1. Introduction
weight gain, txt4two
txt4two is a multi-modality intervention promoting healthy pregnancy nutrition, physical activity (PA), and gestational weight gain (GWG), which had been previously evaluated in a pilot randomized controlled trial (RCT). This study aimed to evaluate a pragmatic implementation of an adapted version of txt4two in a public tertiary hospital. Using a consecutive cohort design, txt4two was delivered to women with a pre-pregnancy BMI > 25 kg/mSuboptimal antenatal health behaviors, including diet quality and physical activity, and excess gestational weight gain (GWG) are associated with negative pregnancy-related and long-term health outcomes for both the mother and offspring. These include the increased risk of caesarean sections [In Queensland, Australia, between 30% to 100% of women (depending on their body mass index (BMI) category) gain more weight than recommended during pregnancy [A recent systematic review and meta-analysis noted that weighing, as a stand-alone intervention, does not reduce excess GWG [Since the opening of the new Mater Mothers’ Hospital (MMH) in Queensland, Australia, in 2008, a number of service delivery initiatives have been developed, implemented, and evaluated to meet the identified nutrition needs of women attending the service [The next service priority for the MMH was the development of personally tailored strategies to support women to improve diet quality and decrease excess GWG. This priority is to be realized through exploring the potential of broad reach/low intensity methods of delivery, such as digital health approaches. When these approaches are embedded in maternity service, they can offer the opportunity for tailored messages that provide information and resources to facilitate knowledge acquisition and behavior change. This approach may help to clarify the complexity women experience from the ‘noise’ of social media and traditional media by offering evidence-based messages from trusted health services in more accessible modalities [The program to be adopted and adapted is the txt4two program [The aim of this current study was to evaluate the pragmatic implementation of an adapted and site-specific version of the txt4two program into the MMH antenatal nutrition and dietetic service. The outcomes provide further understanding of implementing an intervention in a system with a different service infrastructure to the original research context [