| Autor: |
Savage JS; Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, USA., Moore AM; Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, USA., Kling SMR; Evaluation Sciences Unit, Division of Primary Care Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA., Marini M; Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, USA., Hernandez E; Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, USA., Franceschelli Hosterman J; Center for Nutrition and Weight Management, Geisinger, Danville, PA, USA., Hassink S; Nemours Children's Health (Emeritus), Wilmington, DE, USA., Paul IM; Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA., Bailey-Davis L; Population Health Sciences, Obesity Institute, Geisinger, Danville, PA, USA. |
| Abstrakt: |
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. |
