Evaluation of the Olo Prenatal Nutrition Follow-up Care for Vulnerable Pregnant Women

Publication: Canadian Journal of Dietetic Practice and Research
23 May 2023

Abstract

Olo nutritional follow-up care offers vulnerable pregnant women food vouchers, multivitamin supplements, tools, and nutritional counselling to support healthy pregnancy outcomes.
Purpose: To evaluate the contribution of Olo follow-up care to nutritional intakes and eating practices, as well as to assess the programme-related experience of participants.
Methods: Participants (n = 30) responded to questionnaires and web-based 24-hour dietary recalls and participated in a semi-structured interview (n = 10).
Results: Olo follow-up care reduced the proportion of participants below the recommended intake for groups for many micronutrients, with the greatest reduction for folate (by 96.7%), vitamin D (by 93.3%), iron (by 70.0%), calcium (by 50.0%), and zinc (by 30.0%), mainly due to the prenatal multivitamin supplements. Most participants (96.7%) did not follow Olo’s typical recommendations but, if they had, hypothetically they would have consumed an average of 746 additional calories per day and be above the recommendations for excessive intakes of folic acid and iron (100% and 33.3%, respectively). More than half of the participants were moderately to severely food insecure. Olo contributed to reducing the impact of isolation and increased food accessibility and budget flexibility among participants.
Conclusion: Olo follow-up care helped reduce the proportion of women below the recommended intake for micronutrients, but revising the food offered and strategies to address food insecurity may be necessary.

Résumé

Le suivi nutritionnel Olo offre aux femmes enceintes vulnérables des coupons alimentaires, des suppléments de multivitamines, des outils et du counseling nutritionnels pour favoriser des issues de grossesse positives.
Objectif. Évaluer la contribution du suivi Olo aux apports nutritionnels et aux pratiques alimentaires, ainsi qu’exposer les expériences du programme telles que vécues par les participantes.
Méthodes. Les participantes (n = 30) ont répondu à des questionnaires et des rappels alimentaires de 24 heures en ligne et ont participé à un entretien semi-structuré (n = 10).
Résultats. Le suivi a permis de réduire la proportion de participantes sous les apports recommandés pour les groupes pour de nombreux micronutriments, notamment pour le folate (de 96.7 %), la vitamine D (de 93,3 %), le fer (de 70,0 %), le calcium (de 50,0 %) et le zinc (de 30,0 %), principalement en raison de l’utilisation de multivitamines prénatales. La plupart des participantes (96,7 %) n’ont pas suivi les recommandations Olo, mais si elles l’avaient fait, elles auraient hypothétiquement consommé en moyenne 746 calories supplémentaires par jour et seraient au-dessus des recommandations d’apports excessifs en acide folique et en fer (100 % et 33,3 %, respectivement). Plus de la moitié des participantes étaient en insécurité alimentaire modérée à sévère. Olo a contribué à réduire l’impact de l’isolement, ainsi qu’à augmenter l’accessibilité des aliments et la flexibilité budgétaire chez les participantes.
Conclusion. Le suivi Olo a contribué à réduire la proportion de femmes sous les apports recommandés en micronutriments, cependant, il y aurait lieu de revoir les aliments proposés et les stratégies pour contrer l’insécurité alimentaire.

Get full access to this article

View all available purchase options and get full access to this article.

Funding: This research received external funding from the Olo Foundation.
Conflicts of interest: The authors declare no conflict of interest.

