TY - JOUR
T1 - The Baby Bites Text Messaging Project with randomized controlled trial
T2 - texting to improve infant feeding practices
AU - Davis, Kathleen E.
AU - Klingenberg, Adyson
AU - Massey-Stokes, Marilyn
AU - Habiba, Nusrath
AU - Gautam, Rupali
AU - Warren, Cynthia
AU - Yeatts, Paul
N1 - Funding Information:
We want to thank Madhavi Kaluva, MS, for assisting in developing the text messages and recruiting participants, and collecting 24-hour recalls. We also wish to acknowledge Leah Zimmerman for recruiting participants and collecting patient weights and lengths. Finally, we thank Lona Sandon, PhD, RDN, LD, Kimberly Mory, PhD, CCC-SLP, and Kathleen Eustace, MPH, RDN, LD for their assistance in evaluating the text messages and web landing page content. Funding: This work was supported by the Texas Woman’s University Research Enhancement Program.
Publisher Copyright:
© 2022 National Academy of Kinesiology.
PY - 2023/4
Y1 - 2023/4
N2 - Background: Rapid weight gain and overweight in infancy are associated with childhood obesity. Thus, effective, accessible interventions to promote healthy infant feeding practices to prevent early obesity are essential. Methods: This mixed-methods study involved diverse parents of infants in an urban, low-income pediatric clinic. Qualitative interviews explored parental attitudes towards feeding, early obesity, and communication with the pediatrician. A pilot, randomized controlled trial (RCT) informed by feedback provided by clinic parents compared text messages delivered for 12 months promoting healthy feeding practices to usual care to prevent early pediatric obesity. A computer-generated randomization schedule with balanced distribution for sex was used to place infants into groups. Weight-for-length percentiles and z-scores and feeding practices were measured at 0-2 weeks (baseline), 2-4 months, 6-9 months, and 12 months. Interviews were recorded, transcribed, and coded using thematic analysis. Weight for length percentile, Weight for length z scores, and feeding practices were compared between groups using repeated measures mixed analysis of variance (ANOVA). Results: Participants in the interviews were 15 parents of infants less than 1 month old. RCT participants were 38 parents of newborns (17 control; 21 intervention). Most parents in the qualitative evaluation viewed breastfeeding positively but also discussed barriers. Most also wanted practical information regarding infant feeding. There were no differences in weight-for-length percentile (F=0.52; P=0.60) or z-scores (F=0.7922; P=0.79), breastfeeding persistence χ2(1) =1.45, P=0.23, or age of introduction of solids in the intervention (statistical analysis not possible due to low counts) compared to the control group; however, low response to surveys limited the study's power. Conclusions: Text messaging has potential to extend the healthcare provider's communication beyond clinic. However, texting interventions should be flexible to mitigate barriers such as loss of phone service and challenges customizing messages to parent needs.
AB - Background: Rapid weight gain and overweight in infancy are associated with childhood obesity. Thus, effective, accessible interventions to promote healthy infant feeding practices to prevent early obesity are essential. Methods: This mixed-methods study involved diverse parents of infants in an urban, low-income pediatric clinic. Qualitative interviews explored parental attitudes towards feeding, early obesity, and communication with the pediatrician. A pilot, randomized controlled trial (RCT) informed by feedback provided by clinic parents compared text messages delivered for 12 months promoting healthy feeding practices to usual care to prevent early pediatric obesity. A computer-generated randomization schedule with balanced distribution for sex was used to place infants into groups. Weight-for-length percentiles and z-scores and feeding practices were measured at 0-2 weeks (baseline), 2-4 months, 6-9 months, and 12 months. Interviews were recorded, transcribed, and coded using thematic analysis. Weight for length percentile, Weight for length z scores, and feeding practices were compared between groups using repeated measures mixed analysis of variance (ANOVA). Results: Participants in the interviews were 15 parents of infants less than 1 month old. RCT participants were 38 parents of newborns (17 control; 21 intervention). Most parents in the qualitative evaluation viewed breastfeeding positively but also discussed barriers. Most also wanted practical information regarding infant feeding. There were no differences in weight-for-length percentile (F=0.52; P=0.60) or z-scores (F=0.7922; P=0.79), breastfeeding persistence χ2(1) =1.45, P=0.23, or age of introduction of solids in the intervention (statistical analysis not possible due to low counts) compared to the control group; however, low response to surveys limited the study's power. Conclusions: Text messaging has potential to extend the healthcare provider's communication beyond clinic. However, texting interventions should be flexible to mitigate barriers such as loss of phone service and challenges customizing messages to parent needs.
KW - breastfeeding
KW - eHealth
KW - Infant feeding
KW - mHealth
KW - text messaging
UR - http://www.scopus.com/inward/record.url?scp=85152552171&partnerID=8YFLogxK
U2 - 10.21037/MHEALTH-22-31
DO - 10.21037/MHEALTH-22-31
M3 - Article
AN - SCOPUS:85152552171
SN - 2306-9740
VL - 9
JO - mHealth
JF - mHealth
ER -