A randomised safety promotion intervention trial among low-income families with toddlers

BackgroundToddler-aged children are vulnerable to unintentional injuries, especially those in low-income families.ObjectiveTo examine the effectiveness of an intervention grounded in social cognitive theory (SCT) on the reduction of home safety problems among low-income families with toddlers.Methods277 low-income mother–toddler dyads were randomised into a safety promotion intervention (n=91) or an attention-control group (n=186). Mothers in the safety promotion intervention group received an eight-session, group-delivered safety intervention targeting fire prevention, fall prevention, poison control and car seat use, through health education, goal-setting and social support. Data collectors observed participants' homes and completed a nine-item checklist of home safety problems at study enrolment (baseline), 6 and 12 months after baseline. A total score was summed, with high scores indicating more problems. Linear mixed models compared the changes over time in home safety problems between intervention and control groups.ResultsThe intent-to-treat analysis indicated that the safety promotion intervention group significantly reduced safety problems to a greater degree than the attention-control group at the 12-month follow-up (between-group difference in change over time β=−0.54, 95% CI −0.05 to −1.03, p=0.035), with no significant differences at the 6-month follow-up.ConclusionsA safety promotion intervention built on principles of SCT has the potential to promote toddlers' home safety environment. Future studies should examine additional strategies to determine whether better penetration/compliance can produce more clinically important improvement in home safety practices.Trial registration numberNCT02615158; post-results.

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A Randomized Controlled Trial of Prenatal Pediatric Visits for Urban, Low-income Families

PEDIATRICS ◽

10.1542/peds.98.6.1069 ◽

1996 ◽

Vol 98 (6) ◽

pp. 1069-1075

Author(s):

Janet R. Serwint ◽

Modena E. H. Wilson ◽

Judith W. Vogelhut ◽

John T. Repke ◽

Henry M. Seidel

Keyword(s):

Health Care ◽

Low Income ◽

Controlled Trial ◽

Intervention Group ◽

Care Utilization ◽

Control Group ◽

Health Maintenance ◽

Car Safety ◽

Low Income Families ◽

Safety Seat

Background. Prenatal pediatric visits have been recommended by the American Academy of Pediatrics to allow the pediatrician to counsel parents on infant care issues, establish a supportive relationship, and provide pediatric practice information to parents. We hypothesized that prenatal pediatric visits would have an impact on breastfeeding decisions, health care behaviors, health care utilization, and the doctor-patient relationship. Methods. We conducted a randomized controlled trial of prenatal pediatric visits for urban, low-income families to measure the impact on breastfeeding decisions, infant car safety seat use, circumcision, health maintenance, and emergency room visits and the pediatrician's perception that he/she would know the mother better. Pregnant women were recruited prenatally from the obstetrics clinic. Outcomes were measured by maternal interview prenatally and when the infant was 2 months old, in addition to review of the nursery record. Physicians were interviewed after the 2-month visit. Health care utilization was measured by chart review at 7 months. Results. A total of 156 pregnant women were enrolled and randomized, 81 to the intervention group and 75 to the control group. Of mothers who breastfed, 45% in the intervention group changed their mind in favor of breastfeeding after enrollment compared with 14% in the control group. Mothers in the intervention group compared with the control group were more likely to make fewer emergency room visits, 0.58 compared with 1.0. Pediatricians were more likely to think that they knew mothers in the intervention group well, 54% versus 29% in the control group, yet 67% of mothers in both groups agreed their pediatrician knew them well. There were no differences between groups in initiation or duration of breastfeeding at 30 or 60 days, infant car safety seat use, circumcision, or health maintenance visits. Conclusions. Prenatal pediatric visits have potential impact on a variety of health care outcomes. Among urban, low-income mothers, we found beneficial effects on breastfeeding decisions, a decrease in emergency department visits, and an initial impact on the doctor-patient relationship. We suggest urban practices actively promote prenatal pediatric visits.

