Alexander G Fiks1,2, Rachel S Gruver1, Chanelle T Bishop-Gilyard3,4, Justine Shults5, Senbagam Virudachalam1,2, Andrew W Suh1, Marsha Gerdes1,3, Gurpreet K Kalra6, Patricia A DeRusso2,7, Alexandra Lieberman1, Daniel Weng1, Michal A Elovitz8, Robert I Berkowitz3,4,2, Thomas J Power3,2,9. 1. 1 Division of General Pediatrics, The Children's Hospital of Philadelphia , Philadelphia, PA. 2. 5 Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA. 3. 3 Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia , Philadelphia, PA. 4. 4 Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA. 5. 2 Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA. 6. 6 Sloan Kettering Institute , Memorial Sloan Kettering Cancer Center, New York, NY. 7. 7 Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia , Philadelphia, PA. 8. 8 Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania , Philadelphia, PA. 9. 9 Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia , Philadelphia, PA.
Abstract
BACKGROUND: Few studies have addressed obesity prevention among low-income families whose infants are at increased obesity risk. We tested a Facebook peer-group intervention for low-income mothers to foster behaviors promoting healthy infant growth. METHODS: In this randomized controlled trial, 87 pregnant women (Medicaid insured, BMI ≥25 kg/m2) were randomized to the Grow2Gether intervention or text message appointment reminders. Grow2Gether participants joined a private Facebook group of 9-13 women from 2 months before delivery until infant age 9 months. A psychologist facilitated groups featuring a curriculum of weekly videos addressing feeding, sleep, parenting, and maternal well-being. Feasibility was assessed using the frequency and content of participation, and acceptability using surveys. Maternal beliefs and behaviors and infant growth were assessed at birth, 2, 4, 6, and 9 months. Differences in infant growth between study arms were explored. We conducted intention-to-treat analyses using quasi-least-squares regression. RESULTS: Eighty-eight percent (75/85) of intervention participants (42% (36/85) food insecure, 88% (75/85) black) reported the group was helpful. Participants posted 30 times/group/week on average. At 9 months, the intervention group had significant improvement in feeding behaviors (Infant Feeding Style Questionnaire) compared to the control group (p = 0.01, effect size = 0.45). Intervention group mothers were significantly less likely to pressure infants to finish food and, at age 6 months, give cereal in the bottle. Differences were not observed for other outcomes, including maternal feeding beliefs or infant weight-for-length. CONCLUSIONS: A social media peer-group intervention was engaging and significantly impacted certain feeding behaviors in families with infants at high risk of obesity.
RCT Entities:
BACKGROUND: Few studies have addressed obesity prevention among low-income families whose infants are at increased obesity risk. We tested a Facebook peer-group intervention for low-income mothers to foster behaviors promoting healthy infant growth. METHODS: In this randomized controlled trial, 87 pregnant women (Medicaid insured, BMI ≥25 kg/m2) were randomized to the Grow2Gether intervention or text message appointment reminders. Grow2Gether participants joined a private Facebook group of 9-13 women from 2 months before delivery until infant age 9 months. A psychologist facilitated groups featuring a curriculum of weekly videos addressing feeding, sleep, parenting, and maternal well-being. Feasibility was assessed using the frequency and content of participation, and acceptability using surveys. Maternal beliefs and behaviors and infant growth were assessed at birth, 2, 4, 6, and 9 months. Differences in infant growth between study arms were explored. We conducted intention-to-treat analyses using quasi-least-squares regression. RESULTS: Eighty-eight percent (75/85) of intervention participants (42% (36/85) food insecure, 88% (75/85) black) reported the group was helpful. Participants posted 30 times/group/week on average. At 9 months, the intervention group had significant improvement in feeding behaviors (Infant Feeding Style Questionnaire) compared to the control group (p = 0.01, effect size = 0.45). Intervention group mothers were significantly less likely to pressure infants to finish food and, at age 6 months, give cereal in the bottle. Differences were not observed for other outcomes, including maternal feeding beliefs or infant weight-for-length. CONCLUSIONS: A social media peer-group intervention was engaging and significantly impacted certain feeding behaviors in families with infants at high risk of obesity.
Entities:
Keywords:
Internet; behavior change; infant; mHealth; prevention; social media
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