Health Promotion, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia.
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
JAMA Pediatr. 2020 Jul 1;174(7):657-664. doi: 10.1001/jamapediatrics.2020.0215.
IMPORTANCE: There is limited information as to whether telephone or short message service (SMS) support is effective in improving infant feeding practices and tummy time and reducing screen time. OBJECTIVE: To determine the effectiveness of either nurse-led telephone or SMS support in improving infant feeding practices and tummy time and reducing screen time. DESIGN, SETTING, AND PARTICIPANTS: This study was part of a 2-year, 3-group parallel, randomized clinical trial conducted from February 23, 2017, to November 30, 2018, among 1155 women in the third trimester of pregnancy in New South Wales, Australia. It reports the main outcomes at 6 and 12 months of child age. All analyses were conducted on an intention-to-treat principle. INTERVENTIONS: The intervention consisted of staged information booklets mailed to the intervention groups, each followed by either a nurse-led telephone support session or SMS intervention, antenatally and at 1, 3, 5, 7, and 10 months after birth. MAIN OUTCOMES AND MEASURES: The primary outcomes were infant feeding practices at both 6 and 12 months and tummy time at 6 months. The secondary outcome was screen time at 12 months. RESULTS: Of 1155 mothers, 947 (82%; mean [SD] age, 32.5 [5.0] years) completed follow-up surveys at 6 months; 920 mothers (80%) completed follow-up surveys at 12 months. Compared with the control group, telephone support led to higher odds of appropriate timing of introducing solid foods (adjusted odds ratio [AOR], 1.68 [95% CI, 1.22-2.32]), cup use (AOR, 1.54 [95% CI, 1.12-2.13]), and early-start tummy time (AOR, 1.63 [95% CI, 1.18-2.25]) at 6 months and higher odds of having no screen time (AOR, 1.80 [95% CI, 1.28-2.53]) and no bottle at bedtime (AOR, 1.73 [95% CI, 1.23-2.42]) at 12 months. Use of SMS also led to higher odds than the control group of having no screen time (AOR, 1.28 [95% CI, 1.08-1.52]) and having no bottle at bedtime (AOR, 1.29 [95% CI, 1.10-1.51]) at 12 months. No significant differences were found in breastfeeding rates between the telephone support, SMS support, and control groups. CONCLUSIONS AND RELEVANCE: Both the nurse-led telephone support and SMS interventions were effective in reducing screen time and bottle use at bedtime. Telephone support was also effective in promoting the appropriate timing of the introduction of solid foods, early-start tummy time, and cup use. TRIAL REGISTRATION: http://anzctr.org.au Identifier: ACTRN12616001470482.
重要性：关于电话或短信支持是否能有效改善婴儿喂养方式、增加俯趴时间和减少屏幕时间，信息有限。 目的：确定护士主导的电话或短信支持在改善婴儿喂养方式、增加俯趴时间和减少屏幕时间方面的有效性。 设计、地点和参与者：这是一项为期 2 年、3 组平行、随机临床试验的一部分，于 2017 年 2 月 23 日至 2018 年 11 月 30 日在澳大利亚新南威尔士州的 1155 名妊娠晚期妇女中进行，主要结局报告在儿童 6 个月和 12 个月时。所有分析均基于意向治疗原则进行。 干预措施：干预措施包括分阶段邮寄给干预组的信息手册，每组随后分别进行护士主导的电话支持或短信干预，在产前和产后 1、3、5、7 和 10 个月进行。 主要结局和测量指标：主要结局是婴儿在 6 个月和 12 个月时的喂养方式和 6 个月时的俯趴时间。次要结局是 12 个月时的屏幕时间。 结果：在 1155 名母亲中，947 名（82%；平均[SD]年龄，32.5[5.0]岁）完成了 6 个月时的随访调查；920 名母亲（80%）完成了 12 个月时的随访调查。与对照组相比，电话支持可增加适时引入固体食物（调整后的优势比[OR]，1.68[95%CI，1.22-2.32]）、使用杯子（OR，1.54[95%CI，1.12-2.13]）和早期开始俯趴时间（OR，1.63[95%CI，1.18-2.25]）的可能性，且在 12 个月时，不使用屏幕（OR，1.80[95%CI，1.28-2.53]）和不使用奶瓶（OR，1.73[95%CI，1.23-2.42]）的可能性也更高。短信使用也比对照组更有可能没有屏幕时间（OR，1.28[95%CI，1.08-1.52]）和没有睡前奶瓶（OR，1.29[95%CI，1.10-1.51]）在 12 个月时。在母乳喂养率方面，电话支持组、短信支持组和对照组之间没有显著差异。 结论和相关性：护士主导的电话支持和短信干预都能有效减少屏幕时间和睡前奶瓶使用。电话支持还能有效促进适时引入固体食物、早期开始俯趴时间和使用杯子。 试验注册：http://anzctr.org.au 标识符：ACTRN12616001470482。
Arch Pediatr Adolesc Med. 2011-8
Cochrane Database Syst Rev. 2022-2-1
Child Dev Perspect. 2024-6
J Health Popul Nutr. 2023-12-8
Matern Child Nutr. 2024-1
Annu Rev Public Health. 2015-3-18
BMC Pregnancy Childbirth. 2014-11-6
Pediatrics. 2014-9
Zotero 插件