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Diet quality from pre-school to school age in Brazilian children: a 4-year follow-up in a randomised control study

British Journal Of Nutrition ◽

10.1017/s0007114513002857 ◽

2013 ◽

Vol 111 (3) ◽

pp. 499-505 ◽

Cited By ~ 17

Author(s):

Fernanda Rauber ◽

Daniel J. Hoffman ◽

Márcia Regina Vitolo

Keyword(s):

Diet Quality ◽

Low Income ◽

Controlled Trial ◽

Intervention Group ◽

Saturated Fat ◽

Healthy Eating Index ◽

Control Group ◽

School Age

A previous study demonstrated that dietary counselling for mothers during the first year of life improved overall diet quality of children at pre-school age in a low-income population. Thus, the objective of the present study was to assess the long-term effect of this intervention on diet quality of children at school age and examine the tracking of dietary intake throughout childhood. The present study was a follow-up of a randomised controlled trial with children who were assessed at 3–4 years (n 345) and 7–8 years (n 307) of age. We collected two 24 h dietary recalls and assessed diet quality using the Healthy Eating Index (HEI). Analyses were performed by group using a paired t test and a Student's t test for independent samples. Diet quality did not differ between the intervention and control groups at 7–8 years of age (HEI score 65·2 (sd 9·5) v. 64·9 (sd 8·5)). Regarding changes in diet quality from pre-school to school age, we observed the tracking of diet quality in the control group and the loss of the intervention effect in the intervention group. In both groups, the score for fruit and milk intake decreased, while that for saturated fat and dietary variety intake increased. The score for the intakes of grains, meat and legumes, and total fat remained constant for all children. The present data provide evidence that diet quality tracks during childhood since the total HEI score did not differ over time in the control group. The decrease in score for some HEI components did not affect the overall diet quality due to the increase in score for other HEI components.

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A computerised tailored intervention for increasing intakes of fruit, vegetables, brown bread and wholegrain cereals in adolescent girls

Public Health Nutrition ◽

10.1017/s1368980009992953 ◽

2010 ◽

Vol 13 (8) ◽

pp. 1271-1278 ◽

Cited By ~ 7

Author(s):

Gail Rees ◽

Savita Bakhshi ◽

Alecia Surujlal-Harry ◽

Mikis Stasinopoulos ◽

Anna Baker

Keyword(s):

Dietary Intake ◽

Adolescent Girls ◽

Low Income ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Tailored Intervention ◽

Motivation To Change ◽

Brown Bread

AbstractObjectiveTo evaluate the effectiveness of a computer-generated tailored intervention leaflet compared with a generic leaflet aimed at increasing brown bread, wholegrain cereal, fruit and vegetable intakes in adolescent girls.DesignClustered randomised controlled trial. Dietary intake was assessed via three 24 h dietary recalls.SettingEight secondary schools in areas of low income and/or high ethnic diversity, five in London and three in the West Midlands, UK.SubjectsGirls aged 12–16 years participated (n 823) and were randomised by school class to receive either the tailored intervention (n 406) or a generic leaflet (n 417).ResultsAt follow-up 637 (77 %) participants completed both baseline and follow-up dietary recalls. The tailored intervention leaflet had a statistically significant effect on brown bread intake (increasing from 0·39 to 0·51 servings/d) with a smaller but significant increase in the control group also (increasing from 0·28 to 0·35 servings/d). The intervention group achieved 0·05 more servings of brown bread daily than the control group (P < 0·05), which is equivalent to 0·35 servings/week. For the other foods there were no significant effects of the tailored intervention.ConclusionsThe intervention group consumed approximately 0·35 more servings of brown bread weekly than the control group from baseline. Although this change between groups was statistically significant the magnitude was small. Evaluation of the intervention was disappointing but the tailored leaflet was received more positively in some respects than the control leaflet. More needs to be done to increase motivation to change dietary intake in adolescent girls.

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Physical Activity Adherence Rates in Older Kidney Transplant Recipients: A Pilot Randomized Controlled Trial

Innovation in Aging ◽

10.1093/geroni/igaa057.3263 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 884-884

Author(s):

Tara O’Brien ◽

Karen Rose ◽

Alai Tan

Keyword(s):

Kidney Transplant ◽

Controlled Trial ◽

Intervention Group ◽

Attention Control ◽

Control Group ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Activity Tracker ◽

