Taki Sarah, Marshall Sarah, Smith Wendy, Phillis Christine, Lavery Annmaree, Cant Trisha, Jones Jennifer, Gordon Paola, Llewelyn Cathy, Baur Louise A, Wen Li Ming
Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), Sydney, New South Wales, Australia.
Int J Nurs Pract. 2025 Aug;31(4):e70037. doi: 10.1111/ijn.70037.
While preventive health behaviour change interventions target specific behaviours and health-related outcomes, there can be further benefits, that is, cobenefits, for participants. Healthy Beginnings is an established behavioural intervention targeting mothers of young children to promote optimal child nutrition, physical activity and screen time behaviours and to prevent obesity in early childhood.
To (1) identify the cobenefits among mothers and children participating in the one-to-one telephone support arm of the intervention and (2) explore the factors contributing to these identified cobenefits, both from the perspective of the intervention providers, the Child and Family Health Nurses.
The telephone-based Healthy Beginnings intervention was conducted as a randomised controlled trial in NSW, Australia from 2017 to 2019. The intervention, delivered by Child and Family Health Nurses, included nine staged intervention telephone calls from pregnancy to child age 24 months. The nurses' notes from all telephone calls were collated and analysed using content analysis to identify cobenefits. A focus group was conducted with four intervention nurses and analysed using thematic analysis to explore their experiences of delivering the calls and their perceptions of factors that enabled intervention cobenefits for participants.
From the content analysis of the call notes, we derived categories for the types of issues, beyond the target behaviours, for which participants received support. This support primarily pertained to psychosocial and situational factors, for example, relationship challenges. From the thematic analysis of the focus group, we identified two main themes relating to factors that enabled intervention cobenefits for participants: (a) delivery features, relating to the way the intervention was structured and (b) nurse interactions, relating to the way nurses interacted with participants and approached care holistically. The nurses, via the nurse-initiated staged telephone calls, connected with participants, built rapport, offered tailored child-parent-centred support and addressed social determinants of health.
Scheduled nurse telephone support was crucial for delivering tailored intervention messages for targeted behaviour changes and achieving further cobenefits for participants. Nurse-led early childhood interventions for optimal nutrition, sleep and movement behaviours have the potential to support families' broader social contextual factors for greater impacts. Behavioural intervention research must capture and consider a broader concept of participant benefits.
虽然预防性健康行为改变干预措施针对特定行为和与健康相关的结果，但对参与者可能还有其他益处，即附带益处。“健康开端”是一项既定的行为干预措施，目标是幼儿的母亲，以促进最佳的儿童营养、身体活动和屏幕时间行为，并预防幼儿肥胖。
（1）确定参与该干预措施一对一电话支持组的母亲和儿童的附带益处，（2）从干预提供者儿童和家庭健康护士的角度探讨促成这些已确定附带益处的因素。
基于电话的“健康开端”干预措施于2017年至2019年在澳大利亚新南威尔士州作为一项随机对照试验进行。由儿童和家庭健康护士提供的干预措施包括从怀孕到孩子24个月大的九个阶段的干预电话。整理并分析所有电话的护士记录，采用内容分析法确定附带益处。与四名干预护士进行了焦点小组讨论，并采用主题分析法进行分析，以探讨她们拨打这些电话的经历以及她们对促成参与者获得干预附带益处的因素的看法。
通过对电话记录的内容分析，我们得出了除目标行为外参与者获得支持的问题类型类别。这种支持主要涉及心理社会和情境因素，例如关系挑战。通过对焦点小组的主题分析，我们确定了与促成参与者获得干预附带益处的因素相关的两个主要主题：（a）实施特征，与干预措施的构建方式有关；（b）护士互动，与护士与参与者互动以及全面提供护理的方式有关。护士通过发起阶段性电话与参与者建立联系，建立融洽关系，提供以儿童和家长为中心的量身定制的支持，并解决健康的社会决定因素。
定期的护士电话支持对于传递针对目标行为改变的量身定制的干预信息以及为参与者实现进一步的附带益处至关重要。由护士主导的针对最佳营养、睡眠和运动行为的幼儿期干预措施有可能支持家庭更广泛的社会背景因素，以产生更大影响。行为干预研究必须捕捉并考虑参与者益处的更广泛概念。