REFERENCES

1
Ravelli GP, Stein ZA, and Susser MW. Obesity in Young Men after Famine Exposure in Utero and Early Infancy. N Engl J Med. 1976 Aug 12;295(7):349–353.
2
Roseboom TJ, van der Meulen JHP, Ravelli ACJ, Osmond C, Barker DJP, and Bleker OP. Effects of prenatal exposure to the Dutch famine on adult disease in later life: an overview. Mol Cell Endocrinol. 2001 Dec 20;185(1):93–98.
3
World Health Organization. Malnutrition [Internet]. [cited 2022 Jul 15]. Available from: https://www.who.int/news-room/questions-and-answers/item/malnutrition
4
Government of Canada. The Direct Economic Burden of Socio-Economic Health Inequalities in Canada. Ottawa (ON): Public Health Agency of Canada; 2016.
5
A joint initiative of the Public Health Agency of Canada, the Pan-Canadian Public Health Network, Statistics Canada and the Canadian Institute of Health Information. Pan-Canadian Health Inequalities Data Tool, 2017 Edition [Internet]. 2019 Nov [cited 2020 Mar 9]. Available from: https://health-infobase.canada.ca/health-inequalities/data-tool/index
6
Institute of Medicine (US) Committee on Dietary Risk Assessment in the WIC. Evidence of Dietary Risk Among Low-Income Women and Children [Internet]. Dietary Risk Assessment in the WIC Program. Washington (DC): National Academies Press, 2002 [cited 2021 Oct 31]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK220566/
7
Fox M, Hamilton W, and Lin B. Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 3, Literature Review. In: Food Assistance and Nutrition Research Report No 19-3. Washington: U.S.: Department of Agriculture, Economic Research Service; 2004.
8
Department of Health, Social Services and Public Safety. Healthy Start [Internet]. n.d. [cited 2017 Oct 31]. Available from: https://www.healthystart.nhs.uk/
9
Stevens B, Buettner P, Watt K, Clough A, Brimblecombe J, and Judd J. The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis. Matern Child Nutr. 2015 Oct 1;11(4):415–432.
10
Haider BA and Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2017;4(CD004905).
11
Kramer MS, Séguin L, Lydon J, and Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol. 2000 Jul 1;14(3):194–210.
12
Richard C, Badlissi D, and Cousineau A. Évaluation du programme OLO dans les centres de santé et de services sociaux du Québec. Joliette: Fondation OLO et Agence de la santé et des services sociaux de Lanaudière, Direction de santé publique et d’évaluation, Service de surveillance, recherche et évaluation et Service prévention-promotion; 2011 p. 86.
13
Fondation Olo. Rapport annuel 2018-2019 [Internet]. 2019 [cited 2020 Aug 2]. Available from: https://fondationolo.ca/wp-content/uploads/2019/06/fondation-olo-rapport-annuel-2018-2019.pdf
14
Haeck C and Lefebvre P. A simple recipe: The effect of a prenatal nutrition program on child health at birth. Labour Econ. 2016 Aug 1;41:77–89.
15
Creswell J and Plano Clark V. Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage; 2006.
16
Hertzog MA. Considerations in Determining Sample Size for Pilot Studies. Res Nurs Health. 2008;31:180–91.
17
Harris P, Taylor R, Minor B, Elliott V, Fernandez M, and O’Neal L et al. The REDCap consortium: Building an international community of software partners. J Biomed Inf. 2019 May 9;
18
Health Canada. Canadian Community Health Survey, Cycle 2.2, Nutrition 2004 Income-Related Household Food Security in Canada [Internet]. Canadian Community Health Survey. 2007 [cited 2019 Sep 3]. Available from: https://www.canada.ca/en/health-canada/services/food-nutrition/food-nutrition-surveillance/health-nutrition-surveys/canadian-community-health-survey-cchs/canadian-community-health-survey-cycle-2-2-nutrition-2004-income-related-household-food-security-canada-health-canada-2007.html#appa
19
Leclerc BS et al. Évaluation de l’approche « 1000 jours pour savourer la vie » de la Fondation Olo, Montréal, Centre de recherche et de partages des savoirs InterActions, Centre intégré universitaire de santé et de services sociaux du Nord-de-l’Île-de-Montréal, 2020, 116 p. Available from: https://fondationolo.ca/wp-content/uploads/2022/05/2020-interactions-evaluation-1000-jours-pour-savourer-la-vieversion-finale.pdf
20
Jacques S, Lemieux S, Lamarche B, Laramée C, Corneau L, and Lapointe A et al. Development of a Web-Based 24-h Dietary Recall for a French-Canadian Population. Nutrients. 2016 Nov 15;8(11):724.
21
Savard C, Lemieux S, Lafrenière J, Laramée C, Robitaille J, and Morisset AS. Validation of a self-administered web-based 24-hour dietary recall among pregnant women. BMC Pregnancy Childbirth. 2018 23;18(1):112.
22
Institute of Medicine. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. National Academies Press; 2006. 1344 p.
