Supported by the National Institute of Nursing Research (NINR)

Knowing that women in American Samoa who enter pregnancy with overweight or obesity often exceeded guidelines for healthy pregnancy weight gain we designed the STRONG study to examine whether an intervention delivered using group prenatal care could prevent excess gestational weight gain, improve uptake of gestational diabetes screening, and extend exclusive breastfeeding.
Rather than attending one-on-one appointments with their doctor, women who received the STRONG intervention attended their appointments with a group of other women who were all in the same month of pregnancy. We followed a group prenatal care curriculum called Expect With Me that uses a faciliated discussion model to deliver education and intervention content.
The STRONG intervention was an incredible success. On average women who received group care gained ~5kgs less weight during pregnancy, breastfed their babies exclusively for longer, and had fewer high birth weight babies. Importantly, there was also some early evidence that the program may be effective in reducing risk of gestational diabetes. You can read the full paper here.

We enrolled 80 women who were less than 14 weeks pregnant. We randomized them to receive either the STRONG intervention or to continue with their usual prenatal care.
The STRONG curriculum is available from the study Principal Investigator (nicola.hawley@yale.edu). We recently submitted a grant to test the intervention in a full scale clinical trial to see if we can confirm the study’s findings and understand whether or not the program can be used to prevent gestational diabetes.
Please keep an eye out for our publications! For more information about the study, please email Principal Investigator Dr. Nicola Hawley (nicola.hawley@yale.edu).