Hewitt Lyndel, Stephens Samantha, Spencer Abbe, Stanley Rebecca M, Okely Anthony D
Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales 2522 Australia.
Illawarra Health and Medical Research Institute, Wollongong, New South Wales 2500 Australia.
Pilot Feasibility Stud. 2020 Oct 14;6:155. doi: 10.1186/s40814-020-00695-x. eCollection 2020.
The World Health Organization recommends 30 min of tummy time daily for improved motor development and reduced likelihood of plagiocephaly. As only 30% of infants meet this recommendation, parents require strategies and support to increase this proportion.
The aim of this study was to determine the feasibility, acceptability, and potential efficacy of a group intervention to promote tummy time. The design is a cluster randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Five groups of healthy infants ( = 35, baseline mean (SD) age 5.9 (2.8) weeks) and their mothers attending local mother's groups (Australia) were randomly allocated to the intervention or control group. The intervention group received group tummy time classes in addition to usual care. The control group received usual care with their child and family health nurse. Primary outcomes were intervention feasibility and acceptability. Secondary outcomes were tummy time duration (accelerometry), adherence to physical activity guidelines, head shape, and motor development. Measures were taken at baseline, post-intervention, and when infants were 6 months of age. Analyses were by linear mixed models and Cohen's statistic.
Recruitment, retention, and collection of objective data met feasibility targets. Acceptability was also met with intervention mothers reporting the information, goal planning, and handouts significantly more useful and relevant than control group mothers ( < 0.01). Moderate effect sizes were also found at post-intervention for tummy time duration, adherence to physical activity guidelines and infant ability in prone and supine favoring the intervention group (intervention infants had a mean of 30 min and 30% adherence to guidelines (95% CI 0 to 60.6 min) compared to the control infants who had a mean of 16.6 min and 13% adherence to the guidelines (95% CI 0 to 42.1 min, Cohen's = 0.5). Limitations were the small sample size, 4-week intervention, limited accelerometer use, and a homogenous sample of participants.
Group tummy time classes delivered in a mother's group setting were shown to be feasible and acceptable. A larger randomized controlled trial is warranted.
ANZCTR, ACTRN12617001298303p. Registered 11 September 2017.
世界卫生组织建议每天进行30分钟的趴卧时间，以促进运动发育并降低扁头畸形的可能性。由于只有30%的婴儿达到这一建议，家长需要策略和支持来提高这一比例。
本研究的目的是确定促进趴卧时间的小组干预措施的可行性、可接受性和潜在效果。研究设计为整群随机对照试验，采用隐蔽分配、评估者盲法和意向性分析。五组健康婴儿（n = 35，基线平均（标准差）年龄5.9（2.8）周）及其参加当地妈妈小组（澳大利亚）的母亲被随机分配到干预组或对照组。干预组除接受常规护理外，还参加小组趴卧时间课程。对照组在儿童和家庭健康护士的指导下接受常规护理。主要结局是干预措施的可行性和可接受性。次要结局包括趴卧时间（加速度计测量）、对体育活动指南的依从性、头型和运动发育。在基线、干预后以及婴儿6个月大时进行测量。分析采用线性混合模型和科恩效应量统计。
招募、保留和客观数据收集均达到可行性目标。干预措施的可接受性也得到了满足，干预组母亲报告信息、目标规划和资料手册比对照组母亲更有用、更相关（P < 0.01）。干预后，在趴卧时间、对体育活动指南的依从性以及婴儿俯卧和仰卧能力方面也发现了中等效应量，有利于干预组（干预组婴儿平均趴卧时间为30分钟，对指南的依从性为30%（95%CI 0至60.6分钟），而对照组婴儿平均趴卧时间为16.6分钟，对指南的依从性为13%（95%CI 0至42.1分钟），科恩效应量 = 0.5）。局限性在于样本量小、4周的干预时间、加速度计使用有限以及参与者样本同质性。
在妈妈小组环境中开展的小组趴卧时间课程被证明是可行且可接受的。有必要进行更大规模的随机对照试验。
澳大利亚新西兰临床试验注册中心，ACTRN12617001298303p。2017年9月11日注册。
