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Acceptability of a text message-based intervention for obesity prevention in infants from Hawai'i and Puerto Rico WIC.

ABSTRACT: BACKGROUND:Low-income and minority children are at increased risk for obesity. Text messaging offers advantages for delivering education, but few studies have assessed the acceptability of text messaging in interventions aimed at preventing excessive weight gain in infants. This study investigated the acceptability of a text message-based intervention for prevention of excessive weight gain in infants from Hawai'i and Puerto Rico WIC clinics. METHODS:The four-month text message based intervention designed to improve infant feeding practices and reduce excessive weight gain was a randomized controlled trial that included mothers with infants ages 0-2?months at baseline. Participants in the intervention arm received 18 text messages (1/week) promoting breastfeeding and appropriate complementary feeding. Acceptability of the intervention was assessed from participant retention, satisfaction, and evidence of behavior change in a sequential multimethod approach, quantitatively from questions sent via text and qualitatively during the in-person exit interview. The final analysis included 80 mother-infant pairs from the intervention arm. RESULTS:When asked about messages liked and disliked the most, the majority of responses via text indicated that they liked all messages. From the qualitative analyses, most participants reported that all messages were useful and that the messages led them to make changes in the way they fed their infants. Participant retention was good at 78.4%. CONCLUSIONS:The intervention was acceptable to participants based upon participant retention, measures of satisfaction, and reports of behavior change. Results may inform development of mobile health programs for minority childhood obesity prevention. TRIAL REGISTRATION:ClinicalTrials.gov Identifier; NCT02903186; September 16, 2016.

SUBMITTER: Gibby CLK

PROVIDER: S-EPMC6692961 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Acceptability of a text message-based intervention for obesity prevention in infants from Hawai'i and Puerto Rico WIC.

Gibby Cheryl L K CLK Palacios Cristina C Campos Maribel M Graulau Rafael E RE Banna Jinan J

BMC pregnancy and childbirth 20190813 1

<h4>Background</h4>Low-income and minority children are at increased risk for obesity. Text messaging offers advantages for delivering education, but few studies have assessed the acceptability of text messaging in interventions aimed at preventing excessive weight gain in infants. This study investigated the acceptability of a text message-based intervention for prevention of excessive weight gain in infants from Hawai'i and Puerto Rico WIC clinics.<h4>Methods</h4>The four-month text message ba ...[more]

PMID: 31409286

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Project description:Background:Excessive gestational weight gain and rapid infancy weight gain (RIWG) are associated with increased susceptibility to childhood obesity. Since low-income and minority children are particularly at risk, investigation of the associations between gestational weight gain and rate of infancy weight gain may inform childhood obesity prevention. This study investigated the associations between gestational weight gain and rate of infancy weight gain during the first four to six months postpartum in participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Hawai'i and Puerto Rico. Methods:This was a cross-sectional secondary data analysis from a text message-based intervention in WIC participants in Hawai'i and Puerto Rico. The analysis included 80 mother/infant pairs from the control group who completed the follow-up visit when infants were four to six months old. Maternal weight, height, and gestational weight gain were self-reported. Infant weight was measured at baseline and follow-up. A proportional odds model was used to investigate the association between gestational weight gain and infancy weight gain rate (rapid or extremely rapid, on-track, or slow), adjusting for maternal age, pregravid body mass index (BMI) status, parity, and being up-to-date with infant vaccinations. Results:In comparison to recommended gestational weight gain, excessive and inadequate (under the recommended amount) gestational weight gain was associated with 77% decreased (adjusted odds ratio [AOR]?=?0.23; 95% confidence interval [CI]?=?0.08, 0.70; p?=?0.01) and 71% decreased (AOR?=?0.29; 95% CI?=?0.09, 0.94; p?=?0.04) odds of RIWG versus on-track or slow infant weight gain, respectively. In comparison to women with one child, women with two children (AOR?=?0.31; 95% CI?=?0.11, 0.87; p?=?0.03) or three or four children (AOR?=?0.24; 95% CI?=?0.07, 0.88; p?=?0.03) had significantly lower odds of RIWG versus on-track or slow infancy weight gain. Conclusions:Women with excessive or inadequate gestational weight gain had lower proportional odds of RIWG and were more likely to have slower infant weight gain than women who gained the recommended amount of weight. Trial registration:ClinicalTrials.gov Identifier; NCT02903186; September 16, 2016.

