Laws Rachel A, Denney-Wilson Elizabeth A, Taki Sarah, Russell Catherine G, Zheng Miaobing, Litterbach Eloise-Kate, Ong Kok-Leong, Lymer Sharyn J, Elliott Rosalind, Campbell Karen J
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.
JMIR Mhealth Uhealth. 2018 Apr 19;6(4):e78. doi: 10.2196/mhealth.9040.
BACKGROUND: The first year of life is an important window to initiate healthy infant feeding practices to promote healthy growth. Interventions delivered by mobile phone (mHealth) provide a novel approach for reaching parents; however, little is known about the effectiveness of mHealth for child obesity prevention. OBJECTIVE: The objective of this study was to determine the feasibility and effectiveness of an mHealth obesity prevention intervention in terms of reach, acceptability, and impact on key infant feeding outcomes. METHODS: A quasi-experimental study was conducted with an mHealth intervention group (Growing healthy) and a nonrandomized comparison group (Baby's First Food). The intervention group received access to a free app and website containing information on infant feeding, sleep and settling, and general support for parents with infants aged 0 to 9 months. App-generated notifications directed parents to age-and feeding-specific content within the app. Both groups completed Web-based surveys when infants were less than 3 months old (T1), at 6 months of age (T2), and 9 months of age (T3). Survival analysis was used to examine the duration of any breastfeeding and formula introduction, and cox proportional hazard regression was performed to examine the hazard ratio for ceasing breast feeding between the two groups. Multivariate logistic regression with adjustment for a range of child and parental factors was used to compare the exclusive breastfeeding, formula feeding behaviors, and timing of solid introduction between the 2 groups. Mixed effect polynomial regression models were performed to examine the group differences in growth trajectory from birth to T3. RESULTS: A total of 909 parents initiated the enrollment process, and a final sample of 645 parents (Growing healthy=301, Baby's First Food=344) met the eligibility criteria. Most mothers were Australian born and just under half had completed a university education. Retention of participants was high (80.3%, 518/645) in both groups. Most parents (226/260, 86.9%) downloaded and used the app; however, usage declined over time. There was a high level of satisfaction with the program, with 86.1% (143/166) reporting that they trusted the information in the app and 84.6% (170/201) claiming that they would recommend it to a friend. However, some technical problems were encountered with just over a quarter of parents reporting that the app failed to work at times. There were no significant differences between groups in any of the target behaviors. Growth trajectories also did not differ between the 2 groups. CONCLUSIONS: An mHealth intervention using a smartphone app to promote healthy infant feeding behaviors is a feasible and acceptable mode for delivering obesity prevention intervention to parents; however, app usage declined over time. Learnings from this study will be used to further enhance the program so as to improve its potential for changing infant feeding behaviors.
背景:生命的第一年是启动健康婴儿喂养习惯以促进健康成长的重要窗口期。通过手机进行的干预措施(移动健康,mHealth)为接触家长提供了一种新方法;然而,关于移动健康对预防儿童肥胖的有效性知之甚少。 目的:本研究的目的是确定一项移动健康肥胖预防干预措施在覆盖面、可接受性以及对关键婴儿喂养结果的影响方面的可行性和有效性。 方法:进行了一项准实验研究,设有移动健康干预组(健康成长组)和非随机对照组(宝宝的第一口食物组)。干预组可以使用一个免费应用程序和网站,其中包含有关婴儿喂养、睡眠和安抚方面的信息,以及为0至9个月婴儿的家长提供的一般支持。应用程序生成的通知引导家长查看应用程序内针对不同年龄和喂养阶段的内容。两组在婴儿小于3个月时(T1)、6个月大时(T2)和9个月大时(T3)均完成了基于网络的调查。采用生存分析来研究任何母乳喂养和引入配方奶的持续时间,并进行Cox比例风险回归以检查两组之间停止母乳喂养的风险比。使用对一系列儿童和家长因素进行调整的多变量逻辑回归来比较两组之间的纯母乳喂养、配方奶喂养行为以及引入固体食物的时间。进行混合效应多项式回归模型以检查从出生到T3的生长轨迹在组间的差异。 结果:共有909名家长开始了注册流程,最终645名家长(健康成长组 = 301名,宝宝的第一口食物组 = 344名)的样本符合纳入标准。大多数母亲出生在澳大利亚,略少于一半的母亲完成了大学教育。两组参与者的留存率都很高(80.3%,518/645)。大多数家长(226/260,86.9%)下载并使用了该应用程序;然而,随着时间的推移使用率下降。对该项目的满意度很高,86.1%(143/166)的家长表示他们信任应用程序中的信息,84.6%(170/201)的家长声称他们会向朋友推荐它。然而,遇到了一些技术问题,略多于四分之一的家长报告称应用程序有时无法正常运行。两组在任何目标行为上均无显著差异。两组之间的生长轨迹也没有差异。 结论:使用智能手机应用程序促进健康婴儿喂养行为的移动健康干预措施是向家长提供肥胖预防干预的一种可行且可接受的方式;然而,应用程序的使用率随着时间的推移而下降。本研究的经验教训将用于进一步改进该项目,以提高其改变婴儿喂养行为的潜力。
BMJ Open. 2015-11-30
JMIR Pediatr Parent. 2025-2-21
Matern Child Nutr. 2025-1
Pilot Feasibility Stud. 2024-5-18
JMIR Mhealth Uhealth. 2023-7-20
Int J Behav Nutr Phys Act. 2016-12-7
Matern Child Health J. 2016-11
BMC Pregnancy Childbirth. 2016-7-19