Page 161 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

3.5 Feasibility and effectiveness of a lifestyle intervention| 159
Gen.3 (GLUC3), Cobas®, Roche Diagnostics), fasting insulin (Insulin, Cobas®, Roche Diagnostics), the Homeostasis Model Assessment (HOMA)2-score271 as measure of insulin sensitivity and high-sensitive C-reactive protein (CRP) (C- Reactive Protein Gen.3 (CRPL3), Cobas®, Roche Diagnostics). Lifestyle was evaluated by three questionnaires, i.e. for saturated fat-intake the Maastricht Fatlist272, for physical activity the International Physical Activity Questionnaire (IPAQ)273 and for smoking habits the short version of the questionnaire of STIVORO (the Dutch anti-smoking association, www.stivoro.nl).
Three subsequent sessions with a trained lifestyle counsellor (MH) were scheduled between 7 and 10 months postpartum. The intervention consisted of a combination of individual counselling sessions based on the technique of motivational interviewing193 and the use of a computer-tailored Dutch health education program (www.gezondlevencheck.nl of the Dutch Heart Association). The counselling sessions were preferably face-to-face, but could be taken by telephone if the woman wanted. The computer-tailored health education program and the three questionnaires were completed by the participants before each counselling session. The program provided feedback on the individual scores on the questionnaires. Based on these scores, Individual tailored lifestyle advice was discussed during the sessions and used to set personal lifestyle goals. Progress on the individual goals was discussed, and if applicable adjusted, at each subsequent session.
During the visit at 10 months postpartum the complete screening for cardiometabolic risk factors was repeated with exclusion of the lifestyle questionnaires. Women were encouraged to maintain their lifestyle program.
The final visit of the study was scheduled 13 months postpartum. The complete screening for cardiometabolic risk factors was repeated again, including the lifestyle questionnaires. In addition, women who participated in