Objective:
To describe the feasibility, acceptability, and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention.
Design:
Pilot randomized controlled trial
Participants:
Parents and their 2–5-year-old child were randomized into intervention (responsive food parenting practices/ nutrition) or control (reading readiness) groups.
Setting:
Participants received 6 visits with a community health worker trained in motivational interviewing (3 home visits; 3 phone calls); an in-home cooking or reading activity; personalized feedback on a recorded family meal or reading activity; text messages; and tailored printed materials.
Results:
Parents (n=63) were mostly mothers (90%), Hispanic/Latinx (87%), born outside the United States (62%), with household incomes <$25k (54%). Despite delivery during COVID-19, 63% of dyads were retained at 6 months. The intervention was delivered with high fidelity.
All parents in the intervention group (n=24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component HEI-2015 scores (PE=2.14, 95%CI 0.17-1.48; PE= 1.71,95%CI 0.16-1.47, respectively) and negative treatment effects for sodium (PE=-2.09,95%CI -1.35-0.04). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE=1.08, 95%CI 0.61-2.00), reducing distractions during mealtimes (PE=-0.79,95%CI -1.52- -0.19), using food as a reward (PE=-0.54, 95% CI -1.35- -0.04) and providing a supportive meal environment (PE=0.73, 95% CI 0.18-1.51).
Conclusion:
Given the continued disparities in diet quality among low-income, and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.
Complementary feeding practices promote healthy eating habits and food preferences later in life. Little is known about how US pediatricians communicate infant feeding practices to caregivers or how caregivers respond to this information. The purpose of this study is to explore mothers’ experiences and perceptions of the complementary feeding recommendations they receive in primary care settings. English- and Spanish-speaking mothers of infants were recruited from Special Supplemental Nutrition for Women, Infants, and Children offices in Rhode Island, US, and snowball sampling. Semi-structured telephone interviews were conducted to investigate mothers’ discussions with pediatricians about complementary feeding and their overall impressions of wellness visits. Thematic analysis was informed by the Fundamentals of Care theoretical framework. The mean age of the sample (n = 13) was 30.5 years and 62% self-identified as Latina. Four themes emerged from the analysis: (1) wellness visits are mostly positive experiences, (2) not all infant feeding recommendations are easy to follow, (3) alternative sources of infant feeding recommendations can be just as helpful, and (4) there is room for improvement at wellness visits. Improving the content, delivery, and cultural relevance of infant feeding recommendations in primary care settings with more specific and tailored information may promote adherence to evidence-based practices.
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