Project description:Importance:Existing research has established a causal link between Zika virus (ZIKV) infection and severe birth defects or consequent health impairments; however, more subtle cognitive impairments have not been explored. Objective:To determine whether infants of mothers with at least 1 positive ZIKV test show differences in cognitive scores at ages 3 to 6 months and ages 9 to 12 months. Design, Setting, and Participants:This cross-sectional study recruited infants enrolled in existing ZIKV study cohorts associated with the Maternal-Infant Studies Center and the Puerto Rico Clinical and Translational Research Consortium at the University of Puerto Rico and from the broader San Juan metropolitan area. The study took place at the Puerto Rico Clinical and Translational Research Consortium at the University of Puerto Rico. Participants were recruited through convenience sampling if their mothers underwent ZIKV testing prenatally and were at the target ages during the study period. Infants who were born preterm (<36 weeks' gestational age), with low birth weight (<2500 g), or with a known genetic disorder were excluded. Infants were tested from ages 3 to 6 months or ages 9 to 12 months from May 2018 to April 2019. Data analysis was performed from March to April 2019. Exposures:Zika virus status was measured prenatally and in the early postnatal period using real-time polymerase chain reaction or a ZIKV IgM antibody capture enzyme-linked immunosorbent assay. Main Outcomes and Measures:The infants' development was assessed using the Mullen Scales of Early Learning (translated to Spanish and adapted for Puerto Rico), and assessors were blinded to each infant's ZIKV status. Results:A total of 65 study participants were included. The mean (SD) age of the infants at the time of cognitive testing was 8.98 (3.19) months. Most of the infants were white (55 [84.6%]) and Puerto Rican (64 [98.5%]); 38 of the infants were male (58.5%). General cognitive and domain-specific scores did not differ significantly between prenatally ZIKV-positive and ZIKV-negative infants except for receptive language score (mean difference = 5.52; t = 2.10; P = .04). Exposure to ZIKV (B = -5.69; β = -0.26 [95% CI -11.01 to -0.36]; P = .04) and a measure of Hurricane Maria exposure (time without water, B = -0.05; β = -0.27 [95% CI, -0.10 to -0.01]; P = .03) were both independently and significantly associated with receptive language scores after adjusting for key confounders. Conclusions and Relevance:Although infants exposed to ZIKV prenatally showed unaffected motor and visually mediated cognitive development, they did show deficits in receptive language scores. Receptive language skills were also associated with the degree of exposure to Hurricane Maria, with those who spent more time without water after the hurricane having lower receptive language scores.

Project description:Dengue is a growing public health threat, causing approximately 400 million infections annually. In June 2021, the Advisory Committee on Immunization Practices recommended the first dengue vaccine (CYD-TDV) for children aged 9-16 years with a previous dengue infection, living in endemic areas, such as Puerto Rico (PR). As the COVID-19 pandemic affected vaccine intention worldwide, we assessed dengue vaccine intention before (pre-COVID) and after (post-COVID) COVID-19 vaccine availability among participants enrolled in the Communities Organized to Prevent Arboviruses (COPA) cohort to prepare for dengue vaccine implementation in PR. We used logistic regression models to evaluate changes in dengue vaccine intention by interview timing and participant characteristics. Among 2,513 participants pre-COVID, 2,512 answered the dengue vaccine intention question for themselves, and 1,564 answered relative to their children. Post-COVID, dengue vaccine intention in adults increased for themselves from 73.4% to 84.5% (adjusted odds ratio (aOR) = 2.27, 95%CI: 1.90-2.71) and relative to their children from 75.6% to 85.5% (aOR = 2.21, 95%CI: 1.75-2.78). Among all participants, groups with higher dengue vaccine intention included those who reported previous year influenza vaccine uptake and those who reported being frequently bitten by mosquitos, compared to those who did not. Adult males were also more likely to intend to vaccinate themselves than females. Respondents who were employed or in school were less likely to intend to vaccinate compared to those who were not working. The primary reasons for vaccine hesitancy were concerns with side effects and not believing in vaccines, which should be considered during educational strategies prior to dengue vaccine implementation. In general, dengue vaccine intention is high in PR and has increased after COVID-19 vaccine availability, potentially due to increased awareness of vaccine importance during the COVID-19 pandemic.

Project description:BackgroundUSDA's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides expert-chosen supplemental foods to improve the diets and health of low-income infants and children <5 y of age, but dietary behaviors of WIC participants are not well characterized.ObjectiveThe purpose of this analysis was to examine differences in food consumption patterns between WIC participants and nonparticipants.MethodsFITS 2016 is a nationwide cross-sectional study of children <4 y (n = 3235). Data were weighted to provide US population-representative results. Children were categorized as WIC participants or nonparticipants, with the latter divided into lower- and higher-income nonparticipants. Group differences were assessed via the Wald test (demographics) and Rao-Scott modified chi-square test (breastfeeding prevalence). Differences in percentage consuming WIC-provided and selected other foods between WIC participants and nonparticipants were evaluated with the use of ORs and 95% CIs.ResultsWIC infants were less likely to breastfeed than were higher-income nonparticipants at 0-5.9 mo (45% compared with 74%) and less likely than both nonparticipant groups at 6-11.9 mo (30% compared with 49-60%). WIC 6- to 11.9-mo-olds were more likely to consume infant cereals and vegetables than were lower-income nonparticipants. WIC 12 to 23.9-mo-olds were more likely to drink whole milk (which WIC provides at this age) than were nonparticipants (72% compared with 59-64%), whereas WIC participants 24-47.9 mo were more likely to drink low- and nonfat milks (which WIC provides at this age) than were nonparticipants (45% compared with 13-22%). WIC participants 6-47.9 mo were more likely to drink juice than were nonparticipants.ConclusionsContinued improvements in early dietary patterns are warranted for WIC and non-WIC children. Breastfeeding among WIC participants is a continuing challenge. Findings suggest that baby-food cereals, vegetables, and fruits (all provided by WIC) contribute importantly to WIC infants' diets, whereas WIC children are more likely to use lower-fat milks after 2 y of age than are non-WIC participants.

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Acceptability of a text message-based intervention for obesity prevention in infants from Hawai'i and Puerto Rico WIC.

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Acceptability of a text message-based intervention for obesity prevention in infants from Hawai'i and Puerto Rico WIC.

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