Jennifer S Savage, Amy M Moore, Samantha M R Kling, Michele Marini, Erika Hernandez, Jennifer Franceschelli Hosterman, Sandra Hassink, Ian M Paul, Lisa Bailey-Davis
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General linear models examined intervention effects on infant conditional weight gain scores, weight-for-age <i>z</i> scores, BMI, and overweight status (BMI-for-age ≥85th percentile) from birth to age 6 months, and mothers' use of food to soothe from age 2 to 6 months. <b><i>Results:</i></b> There were no intervention effects on infant conditional weight gain scores or overweight status at 6 months. Infants in the RP intervention had lower mean weight-for-age <i>z</i> scores [<i>M</i> = -0.04, standard error (SE) = 0.04 vs. <i>M</i> = 0.05, SE = 0.04; <i>p</i> = 0.008] and lower mean BMI (<i>M</i> = 16.05, SE = 0.09 vs. <i>M</i> = 16.24, SE = 0.09; <i>p</i> = 0.03) compared with standard care. Mothers' use of emotion-based food to soothe was lower in the RP intervention compared with standard care from age 2 to 6 months [<i>M</i> difference = -0.32, standard deviation (SD) = 0.81 vs. 0.00, SD = 0.90; <i>p</i> = 0.01]. <b><i>Conclusions:</i></b> This pragmatic, patient-centered RP intervention did not reduce rapid infant weight gain or overweight but was associated with modestly lower infant BMI and reduced mothers' use of emotion-based food to soothe. <b>Trial Registration:</b> clinicaltrials.gov identifier: NCT03482908.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Coordination Between Primary Care and Women, Infants, and Children to Prevent Obesity for Infants from Low-Income Families: A Pragmatic Randomized Clinical Trial.\",\"authors\":\"Jennifer S Savage, Amy M Moore, Samantha M R Kling, Michele Marini, Erika Hernandez, Jennifer Franceschelli Hosterman, Sandra Hassink, Ian M Paul, Lisa Bailey-Davis\",\"doi\":\"10.1089/chi.2022.0137\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Rapid weight gain during infancy is associated with risk for later obesity, yet little research to date has examined the effect of a responsive parenting (RP) intervention with care coordination between pediatric primary care providers and Women, Infants, and Children nutritionists on infant weight. <b><i>Methods:</i></b> The Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study is a pragmatic, randomized clinical trial for mothers and infants (<i>n</i> = 288) designed to examine the effect of a patient-centered RP intervention that used advanced health information technology strategies to coordinate care to reduce rapid infant weight gain compared with standard care. General linear models examined intervention effects on infant conditional weight gain scores, weight-for-age <i>z</i> scores, BMI, and overweight status (BMI-for-age ≥85th percentile) from birth to age 6 months, and mothers' use of food to soothe from age 2 to 6 months. <b><i>Results:</i></b> There were no intervention effects on infant conditional weight gain scores or overweight status at 6 months. Infants in the RP intervention had lower mean weight-for-age <i>z</i> scores [<i>M</i> = -0.04, standard error (SE) = 0.04 vs. <i>M</i> = 0.05, SE = 0.04; <i>p</i> = 0.008] and lower mean BMI (<i>M</i> = 16.05, SE = 0.09 vs. <i>M</i> = 16.24, SE = 0.09; <i>p</i> = 0.03) compared with standard care. Mothers' use of emotion-based food to soothe was lower in the RP intervention compared with standard care from age 2 to 6 months [<i>M</i> difference = -0.32, standard deviation (SD) = 0.81 vs. 0.00, SD = 0.90; <i>p</i> = 0.01]. <b><i>Conclusions:</i></b> This pragmatic, patient-centered RP intervention did not reduce rapid infant weight gain or overweight but was associated with modestly lower infant BMI and reduced mothers' use of emotion-based food to soothe. <b>Trial Registration:</b> clinicaltrials.gov identifier: NCT03482908.