PDF(Pubmed)
Abstract：
Rapid infant weight gain is associated with later obesity. Novel interventions to prevent rapid infant weight gain that are accessible to infants and families are needed, especially for those at the highest risk. Our aims were to examine: (a) feasibility and acceptability of a responsive parenting intervention delivered via Integrated Behavioral Health (IBH) in pediatric primary care and (b) preliminary effects on infant weight gain from birth to 6 (post-treatment) and 9 (follow-up) months.
A parallel design, proof-of-concept randomized control trial was conducted with 65 mother-infant dyads (32 randomized to intervention, 33 randomized an IBH attention control focused on promoting healthy mental health), in which the majority identify as Black (80%) and low income (91% receiving Medicaid). Participants and assessors were masked to treatment condition. Outcomes included feasibility (enrollment), acceptability (retention and adherence), and conditional weight gain (CWG), an indicator of rapid weight gain.
The intervention was feasible (90% of eligible families enrolled) and acceptable (89% of families retained), with 81% receiving ≥3 of 4 treatment sessions. A medium effect was found on CWG (d = -0.54 post-treatment, d = -0.57 follow-up), with the infants in the treatment group showing significantly lower CWG (mean = -0.27, 95% CI, -0.63, 0.09) compared to the control group (mean = 0.29, 95% CI, -0.17, 0.76) at 9 months (p = .04).
This study demonstrates the feasibility of implementing a responsive parenting obesity prevention intervention within primary care. Delivery in pediatric primary care is advantageous for implementation and reaching at-risk populations. The preliminary effects on CWG are promising and support testing in a larger trial.
A parallel design, proof-of-concept randomized control trial was conducted with 65 mother-infant dyads (32 randomized to intervention, 33 randomized an IBH attention control focused on promoting healthy mental health), in which the majority identify as Black (80%) and low income (91% receiving Medicaid). Participants and assessors were masked to treatment condition. Outcomes included feasibility (enrollment), acceptability (retention and adherence), and conditional weight gain (CWG), an indicator of rapid weight gain.
The intervention was feasible (90% of eligible families enrolled) and acceptable (89% of families retained), with 81% receiving ≥3 of 4 treatment sessions. A medium effect was found on CWG (d = -0.54 post-treatment, d = -0.57 follow-up), with the infants in the treatment group showing significantly lower CWG (mean = -0.27, 95% CI, -0.63, 0.09) compared to the control group (mean = 0.29, 95% CI, -0.17, 0.76) at 9 months (p = .04).
This study demonstrates the feasibility of implementing a responsive parenting obesity prevention intervention within primary care. Delivery in pediatric primary care is advantageous for implementation and reaching at-risk populations. The preliminary effects on CWG are promising and support testing in a larger trial.
摘要：
婴儿体重的快速增加与后来的肥胖有关。需要新的干预措施来防止婴儿和家庭可以获得的婴儿体重快速增加，尤其是那些风险最高的人。我们的目的是检查：（a）在儿科初级保健中通过综合行为健康（IBH）进行响应式育儿干预的可行性和可接受性，以及（b）从出生到6（治疗后）和9（随访）对婴儿体重增加的初步影响。
并行设计，概念验证随机对照试验是对65个母婴二元组进行的(32个随机接受干预，33随机分配IBH注意力控制，专注于促进健康的心理健康），其中大多数人认为是黑人(80%)和低收入(91%接受医疗补助)。参与者和评估者对治疗条件进行掩盖。结果包括可行性（注册），可接受性（保留和粘附性），和条件体重增加(CWG)，快速体重增加的指标。
干预措施是可行的（90%的符合条件的家庭登记）和可接受的（89%的家庭保留），81%接受4次治疗中≥3次。对CWG有中等影响(d=-0.54后处理，d=-0.57随访)，在9个月时，治疗组的婴儿CWG（平均值=-0.27，95％CI，-0.63，0.09）明显低于对照组（平均值=0.29，95％CI，-0.17，0.76）（p=.04）。
这项研究证明了在初级保健中实施积极的育儿肥胖预防干预的可行性。儿科初级保健中的分娩对于实施和到达高危人群是有利的。对CWG的初步影响是有希望的，并支持在更大的试验中进行测试。
并行设计，
干预措施是可行的（90%的符合条件的家庭登记）和可接受的（89%的家庭保留），
这项研究证明了在初级保健中实施积极的育儿肥胖预防干预的可行性。
