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Randomized controlled trial of an early child obesity prevention intervention: Impacts on infant tummy time
Rachel S Gross1, Alan L Mendelsohn2,3, H Shonna Yin3,4
1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA.
Insights
Infant tummy time and floor activity were low, but a primary care intervention improved these key obesity prevention behaviors in low-income Hispanic families. This highlights the potential of early intervention programs.
Area of Science:
- Pediatrics
- Public Health
- Obesity Prevention
Background:
- Infant physical activity, including tummy time and floor play, is crucial for healthy development and obesity prevention.
- Low-income and Hispanic populations often face unique barriers to accessing resources that promote early childhood physical activity.
Purpose of the Study:
- To describe infant activity levels at 3 months of age.
- To evaluate the effectiveness of a primary care-based intervention, "Starting Early," in promoting infant physical activity among low-income Hispanic families.
Main Methods:
- A randomized controlled trial involving 533 mother-infant dyads compared a control group with an intervention group receiving nutrition counseling and parenting support.
- Infant activity was measured by tummy time, unrestrained floor time, and time in movement-restricting devices.
- Health literacy was assessed using the Newest Vital Sign.
Main Results:
- At 3 months, only 32.0% practiced floor tummy time and 34.4% had unrestrained floor time; 56.4% spent ≥1 hour daily in restricting devices.
- Inadequate health literacy was linked to reduced tummy time and floor time.
- The intervention group showed significantly more floor tummy time (OR 2.16) and unrestrained floor time (OR 1.69) than controls.
Conclusions:
- Infant engagement in tummy time and unrestrained floor time was notably low.
- Primary care-based obesity prevention programs demonstrate potential for increasing these essential early childhood activities.
Objective:
To describe infant activity at 3 months old and to test the efficacy of a primary care-based child obesity prevention intervention on promoting infant activity in low-income Hispanic families.
Methods:
This study was a randomized controlled trial (n = 533) comparing a control group of mother-infant dyads receiving standard prenatal and pediatric primary care with an intervention group receiving "Starting Early," with individual nutrition counseling and nutrition and parenting support groups coordinated with prenatal and pediatric visits. Outcomes included infant activity (tummy time, unrestrained floor time, time in movement-restricting devices). Health literacy was assessed using the Newest Vital Sign.
Results:
Four hundred fifty-six mothers completed 3-month assessments. Infant activity results were: 82.6% ever practiced tummy time; 32.0% practiced tummy time on the floor; 34.4% reported unrestrained floor time; 56.4% reported ≥1 h/d in movement-restricting devices. Inadequate health literacy was associated with reduced tummy time and unrestrained floor time. The intervention group reported more floor tummy time (OR 2.16, 95% CI 1.44-3.23) and unrestrained floor time (OR 1.69, 95% CI 1.14-2.49) compared to controls. No difference in the time spent in movement-restricting devices was found.
Conclusions:
Tummy time and unrestrained floor time were low. Primary care-based obesity prevention programs have potential to promote these activities.