</p>\",\"PeriodicalId\":48842,\"journal\":{\"name\":\"Childhood Obesity\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Childhood Obesity\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/chi.2022.0137\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/11/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Childhood Obesity","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/chi.2022.0137","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
背景:婴儿期体重快速增加与后期肥胖的风险相关,但迄今为止很少有研究调查反应性育儿(RP)干预与儿科初级保健提供者和妇女、婴儿和儿童营养学家之间的护理协调对婴儿体重的影响。方法:妇女、婴儿和儿童对婴儿早期健康生活方式的增强(WEE Baby)护理研究是一项实用的、针对母亲和婴儿的随机临床试验(n = 288),旨在检验以患者为中心的RP干预的效果,该干预使用先进的卫生信息技术策略来协调护理,以减少与标准护理相比婴儿体重的快速增加。一般线性模型检验了干预对婴儿出生至6个月的条件体重增加评分、年龄体重z评分、BMI和超重状态(BMI年龄≥85百分位数)的影响,以及母亲在2至6个月期间使用食物抚慰的影响。结果:干预对婴儿条件体重增加评分或6个月时的超重状况没有影响。RP干预组婴儿的平均年龄体重z得分较低[M = -0.04,标准误差(SE) = 0.04, M = 0.05, SE = 0.04;p = 0.008)和较低的平均BMI (M = 16.05, SE = 0.09和M = 16.24, SE = 0.09;P = 0.03)。2 ~ 6个月时,RP干预中母亲使用基于情绪的食物进行安抚的比例低于标准护理[M差= -0.32,标准差(SD) = 0.81 vs. 0.00, SD = 0.90;p = 0.01]。结论:这种实用的、以患者为中心的RP干预并没有减少婴儿体重的快速增加或超重,但与婴儿体重指数的适度降低和母亲使用基于情绪的食物来安抚有关。试验注册:clinicaltrials.gov标识符:NCT03482908。
Coordination Between Primary Care and Women, Infants, and Children to Prevent Obesity for Infants from Low-Income Families: A Pragmatic Randomized Clinical Trial.
Background: Rapid weight gain during infancy is associated with risk for later obesity, yet little research to date has examined the effect of a responsive parenting (RP) intervention with care coordination between pediatric primary care providers and Women, Infants, and Children nutritionists on infant weight. Methods: The Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study is a pragmatic, randomized clinical trial for mothers and infants (n = 288) designed to examine the effect of a patient-centered RP intervention that used advanced health information technology strategies to coordinate care to reduce rapid infant weight gain compared with standard care. General linear models examined intervention effects on infant conditional weight gain scores, weight-for-age z scores, BMI, and overweight status (BMI-for-age ≥85th percentile) from birth to age 6 months, and mothers' use of food to soothe from age 2 to 6 months. Results: There were no intervention effects on infant conditional weight gain scores or overweight status at 6 months. Infants in the RP intervention had lower mean weight-for-age z scores [M = -0.04, standard error (SE) = 0.04 vs. M = 0.05, SE = 0.04; p = 0.008] and lower mean BMI (M = 16.05, SE = 0.09 vs. M = 16.24, SE = 0.09; p = 0.03) compared with standard care. Mothers' use of emotion-based food to soothe was lower in the RP intervention compared with standard care from age 2 to 6 months [M difference = -0.32, standard deviation (SD) = 0.81 vs. 0.00, SD = 0.90; p = 0.01]. Conclusions: This pragmatic, patient-centered RP intervention did not reduce rapid infant weight gain or overweight but was associated with modestly lower infant BMI and reduced mothers' use of emotion-based food to soothe. Trial Registration: clinicaltrials.gov identifier: NCT03482908.
期刊介绍:
Childhood Obesity is the only peer-reviewed journal that delivers actionable, real-world obesity prevention and weight management strategies for children and adolescents. Health disparities and cultural sensitivities are addressed, and plans and protocols are recommended to effect change at the family, school, and community level. The Journal also reports on the problem of access to effective healthcare and delivers evidence-based solutions to overcome these barriers.