Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2014 Weight-loss interventions performed to reduce the risk of obesity-related complications Victoria Stephanie Stewart Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Medicine and Health Sciences Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden Universit y College of Health Sciences This is to certify that the doctoral dissertation by Victoria Stewart has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Bernice Kennedy, Committee Chairperson, Public Health Faculty Dr. Marie Caputi, Committee Member, Public Health Faculty Dr. Gudeta Fufaa, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2014 Abstract Weight-Loss Interventions Performed to Reduce the Risk of Obesity-Related Complications by Victoria Stephanie Stewart MSPH, Walden University, 2008 BS, Montclair State University, 1999 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Community Health Promotion and Education Walden University February 2015 Abstract The management of obesity before a woman conceives is one of the most effective efforts a woman can take in decreasing her risk of obesity-related complications during pregnancy. Evidence supports the idea that maternal obesity influences maternal and fetal outcomes, leading to maternal and fetal morbidities. Physicians acknowledge the importance of screening women for obesity, but many do not refer patients for weight- loss therapy. In this study, the health belief model was used to explore the associations between participants’ obesity risk of complications during pregnancy, the number of weight-loss interventions they attempted to implement prior to pregnancy, and how they viewed the success of their interventions. Participants were a random sample of 95 obese pregnant women older than 19 years participating in the supplemental WIC program in an urban community in Newark, New Jersey. A quantitative nonexperimental correlational study using descriptive and inferential statistics was used to analyze the data. The results of this study indicated that obese pregnant women did not perceive the risks associated with obesity as a problem, nor was there an association among the types of weight-loss methods attempted, the overall success of their weight-loss interventions, and ethnicity. Women who tried exercise and dietary restrictions or exercise only were more likely to experience success than those who tried other methods or combinations of methods (p = 0.012). The data provided can lead to better informed strategies by health care professionals to develop standards in healthcare, particularly obstetrics and gynecology offices and clinics, to help obese women be more compliant with treatment recommendations for reducing the risks of obesity-related health problems. Weight-Loss Interventions Performed to Reduce the Risk of Obesity-Related Complications by Victoria Stephanie Stewart MSPH, Walden University, 2008 BS, Montclair State University, 1999 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Community Health Promotion and Education Walden University February 2015 Dedication I would like to dedicate this dissertation to my family and friends for their love, support, and encouragement. This has been a long journey as I tried to balance work, school, and time with my family. I am grateful to my family for their acts of kindness and my friends for their words of encouragement. To my grandmother, thanks for your countless prayers, and my mother, thanks for being there for me to share it all. May my perseverance be an example of what GOD can do when He shows up and shows out! Acknowledgments Now to Him, who is able to do exceedingly and abundantly more than I could ever ask or imagine, according to the power that works in me. I would like to thank God for all that He has done for me and is waiting to do through me. I am thankful for Jacqueline Julio-Martinez, RN, who took the time out of her busy schedule to help me with writing and translating in Spanish…You deserve the best! I am appreciative to Dr. Wendy LaRue and Dr. Christine Storlie, who assisted me in progressing through the proposal. I am also grateful to Dr. Sally Jensen and Dr. Peter Coogan from Academic Coaching and Writing and Dr. John Caruso, Director of Dissertation Statistical Services, who performed the editing and statistical services, respectively. Without them, this journey would have been more painstakingly tedious. Table of Contents List of Tables .......................................................................................................................v Chapter 1: Introduction to the Study ....................................................................................1 Background ....................................................................................................................1 Problem Statement .........................................................................................................5 Purpose of the Study ......................................................................................................7 Nature of the Study ........................................................................................................7 Research Questions ........................................................................................................8 Hypotheses .....................................................................................................................9 Theoretical Framework ................................................................................................10 Definitions of Terms ....................................................................................................10 Assumptions .................................................................................................................13 Limitations ...................................................................................................................13 Delimitations ................................................................................................................15 Significance of the Study .............................................................................................15 Filling the Literature Gap...................................................................................... 16 Professional Applications ..................................................................................... 16 Positive Social Change Implications .................................................................... 17 Summary ......................................................................................................................17 Chapter 2: Literature Review .............................................................................................19 Introduction ..................................................................................................................19 Research Strategy………………………………………………………………...19 i Maternal and Fetal Complications of Obesity .............................................................20 Fetal and Childhood Development of Obesity.............................................................23 Fetal Physiological Adaptations ............................................................................23 Childhood Obesity ..................................................................................................25 Perceived Susceptibility ...............................................................................................26 Perceived Severity… .................................................................................................. 28 Perceived Benefit ........................................................................................................ 29 Barriers Perceived by Women and Health Professionals ........................................... 31 Perceived Self-Efficacy by Obese Women ................................................................. 34 Research Methods…………………………………………………… ........................36 Research Methodology Using the Health Belief Model ..............................................40 Summary ......................................................................................................................44 Chapter 3: Research Method ..............................................................................................44 Introduction ..................................................................................................................44 Research Design...........................................................................................................44 Research Questions ......................................................................................................45 Hypotheses ...................................................................................................................45