Department of Pediatrics, School of Medicine (AL Beck), University of California San Francisco.
School of Medicine (R Mora), University of California San Francisco.
Acad Pediatr. 2023 Sep-Oct;23(7):1351-1360. doi: 10.1016/j.acap.2023.05.006. Epub 2023 May 19.
OBJECTIVE: 1) To evaluate the impact of the Futuros Fuertes intervention on infant feeding, screen time, and sleep practices and 2) To use qualitative methods to explore mechanisms of action. METHODS: Low-income Latino infant-parent dyads were recruited from birth to 1 month and randomized to Futuros Fuertes or a financial coaching control. Parents received health education sessions from a lay health educator at well-child visits in the first year of life. Parents received two text messages per week that reinforced intervention content. We assessed infant feeding, screen time, and sleep practices via surveys. body mass index z-score (BMI-z) was measured at 6 and 12 months. Seventeen parents from the intervention arm participated in a semi-structured interview that explored parental experiences with the intervention. RESULTS: There were n = 96 infant-parent dyads randomized. Fruit intake was higher in the intervention group at 15 months (1.1 vs 0.86 cups p = 0.05). Breastfeeding rates were higher in intervention participants at 6 months (84% vs 59% p = 0.02) and 9 months (81% vs 51% p = 0.008). Mean daily screen time was lower among intervention participants at 6 months (7 vs 22 min p = 0.003), 12 months (35 vs 52 min p = 0.03), and 15 months (60 vs 73 min p = 0.03). Major qualitative themes include 1) parental trust in intervention messaging 2) changes in feeding and screen time parenting practices, 3) text messages supported behavior change for parents and family members, and 4) varying effectiveness of intervention on different health behaviors. CONCLUSIONS: Low-income Latino infants participating in the Futuros Fuertes intervention had modestly healthier feeding and screen time practices compared to control participants.
目的:1)评估 Futuros Fuertes 干预对婴儿喂养、屏幕时间和睡眠习惯的影响,2)使用定性方法探索作用机制。
方法:从出生到 1 个月,从低收入拉丁裔母婴中招募了 Futuros Fuertes 组和财务指导对照组。在婴儿生命的第一年,父母在常规健康检查时接受了由一名兼职健康教育家提供的健康教育课程。父母每周收到两条强化干预内容的短信。我们通过调查评估婴儿喂养、屏幕时间和睡眠习惯。在 6 个月和 12 个月时测量体重指数 z 分数(BMI-z)。干预组的 17 名家长参加了半结构化访谈,探讨了家长对干预的体验。
结果:共有 96 对母婴被随机分组。在 15 个月时,干预组的水果摄入量较高(1.1 杯与 0.86 杯,p=0.05)。在 6 个月(84%比 59%,p=0.02)和 9 个月(81%比 51%,p=0.008)时,干预组的母乳喂养率较高。在 6 个月(7 分钟与 22 分钟,p=0.003)、12 个月(35 分钟与 52 分钟,p=0.03)和 15 个月(60 分钟与 73 分钟,p=0.03)时,干预组的每日屏幕时间较短。主要定性主题包括 1)父母对干预信息的信任,2)喂养和屏幕时间育儿实践的变化,3)短信支持父母和家庭成员的行为改变,以及 4)干预对不同健康行为的不同效果。
结论:与对照组相比,参与 Futuros Fuertes 干预的低收入拉丁裔婴儿的喂养和屏幕时间习惯略为健康。
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