Pro-Change Behavior Systems, Inc. has developed a prototype version of a computer-tailored multiple behavior intervention to promote health during pregnancy. Healthy Pregnancy: Step by Step is an interactive program that addresses smoking cessation and maintenance, stress management, and healthy eating, all three of which are critical health behaviors for a healthy pregnancy and positive birth outcomes. A pilot test was conducted during the summer of 2008 with 87 women at three locations of the Community Health Center, Inc. of Connecticut. The overwhelming majority of women (90%) rated the program exceptionally high on all fourteen evaluation items including that the program could help them be healthier, that they learned new information about having a healthy pregnancy, and that they would recommend the program to a friend. In addition, after the one session pilot program women reported recognizing increased benefits to changing their health behaviors and intention to make behavioral changes. Participants reported planning to smoke fewer cigarettes, to increase effective stress management, and to eat more servings of fruits and vegetables each day.

The ease by which the Community Health Center was able to recruit participants, the ability for the program to be incorporated easily into prenatal care, the comfortableness of participants with using the computer program, and enthusiasm expressed during key informant interviews all lend to the feasibility of dissemination this program. The positive acceptability and feasibility results of the pilot test build confidence both that the program can be effective at impacting the health behaviors of women at a critical time and that it can be disseminated easily on a population-basis through several distribution channels. Dr. Daren Anderson, M.D., served as an advisory council member, and identified the program as, “a brilliant, scalable, and operational program.”

This research was funded by the Centers for Disease Control and Prevention. Pro-Change is preparing a grant proposal to apply for Phase II funding to complete and enhance the development of the intervention and to test it in a clinical effectiveness trial. The Phase II product will include multiple time points and a Spanish module for the computer-based program, in addition to print-based individualized reports and a stage-based behavior change manual. Once proven effective, this program can be disseminated for use in health clinics and provider offices throughout the country, as well as through health promotion and wellness organizations. Stage-based manuals for smoking cessation, healthy eating, stress management, and depression prevention designed specifically for pregnant and postpartum women will be available for purchase in December. For more information, or for a demonstration of this program, please contact Janice M. Prochaska, President and CEO at

UPDATE: A guided demonstration of the healthy pregnancy pilot program is now available.