartum weight loss in Black and Latina mothers.
2020

Translational Behavioral Medicine

Using technology to promote postpartum weight loss in urban, low-income mothers: A pilot randomized controlled trial.
2014

Journal of Nutrition Education and Behavior

Targeting pregnancy-related weight gain to reduce disparities in obesity: Baseline results from the healthy babies trial.
2019

Contemporary Clinical Trials

Influence of sleep duration on postpartum weight change in Black and Hispanic Women.
2019

OBESITY

Determinants of excessive gestational weight gain in urban, low-income women.
2012

Women’s Health Issues

Objectively measured sleep duration and hyperglycemia in pregnancy.
2014

Sleep Medicine

Weight gain in pregnancy and risk of maternal hyperglycemia.
2009

American Journal of Obstetrics and Gynecology

Associations of maternal material hardships during childhood and adulthood with prepregnancy weight, gestational weight gain, and postpartum weight retention.
2015

Journal of Women’s Health

Modifiable predictors associated with having a gestational weight gain goal.
2011

Maternal & Child Health Journal

Association of postpartum depression with weight retention 1 year after childbirth.
2008

Obesity

Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: Findings from a US cohort study.
2008

BMC Pregnancy and Childbirth

Determinants of postpartum sleep duration and sleep efficiency in minority women.
2020

sleep

Perceptions of low-income African-American mothers about excessive gestational weight gain.
2012

Maternal & Child Health Journal

A qualitative study of motivators and barriers to healthy eating in pregnancy for low-income, overweight, African-American mothers.
2013

Journal of the Academy of Nutrition and Dietetics

“It’s not all about my baby’s sleep”: A qualitative study of factors influencing low-income African American mothers’ sleep quality.
2016

Behavioral Sleep Medicine

Determinants of successful weight loss in low-Income African American women: A positive deviance analysis.
2018

Journal of Primary Care and Community Health

Overcoming obesity: A mixed methods study of the impact of primary care physician counseling on low-Income African American women who successfully lost weight.
2018

American Journal of Health Promotion

Addressing obesity in pregnancy: What do obstetric providers recommend?
2010

Journal of Women’s Health

 

Recruitment, retention, and engagement strategies for exercise interventions with rural antenatal adolescents: Qualitative interviews with WIC providers.
2020

Journal of Public Health Management and Practice

Provider advice and patient perceptions on weight across five health systems.
2020

American Journal of Preventative Medicine

Preconceptional and maternal obesity: Epidemiology and health consequences.
2016

The Lancet Diabetes & Endocrinology

Optimizing weight gain in pregnancy to prevent obesity in women and children.
2012

Diabetes, Obesity and Metabolism

 

Obesity and diabetes in mothers and their children: Can we stop the intergenerational cycle?
2011

Current Diabetes Reports

Preventing excessive gestational weight gain: A systematic review of interventions.
2010

Obesity Reviews

Short sleep duration and hyperglycemia in pregnancy: Aggregate and individual patient data meta-analysis.
2018

Sleep Medicine Reviews

Multilevel Community Engagement to Inform a Randomized Clinical Trial
2023

Obstetrics and Gynecology

Antiracism Training for Nutrition Professionals in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): a Promising Strategy to Improve Attitudes, Awareness, and Actions

2022

Journal of Racial and Ethnic Health Disparities

Breastfeeding Awareness and Empowerment (BAE): A Black Women-Led Approach to Promoting a Multigenerational Culture of Health

2022

Societies