Walking Activity ◽

Attention Control Group

Abstract Daily walking activities are associated with improving cardiovascular and well-being in older kidney transplant recipients. Multicomponent interventions using technology and goal setting holds promise for sustaining daily walking activity among this population. The purpose of this randomized controlled trial pilot study was to evaluate the feasibility of a multicomponent intervention called SystemCHANGE™ + activity tracker for daily walking activity in older (age 60 and over) kidney recipients from baseline to 12 months. The intervention group implement a personal-system solution and wore a mobile activity tracker daily for 12 months. The attention-control group received educational information on healthy living as a transplant recipient and was asked to wear a mobile activity tracker daily for 12 months. Participants were randomized 1:1 to the intervention or control group. The sample consisted of 53 participants (n = 27 intervention, and n = 26 control). At the 12-month follow-up visit, the total study attrition rate was 23%. The adherence rates at 12 months were 96.5% in the intervention group and 80.8% in the attention- control group. The intervention group increased their steps from baseline to 12 months by 334 steps per day. The attention-control group demonstrated a decrease in steps by 563 steps per day. We found a mean difference of 1041± 2440 (Cohen’s d = 0.43) in daily steps between the groups from baseline to 12 months. The data suggests SystemCHANGE™ in combination with activity trackers may be feasible for older kidney transplant recipients to enhance and sustain physical activity with daily walking.

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Home-based Intervention Among Non-Hispanic Black Families Finds No Significant Difference in Growth at 15 Months: Results from the ‘Mothers & Others’ Randomized Trial (P04-187-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-187-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Heather Wasser ◽

Amanda Thompson ◽

Margaret Bentley

Keyword(s):

Treatment Group ◽

Obesity Prevention ◽

Intervention Group ◽

Attention Control ◽

Control Group ◽

Primary Efficacy ◽

Home Based ◽

Significant Difference ◽

Home Based Intervention ◽

Attention Control Group

Abstract Objectives Mothers and Others (M&O) was an efficacy trial of a home-based intervention designed to prevent obesity in the first year of life. The primary outcome was infant growth, as assessed by differences in weight-for-age z-scores (WAZ) between the obesity prevention group and an attention-control group on infant safety. Methods The study design was a two-group randomized control trial among 428 non-Hispanic black (NHB) women recruited at 28 weeks’ pregnancy. The primary delivery channel for both groups was 6 home visits by a peer educator (PE). Mothers in the intervention group received anticipatory guidance (AG) on infant feeding and care behaviors related to obesity prevention. Mothers in the attention-control group received AG on child safety. Mothers in both groups identified a study partner, with partners in the control group only completing study assessments. Infant weight was assessed at birth by maternal self-report and at 3, 6, 9, 12 and 15 months of age by direct measurement. Infant WAZ scores were created using the World Health Organization 2006 international growth standards. The primary efficacy analysis was a linear mixed model (LMM) on an intention-to-treat (ITT) dataset with WAZ score at birth, 3, 6, 9, 12 and 15 months as the dependent variable and treatment group, age and their interaction term as the independent variables. Results Enrolled women were 25.76 ± 5.3 years at baseline and the majority were single (72.3%), receiving Medicaid (74.4%), and expecting their first child (56.1%). Baseline characteristics and visit completion rates did not differ by treatment group. At all time points, infants in the intervention group were smaller than those in the control group (e.g., mean WAZ at 15 months was 0.39 ± 1.04 among intervention infants and 0.53 ± 1.07 among control infants), but these differences were not significant. Results of the primary efficacy model yielded no difference in WAZ between infants in the two groups (beta for intervention = −.07, P = 0.659). Conclusions M&O was designed to fill several gaps in early life obesity prevention trials at the time of its inception, including a focus on infant temperament and inclusion of support partners. Despite rich preliminary data and a strong conceptual model, the intervention did not produce a significant difference in infant growth. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases.

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Effectiveness of a combined obesity prevention program in South Korea for children from low-income families that included primary caregiver participation

Child Health Nursing Research ◽

10.4094/chnr.2021.27.3.211 ◽

2021 ◽

Vol 27 (3) ◽

pp. 211-224

Author(s):

Namhee Park ◽

Mihae Im

Keyword(s):

