Conceptualization and Development of a Theory-Based Healthful Eating and Physical Activity Intervention for Postpartum Women Who Are Low Income

¹ codirector of Obesity Research at Children's Hospital Boston and instructor in pediatrics at Harvard Medical School in Boston.
² director of the Food Stamp Nutrition Education Program at the University of Maryland in Columbia.
³ the director of the Center for Community-Based Research at Dana-Farber Cancer Institute, and a professor at Harvard School of Public Health's Department of Society, Human Development and Health in Boston.
⁴ doctoral candidate in the Department of Society, Human Development and Health at the Harvard School of Public Health, Boston.
⁵ professor in the Department of Epidemiology and Biostatistics, Arnold School of Public Health at the University of South Carolina in Columbia and the director of the South Carolina Statewide Cancer Prevention & Control Program based at the Hollings Cancer Center, Medical University of South Carolina in Charleston.
⁶ project manager at the Institute for Community Health Promotion at Brown University, in Providence, Rhode Island.
⁷ director of public health nutrition and associate professor of nutrition and of society, human development and health at the Harvard School of Public Health, in Boston.

^* To whom correspondence should be addressed.

	Abstract

Eating and physical activity behaviors that confer risk for chronic disease are prominent among women from varying ethnic and racial groups who are low income. Conceptualization and development of a theory-based behavioral intervention to address their unique needs during the first year following childbirth comprised four steps: (a) translating public health guidelines and emerging epidemiologic data into specific intervention messages; (b) developing practical strategies to operationalize theoretical constructs, in the context of a social ecological framework; (c) stating achievement-based objectives and writing scripts for five home visits; and (d) conducting formative research. Focus group participants expressed a desire for a "health mentor," not somebody who "nags" or "stresses you out." Paraprofessionals from the Expanded Food and Nutrition Education Program (EFNEP) were directly involved in pretesting the intervention and remain involved as health mentors. This intervention can serve as a basis for future organizational partnerships to benefit the health of populations who are low income.

Key Words: ethnic groups, health education, maternal nutrition

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