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Digital technology to facilitate Proactive Assessment of Obesity Risk during Infancy (ProAsk): a feasibility study
Sarah A Redsell1, Jennie Rose1, Stephen Weng2
1Professor of Public Health, Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge, UK.
Insights
The Proactive Assessment of Obesity Risk during Infancy (ProAsk) tool was acceptable to parents and health visitors (HVs), but recruitment and adherence were challenging. Further resources are needed for successful implementation of this infant obesity risk assessment.
Area of Science:
- Public Health
- Pediatrics
- Health Technology
Background:
- Childhood obesity is a growing public health concern.
- Early identification of obesity risk is crucial for timely intervention.
- Digital health tools offer potential for scalable obesity prevention strategies.
Purpose of the Study:
- To evaluate the feasibility and acceptability of the Proactive Assessment of Obesity Risk during Infancy (ProAsk) digital tool.
- To assess the usability of ProAsk among UK health visitors (HVs) and parents of infants.
- To explore the potential of ProAsk in identifying infants at risk of overweight.
Main Methods:
- A multicentre, pre- and post-intervention feasibility study with process evaluation.
- ProAsk delivered via tablet, including a risk prediction tool and motivational strategies.
- Involved 66 parents and 22 HVs in rural and urban deprived UK settings.
- Qualitative interviews assessed acceptability and intervention fidelity.
Main Results:
- 29% of eligible infants were recruited; 40% of assessed infants were identified as above population risk for overweight.
- Health visitors could collect data and calculate overweight risk.
- Protocol adherence and intervention fidelity were challenging, though the therapeutic wheel information was acceptable.
Conclusions:
- Recruitment and protocol adherence were problematic, indicating challenges in implementing ProAsk.
- The ProAsk intervention was generally acceptable to parents and HVs, but intervention fidelity was low.
- Limited evidence supports ProAsk's feasibility without significant additional resources; a parent-led approach may be more viable.
Objective:
To assess the feasibility and acceptability of using digital technology for Proactive Assessment of Obesity Risk during Infancy (ProAsk) with the UK health visitors (HVs) and parents.
Design:
Multicentre, pre- and post-intervention feasibility study with process evaluation.
Setting:
Rural and urban deprived settings, UK community care.
Participants:
66 parents of infants and 22 HVs.
Intervention:
ProAsk was delivered on a tablet device. It comprises a validated risk prediction tool to quantify overweight risk status and a therapeutic wheel detailing motivational strategies for preventive parental behaviour. Parents were encouraged to agree goals for behaviour change with HVs who received motivational interviewing training.
Outcome Measures:
We assessed recruitment, response and attrition rates. Demographic details were collected, and overweight risk status. The proposed primary outcome measure was weight-for-age z-score. The proposed secondary outcomes were parenting self-efficacy, maternal feeding style, infant diet and exposure to physical activity/sedentary behaviour. Qualitative interviews ascertained the acceptability of study processes and intervention fidelity.
Results:
HVs screened 324/589 infants for inclusion in the study and 66/226 (29%) eligible infants were recruited. Assessment of overweight risk was completed on 53 infants and 40% of these were identified as above population risk. Weight-for-age z-score (SD) between the infants at population risk and those above population risk differed significantly at baseline (-0.67 SD vs 0.32 SD). HVs were able to collect data and calculate overweight risk for the infants. Protocol adherence and intervention fidelity was a challenge. HVs and parents found the information provided in the therapeutic wheel appropriate and acceptable.
Conclusion:
Study recruitment and protocol adherence were problematic. ProAsk was acceptable to most parents and HVs, but intervention fidelity was low. There was limited evidence to support the feasibility of implementing ProAsk without significant additional resources. A future study could evaluate ProAsk as a HV-supported, parent-led intervention.
Trial Registration Number:
NCT02314494 (Feasibility Study Results).
