目的:研究儿童早期肥胖预防计划的文化适应是否促进健康的婴儿喂养实践。
方法:前瞻性的准实验研究,研究了在联邦合格的健康中心为华裔美国父母子女双体(N=298)提供的肥胖预防计划的社区参与的多相文化适应。在一组历史控件中,我们评估了早期婴儿喂养方法(母乳喂养,含糖饮料的摄入量)在6个月大的婴儿中,然后在早期固体食物喂养实践中采用相同的做法(断奶瓶,水果,蔬菜,含糖或咸零食消费)在12个月的孩子中。实施后,我们在6个月和12个月时在干预队列组中评估了这些实践.我们使用横断面分组比较和调整回归分析来评估组间差异。
结果:在6个月时,干预组摄入无糖饮料的几率增加(aOR:5.69[95%CI:1.65,19.63],p=0.006)。12个月时,干预组无糖饮料摄入的几率也增加(aOR:15.22[95%CI:6.33,36.62],p<0.001),奶瓶断奶几率增加(OR:2.34[95%CI:1.05,5.23],p=0.03),含糖零食消费的几率降低(OR:0.36[0.18,0.70],p=0.003)。我们没有发现母乳喂养的改善,水果,蔬菜,或咸零食消费。
结论:针对低收入的华裔移民家庭,基于初级保健的教育肥胖预防计划的文化适应与某些健康的婴儿喂养方式有关。未来的研究应该评估更强化干预措施的文化适应性,更好地解决母乳喂养等复杂的喂养方式,并评估长期体重结果。
OBJECTIVE: To examine whether a cultural adaptation of an early childhood obesity prevention program promotes healthy infant feeding practices.
METHODS: Prospective quasi-experimental study of a community-engaged multiphasic cultural adaptation of an obesity prevention program set at a federally qualified health center serving immigrant Chinese American parent-child dyads (N=298). In a group of historical controls, we assessed early infant feeding practices (breastfeeding, sugar-sweetened beverage intake) in 6-month-olds and then the same practices alongside early solid food feeding practices (bottle weaning, fruit, vegetable, sugary or salty snack consumption) in 12-month-olds. After implementation, we assessed these practices in an intervention cohort group at 6 and 12 months. We used cross-sectional groupwise comparisons and adjusted regression analyses to evaluate group differences.
RESULTS: At 6 months, the intervention group had increased odds of no sugar-sweetened beverage intake (aOR: 5.69 [95% CI: 1.65, 19.63], p=0.006). At 12 months, the intervention group also had increased odds of no sugar-sweetened beverage intake (aOR: 15.22 [95% CI: 6.33, 36.62], p<0.001), increased odds of bottle weaning (aOR: 2.34 [95% CI: 1.05, 5.23], p=0.03), and decreased odds of sugary snack consumption (aOR: 0.36 [0.18, 0.70], p= 0.003). We did not detect improvements in breastfeeding, fruit, vegetable, or salty snack consumption.
CONCLUSIONS: A cultural adaptation of a primary care-based educational obesity prevention program for immigrant Chinese American families with low-income is associated with certain healthy infant feeding practices. Future studies should evaluate cultural adaptations of more intensive interventions that better address complex feeding practices like breastfeeding and evaluate long-term weight outcomes.