Sarah Marshall1,2,3, Sarah Taki4,5,6, Penny Love6,7, Yvonne Laird4, Marianne Kearney5, Nancy Tam5, Louise A Baur4,6,8, Chris Rissel4,6, Li Ming Wen4,5,6. 1. Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia. sarah.marshall@sydney.edu.au. 2. Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, 2037, Australia. sarah.marshall@sydney.edu.au. 3. The National Health and Medical Research Council Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia. sarah.marshall@sydney.edu.au. 4. Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia. 5. Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, 2037, Australia. 6. The National Health and Medical Research Council Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia. 7. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, 3216, Australia. 8. Sydney Medical School, University of Sydney, Camperdown, NSW, 2006, Australia.
Abstract
INTRODUCTION: Healthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life. To improve engagement with culturally and linguistically diverse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. The cultural adaptation process has been published separately. In this article, we aimed to evaluate the feasibility of the culturally adapted program. METHODS: In 2018-2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses). RESULTS: At recruitment, 176 mothers were eligible and consented to participate. Of 163 mothers who completed the baseline survey, 95% completed the program (n = 8 withdrew) and 83% completed the 6-month survey (n = 70 Arabic- and n = 65 Chinese-speaking mothers). Most mothers (n = 127, 78%) completed at least one nurse support call. The qualitative analysis of follow-up interviews with 42 mothers (22 Arabic- and 20 Chinese-speaking mothers) and 10 program delivery staff highlighted the perceived value of the program and the positive role of bi-cultural nurses and in-language resources. Mothers who completed more nurse support calls generally expressed greater acceptability. CONCLUSIONS: The culturally adapted Healthy Beginnings program was feasible to deliver and acceptable to Arabic- and Chinese-speaking mothers. Our results highlight the importance of in-language resources and individualised bi-cultural nurse support by telephone for supporting culturally and linguistically diverse migrant families with infant feeding and active play. These findings support the potential for program refinements and progression to an effectiveness trial.
INTRODUCTION: Healthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life. To improve engagement with culturally and linguistically diverse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. The cultural adaptation process has been published separately. In this article, we aimed to evaluate the feasibility of the culturally adapted program. METHODS: In 2018-2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses). RESULTS: At recruitment, 176 mothers were eligible and consented to participate. Of 163 mothers who completed the baseline survey, 95% completed the program (n = 8 withdrew) and 83% completed the 6-month survey (n = 70 Arabic- and n = 65 Chinese-speaking mothers). Most mothers (n = 127, 78%) completed at least one nurse support call. The qualitative analysis of follow-up interviews with 42 mothers (22 Arabic- and 20 Chinese-speaking mothers) and 10 program delivery staff highlighted the perceived value of the program and the positive role of bi-cultural nurses and in-language resources. Mothers who completed more nurse support calls generally expressed greater acceptability. CONCLUSIONS: The culturally adapted Healthy Beginnings program was feasible to deliver and acceptable to Arabic- and Chinese-speaking mothers. Our results highlight the importance of in-language resources and individualised bi-cultural nurse support by telephone for supporting culturally and linguistically diverse migrant families with infant feeding and active play. These findings support the potential for program refinements and progression to an effectiveness trial.
Entities:
Keywords:
Culture; Ethnicity; Health promotion; Implementation; Infant; Nutrition; Prevention
Authors: Jennifer A Woo Baidal; Lindsey M Locks; Erika R Cheng; Tiffany L Blake-Lamb; Meghan E Perkins; Elsie M Taveras Journal: Am J Prev Med Date: 2016-02-22 Impact factor: 5.043