Baby-Act Intervention to Prevent Excessive Infant Weight Gain: Development, Implementation, Lessons Learned, and
Maria G Kallis Colon1, Adolfo Lopez2, Maribel Campos Rivera3
1University of Puerto Rico, PO Box 365067, San Juan, PR, 00936-5067, USA.
Insights
The Baby-Act trial aimed to prevent excessive infant weight gain in low-income Hispanic families. While adherence was low, the intervention successfully delivered key messages on healthy infant development.
Area of Science:
- Public Health
- Pediatrics
- Behavioral Science
Background:
- Limited interventions exist for preventing excessive infant weight gain in low-income Hispanic populations.
- Early life interventions are crucial for establishing healthy weight trajectories.
- The WIC program serves a key demographic for targeted health initiatives.
Purpose of the Study:
- To describe the development and implementation of the Baby-Act trial, a multi-component intervention.
- To assess adherence and fidelity to the intervention among participants.
- To identify lessons learned and future applications for preventing infant obesity.
Main Methods:
- Cluster-randomized controlled trial involving mother/infant WIC participants in Puerto Rico.
- Multi-modal intervention from pregnancy to one year, including responsive feeding, infant activation, healthy sleep, and limiting sedentary behaviors.
- Weekly online lessons, reinforced by text messages and dietitian calls, based on behavioral change theories.
Main Results:
- Participant adherence varied: 45.7% for pregnancy lessons and 31.4% for infant lessons.
- Average lesson completion was 19, with some participants completing multiple lessons weekly.
- Adherence to monthly dietitian calls was 42.3%, with an average of 5 calls completed per participant.
Conclusions:
- Overall adherence to intervention components was low.
- Despite low adherence, core messages were effectively communicated due to continuous reinforcement.
- Recommendations for future studies include reducing lesson frequency and increasing text messages and media sharing.
Objectives:
There are limited interventions for preventing excessive infant weight gain among Hispanic and low-income populations. Here, we describe the development/implementation of the Baby-Act trial, a multi-component/multi-model intervention for preventing excessive infant weight gain in low-income Hispanics. We also report adherence/fidelity, lessons learned, and future applications.
Methods:
We conducted a cluster-randomized controlled trial among mother/infant participants of the WIC program in Puerto Rico. The intervention included responsive feeding, infant activation, healthy sleep, and limiting sedentary behaviors using behavioral change theories. It was implemented as a multi-modal approach from pregnancy to the first year of life through weekly online interactive lessons (n = 56) that focused on one of the topics, reinforced with weekly text messages and monthly calls with a dietitian. Adherence/fidelity was recorded as the number of lessons/calls completed and text messages sent/received in the order designed.
Results:
Adherence from 207 participants was 45.7% for pregnancy lessons and 31.4% for baby lessons (higher in months 0-3 and for lessons that suggested uploading images/videos). On average, 19 lessons were completed (with 3.6 lessons completed on the same day instead of once per week). Adherence to calls was 42.3% (higher in the first months, 49.0%). On average, each participant completed 5 calls. Lessons/calls/texts were completed/received as designed; 99.3% of text messages were sent.
Conclusions:
Adherence to all intervention components was low, but all participants received the main messages because the topics were repeated continuously. Future studies should reduce the frequency of lessons, include more text messages, and more sharing of videos/photos.
Clinicaltrials:
GOV: NCT03517891.
