Healthy Mom Zone Gestational Weight Gain Management Intervention 2.0

Inclusion Criteria:

• Pregnant women

• ≥ 8 and < 18 weeks gestation at time of screening. This range of gestational age ischosen to: a) reduce chances of false pregnancy or miscarriage under 8 weeksgestation and b) recruit women in the 1st trimester for greatest impact of theintervention on gestational weight gain. In the feasibility and initial impactstudy, the investigators had less than 10% (n=3) miscarriages prior to randomizationusing these criteria

• Singleton gestation

• Not currently heavily smoking (>20 cigarettes/day)

• Any parity (i.e., first-time pregnancy, second pregnancy, etc.)

• Any race/ethnicity

• Ages 18-45 years

• Overweight or obese: body mass index (BMI) range 24.0 to 45.0. If BMI is over 40,consultation with woman's health care provider will be made to determine eligibilityand ensure she does not have any contraindications to physical activity or otherconcerns with intervention participation.

• Haven't exceeded 25% or more of their total GWG (based on BMI and IOM guidelines)from pre-pregnancy to date of enrollment.

• Participant has physician consent to confirm subject participation

• Able to read, understand, and speak English

• Access to a computer/phone

• Willingness and ability to complete study materials and intervention sessionselectronically (e.g., email, Facetime, Zoom), at home (e.g., Zoom sessions deliveredsynchronous and asynchronous) or if requested by the participant, on-site at PennState University Park or Hershey campuses.

• No current use of weight loss medications

• No current participation in another interventional study or program that influencesweight control

• No planned bariatric surgery during this current pregnancy

• No absolute contraindications to exercise in pregnancy and relativecontraindications with provider consent (see below)

Exclusion Criteria:

• Not pregnant women

• Men (unable to become pregnant)

• Multiple gestation

• < 8 weeks gestation or > 18 weeks gestation at time of pre-intervention assessment

• Currently smoking > 20 cigarettes/day

• Outside of the age range of 18-45 years

• Outside of the BMI range of 24.0-45.0

• Exceeded 25% of their total GWG (based on BMI and IOM guidelines) from pre-pregnancyto date of enrollment

• Not able to read and/or understand English

• Unable to access materials by computer or phone (even with data plan assistance ifnecessary)

• Current use of weight loss medications

• Current participation in another interventional study or program that influencesweight control

• Planned bariatric surgery during this current pregnancy

• Contraindications to aerobic exercise in pregnancy:

Absolute contraindications to exercise:

• Hemodynamically significant heart disease

• Restrictive lung disease (pulmonary fibrosis, sarcoidosis, pleural effusion,neuromuscular disease). This DOES NOT include ASTHMA

• Incompetent cervix/cerclage

• Severe anemia

• Multiple gestation at risk for premature labor

• Persistent 2nd or 3rd trimester bleeding

• Placenta previa after 26 weeks gestation

• Premature labor during the current pregnancy

• Ruptured membranes

• Poorly controlled chronic hypertension

• Preeclampsia diagnosis during current pregnancy

• Poorly controlled Type 1 diabetes

Relative contraindications to exercise (if permission is not given by provider):

• Unevaluated maternal cardiac arrhythmia

• Chronic bronchitis

• Extreme morbid obesity (BMI > 40.0; needs provider consent to participate)

• Extreme underweight (BMI < 12.0)

• History of extremely sedentary lifestyle

• Current eating disorder(s) diagnosis

• Severe food allergies and/or dietary restrictions that may preclude studyparticipation.

• Intrauterine growth restriction in current pregnancy

• Poorly controlled respiratory disorder (severe asthma) that precludes studyparticipation

• Orthopedic limitations

• Poorly controlled seizure disorder

• Poorly controlled thyroid disease

• Uncontrolled sleep disorder (insomnia, sleep-disordered breathing)