23
USDA-FNS. WIC Food Packages - Regulatory Requirements for WIC-Eligible Foods [Internet]. 2013 [cited 2021 May 26]. Available from: https://www.fns.usda.gov/wic/wic-food-packages-regulatory-requirements-wic-eligible-foods
24
Swensen AR, Harnack LJ, and Ross JA. Nutritional Assessment of Pregnant Women Enrolled in the Special Supplemental Program for Women, Infants, and Children (WIC). J Am Diet Assoc. 2001 Aug 1;101(8):903–08.
25
Endres J, Sawicki M, and Casper J. Dietary assessment of pregnant women in a supplemental food program. J Am Diet Assoc. 1981;79:121–26.
26
Rush D, Leighton J, Sloan N, Alvir J, and Garbowski G. The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. II. Review of past studies of WIC. Am J Clin Nutr. 1988 Sep 1;48:394–411.
27
Rush D, Sloan NL, Leighton J, Alvir JM, Horvitz DG, and Seaver WB et al. The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. V. Longitudinal study of pregnant women. Am J Clin Nutr. 1988 Aug 1;48(2):439–83.
28
Jarman M, Yuan Y, Pakseresht M, Shi Q, Robson PJ, and Bell RC et al. Patterns and trajectories of gestational weight gain: a prospective cohort study. CMAJ Open. 2016 Jun 23;4(2):E338–45.
29
Morisset AS, Dubois L, Colapinto CK, Luo ZC, and Fraser WD. Prepregnancy Body Mass Index as a Significant Predictor of Total Gestational Weight Gain and Birth Weight. Can J Diet Pract Res Publ Dietit Can Rev Can Prat Rech En Diet Une Publ Diet Can. 2017 01;78(2):66–73.
30
Begum F, Colman I, McCargar LJ, and Bell RC. Gestational weight gain and early postpartum weight retention in a prospective cohort of Alberta women. J Obstet Gynaecol Can. 2012 Jul;34(7):637–47.
31
Paul KH, Graham ML, and Olson CM. The Web of Risk Factors for Excessive Gestational Weight Gain in Low Income Women. Matern Child Health J. 2013 Feb;17(2):344–51.
32
Household Food Insecurity in Canada [Internet]. PROOF. [cited 2021 Nov 1]. Available from: https://proof.utoronto.ca/food-insecurity/
33
Kupis J, Johnson S, Hallihan G, and Olstad DL. Assessing the Usability of the Automated Self-Administered Dietary Assessment Tool (ASA24) among Low-Income Adults. Nutrients [Internet]. 2019 Jan 10 [cited 2020 Apr 4];11(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357069/.
34
Brassard D, Laramée C, Robitaille J, Lemieux S, and Lamarche B. Differences in Population-Based Dietary Intake Estimates Obtained From an Interviewer-Administered and a Self-Administered Web-Based 24-h Recall. Front Nutr. 2020;7:137.
35
Thompson FEKirkpatrick SIKrebs-Smith SMReedy JSchap TESubar AF et al. The National Cancer Institute’s Dietary Assessment Primer: A Resource for Diet Research. J Acad Nutr Diet. 2015 Dec;115(12):1986–95.
36
Herrick KA, Rossen LM, Parsons R, and Dodd KW. Estimating Usual Dietary In take From National Health and Nutrition Examination Survey Data Using the National Cancer Institute Method. Vital Health Stat 2. 2018 Feb;(178):1–63.
37
Brassard D, Fulgoni VL, Robitaille J, Lemieux S, and Lamarche B. Examining the Advantages of Using Multiple Web-Based Dietary Assessment Instruments to Measure Population Dietary Intake: The PREDISE Study. Curr Dev Nutr. 2019 May;3(5):3005005.
38
Hambidge KM and Krebs NF. Strategies for optimizing maternal nutrition to promote infant development. Reprod Health. 2018 Jun 22;15(1):87.
39
Hardcastle SJ, Thøgersen-Ntoumani C, and Chatzisarantis NL. Food Choice and Nutrition: A Social Psychological Perspective. Nutrients. 2015 Oct;7(10):8712–15.

Supplementary Material

File (cjdpr-2023-006suppla.pdf)
File (cjdpr-2023-006supplb.docx)

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 85Number 1March 2024
Pages: 2 - 11
Editor: Naomi Cahill

History

Version of record online: 23 May 2023

Key Words

  1. nutrition assessment
  2. pregnancy
  3. prenatal care
  4. social determinants of health
  5. poverty
  6. Supplemental Nutrition Assistance Program

Mots-clés

  1. évaluation nutritionnelle
  2. grossesse
  3. soins prénataux
  4. déterminants sociaux de la santé
  5. pauvreté
  6. programme nutritionnel d’assistance alimentaire

Authors

Affiliations

Noémie Charpentier RD, MSc
Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON
Alex Dumas PhD
School of Human Kinetics, University of Ottawa, Ottawa, ON
Anne-Sophie Morisset RD, PhD
École de nutrition, Université Laval, Québec, QC
Bénédicte Fontaine-Bisson RD, PhD
School of Nutrition Sciences, University of Ottawa, Ottawa, ON
Institut du savoir Montfort, Montfort Hospital, Ottawa, ON

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

Cited by

1. Celebrating the Impact and Contribution of Dietitians

View Options

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media