The TOTS Community Intervention to Prevent Overweight in American Indian Toddlers Beginning at Birth: A Feasibility and Efficacy Study

Karanja, Njeri; Lutz, Tam; Ritenbaugh, Cheryl; Maupomé, Gerardo; Jones, Joshua D.; Becker, Thomas M.; Aickin, Mikel

doi:10.1007/s10900-010-9270-5

Cited by 51 publications

(153 citation statements)

References 12 publications

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“…(2009), UK, low income mothers [41]√√√√√RCT31210 weeks ageTrained volunteers12, 18 m & 4 yearsHigh-BF, -solids+diet, +PFP, 1° Aim: Improve PFP and child diet -anthro Harvey-Berino (2003), USA, Native American Toddlers/Pre-school children [49]√√√√√RCT439 months to 3 yearsIndigenous peer educators4 mLow+PFP, -anthro, +diet, -PA 1° Aim: Obesity prevention Karanja et al . (2010), USA, American Indian/√√√Simulated before and after design205AntenatallyCommunity health workers2 yearsLow?BF, diet NR,-anthroNative Alaskan [48] 1° Aim: Obesity prevention Haines et al . (2013), USA, low income racial minority families with preschool children [50]√√√√RCT1212 to 5 yearsBi-lingual health educators6 m…”

Section: Resultsmentioning

confidence: 99%

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

et al. 2014

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BackgroundChildren from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families.MethodsSearches of major electronic databases identified articles published from 1993–2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity.ResultsThirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m2 to -0.54 kg/m2 for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3–5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery.ConclusionThere is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required.Trial registrationPROSPERO Registration no: CRD42013006536.

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Section: Resultsmentioning

confidence: 99%

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

et al. 2014

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“…21,23,24,28,30,32 Eight interventions (40%) worked with more than one tribal community (e.g., Pathways 33 worked with seven American Indian tribes residing in Arizona, New Mexico and South Dakota). 23,24,27,29–31,33,34 Only four interventions had a sample size or recruitment goal greater than 500 participants. 22,25,29,30 …”

Section: Resultsmentioning

confidence: 99%

“…20,22,24,29–31,35 The remaining two-thirds of the interventions were non-randomized trials (n=5; 25%) 25,28,32,38,40 or pilot/feasibility studies (n=8; 40%) 21,23,26,27,34,36,39,41 . Three of the non-randomized trials discussed why using a randomized controlled trial would not be appropriate within their community contexts.…”

Section: Resultsmentioning

confidence: 99%

Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives

Fleischhacker

Roberts

Camplain

et al. 2015

J. Racial and Ethnic Health Disparities

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Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally-led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally-driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.

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“…Two studies 56,57 were identified evaluating the effectiveness of enhanced breastfeeding programs. Supporting the findings of Chapman and Pérez-Escamilla, 22 results from one study 56 demonstrated that enhanced hospital practices and WIC-based services can have a significant impact on breastfeeding initiation rates.…”

Section: Enhanced Breastfeeding Programsmentioning

confidence: 99%

“…The second study 57 identified that implemented an enhanced breastfeeding intervention was also the only study found targeting AI/AN women. The main purpose of this study was to investigate the feasibility of delivering a community-wide intervention, alone or in combination with a family-based intervention, among three AI/AN tribes to promote breastfeeding and reduce the intake of sugarsweetened beverages.…”

Section: Enhanced Breastfeeding Programsmentioning

confidence: 99%

Racial and Ethnic Disparities in Breastfeeding

Jones

Power²,

Queenan³

et al. 2015

Breastfeeding Medicine

307

255

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This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted. Racial and ethnic minority women continue to have lower breastfeeding rates than white women and are not close to meeting the Healthy People 2020 goals. Minority women report many barriers to breastfeeding. Major efforts are still needed to improve breastfeeding initiation and duration rates among minority women in the United States. Obstetrician-gynecologists have a unique opportunity to promote and support breastfeeding through their clinical practices and public policy, and their efforts can have a meaningful impact on the future health of the mother and child.

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The TOTS Community Intervention to Prevent Overweight in American Indian Toddlers Beginning at Birth: A Feasibility and Efficacy Study

Cited by 51 publications

References 12 publications

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives

Racial and Ethnic Disparities in Breastfeeding

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