Coordination Between Primary Care and Women, Infants, and Children to Prevent Obesity for Infants from Low-Income Families: A Pragmatic Randomized Clinical Trial

Background: Rapid weight gain during infancy is associated with risk for later obesity, yet little research to date has examined the effect of a responsive parenting (RP) intervention with care coordination between pediatric primary care providers and Women, Infants, and Children nutritionists on infant weight. Methods: The Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study is a pragmatic, randomized clinical trial for mothers and infants (n=288) designed to examine the effect of a patient-centered RP intervention that used advanced health information technology strategies to coordinate care to reduce rapid infant weight gain compared with standard care. General linear models examined intervention effects on infant conditional weight gain scores, weight-for-age z scores, BMI, and overweight status (BMI-for-age ≥85th percentile) from birth to age 6 months, and mothers' use of food to soothe from age 2 to 6 months. Results: There were no intervention effects on infant conditional weight gain scores or overweight status at 6 months. Infants in the RP intervention had lower mean weight-for-age z scores [M=−0.04, standard error (SE)=0.04 vs. M=0.05, SE=0.04; p=0.008] and lower mean BMI (M=16.05, SE=0.09 vs. M=16.24, SE=0.09; p=0.03) compared with standard care. Mothers' use of emotion-based food to soothe was lower in the RP intervention compared with standard care from age 2 to 6 months [M difference=−0.32, standard deviation (SD)=0.81 vs. 0.00, SD=0.90; p=0.01]. Conclusions: This pragmatic, patient-centered RP intervention did not reduce rapid infant weight gain or overweight but was associated with modestly lower infant BMI and reduced mothers' use of emotion-based food to soothe.

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Work Title Coordination Between Primary Care and Women, Infants, and Children to Prevent Obesity for Infants from Low-Income Families: A Pragmatic Randomized Clinical Trial
Access
Open Access
Creators
  1. Jennifer S. Savage
  2. Amy Moore
  3. Samantha MR Kling
  4. Michele Marini
  5. Erika Hernandez
  6. Jennifer Franceschelli Hosterman
  7. Sandra Hassink
  8. Ian M. Paul
  9. L Bailey-Davis
Keyword
  1. care coordination
  2. food to soothe
  3. pragmatic trials
  4. rapid infant weight gain
  5. responsive parenting
  6. women, infants, and children
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Childhood Obesity
Publication Date November 30, 2023
Publisher Identifier (DOI)
  1. https://doi.org/10.1089/chi.2022.0137
Deposited August 12, 2024

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Version 1
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  • Created
  • Added 2023_Wee_Baby_Primary_Outcome_Childhood_Obesity.pdf
  • Added Creator Jennifer S. Savage
  • Added Creator A M ***Moore
  • Added Creator Amy Moore
  • Added Creator Samantha MR Kling
  • Added Creator Michele Marini
  • Added Creator Erika Hernandez
  • Added Creator E ***Hernandez
  • Added Creator J Franceschelli
  • Added Creator Jennifer Franceschelli Hosterman
  • Added Creator Sandra Hassink
  • Added Creator Ian M. Paul
  • Added Creator L Bailey-Davis
  • Published
  • Updated
  • Updated Keyword, Publication Date Show Changes
    Keyword
    • care coordination, food to soothe, pragmatic trials, rapid infant weight gain, responsive parenting, women, infants, and children
    Publication Date
    • 2022-01-01
    • 2023-11-30
  • Deleted Creator A M ***Moore
  • Deleted Creator E ***Hernandez
  • Deleted Creator J Franceschelli
  • Updated Creator Amy Moore
  • Updated Creator Samantha MR Kling
  • Updated Creator Michele Marini
  • Updated Creator Erika Hernandez
  • Updated Creator Jennifer Franceschelli Hosterman
  • Updated Creator Sandra Hassink
  • Updated Creator Ian M. Paul
  • Updated Creator L Bailey-Davis