Obesity Prevention ◽

Low Income ◽

Prevention Program ◽

Intervention Program ◽

Intervention Group ◽

Primary Caregivers ◽

Primary Caregiver ◽

Control Group ◽

Low Income Families ◽

Obesity Prevention Program

Purpose: Obesity among children from low-income families is becoming a social problem. The aim of this study was to evaluate the effectiveness of an obesity prevention program that included physical activity, nutrition education, behavioral modification, and primary caregiver participation components among children from low-income families.Methods: The study analyzed a nonequivalent control group using a pretest-posttest design. A total of 77 children were recruited from six community childcare centers using purposive sampling. For the intervention group (n=40), the pretest was administered before the combined intervention program involving the participants' primary caregivers was conducted for 8 weeks. The posttest was conducted immediately after the program and again four weeks after the program.Results: Flexibility (F=4.64, p=.020), muscular endurance (F=11.22, p<.001), nutritional knowledge scores (F=4.79, p=.010), body image satisfaction scores (F=4.74, p=.012), and self-esteem scores (F=3.81, p=.029) showed significant differences and interactions between group and time for the intervention and control groups.Conclusion: Strategies to actively engage the primary caregivers of low-income families in children's obesity programs are needed. Obesity prevention programs for children based on the program in this study should be routinely developed, and continuing attention should be given to children from low-income families.

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Assessing the Immediate and Maintained Effects of Hypnosis on Self-Efficacy and Soccer Wall-Volley Performance

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.32.2.243 ◽

2010 ◽

Vol 32 (2) ◽

pp. 243-252 ◽

Cited By ~ 20

Author(s):

Jamie Barker ◽

Marc Jones ◽

Iain Greenlees

Keyword(s):

Self Efficacy ◽

Attention Control ◽

Soccer Players ◽

Control Group ◽

Specific Questionnaire ◽

Professional Soccer ◽

Attention Control Group ◽

Better Than

This study evaluated the effects of hypnosis on self-efficacy and soccer performance. Fifty-nine collegiate soccer players were randomly allocated to either a hypnosis (n = 30) or video attention-control group (n = 29). A pretest–posttest design with an additional 4-week follow-up was used. Self-efficacy was measured via a task-specific questionnaire comprising 10 items relating to good performance on a soccer wall-volley task. The hypnotic intervention comprised three sessions using ego-strengthening suggestions. The control group watched edited videos of professional soccer games. Results indicated that, following the intervention, the hypnosis group were more efficacious and performed better than the control group. These differences were also seen at the 4-week follow-up stage. Although changes in self-efficacy were associated with changes in performance, the effect of hypnosis on performance was not mediated by changes in self-efficacy. The study demonstrates that hypnosis can be used to enhance and maintain self-efficacy and soccer wall-volley performance.

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The Impact of Micronutrient Fortified Foods on Cognitive Functioning Among Low-Income Children: A Pilot Study (P18-096-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-096-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Juliana Cohen ◽

Kelly Sagar ◽

M Kathryn Dahlgren ◽

Eric Rimm ◽

Staci Gruber

Keyword(s):

Cognitive Functioning ◽

Low Income ◽

Intervention Group ◽

Control Group ◽

Trail Making Test ◽

Fortified Foods ◽

Afterschool Program ◽

Low Income Children ◽

Trail Making ◽

Over Time

Abstract Objectives To examine the association between micronutrient fortified food consumption compared with standard foods and cognitive functioning among low-income children. Methods Low-income children (ages 8–12 years) participating in an afterschool program were recruited for this randomized-controlled trial. At baseline, trained research assistants measured IQ (Shipley-2 Composite Standard Scores) and cognitive functioning (Stroop Color Word Test [Golden Version], Trail Making Test, and Conners Continuous Performance Test [CPT-3]) to evaluate executive functioning, selective attention, and processing speed. Children were then randomly assigned to receive either micronutrient fortified foods (n = 19) or to continue receiving standard foods (n = 16) daily at the afterschool program for approximately three months. The intervention foods contained 75% Daily Value for all essential vitamins and minerals, omega-3 and omega-6 fatty acids, protein, one cup of milk, and one serving of fruits. The standard foods consisted of juice and primarily processed meats with refined grains. The cognitive tests were re-administered post-implementation. Differences in cognitive scores between the intervention and control groups were assessed using repeated measures ANOVAs and ANCOVAs, adjusting for age Results A total of n = 35 children were eligible to participate and had regular attendance at the afterschool program during the study period. When examining differences between the control and intervention groups over time, the results were suggestive of a trend towards the control group performing worse over time CPT Omissions T-scores (P = 0.10), CPT Hit Reaction Time (HRT) T-scores (P = 0.06), and CPT HRT Block Change T-Score (P = 0.09) compared with the intervention group. However, there was a trend towards worse performance in the intervention group on CPT Perseverations T-Scores (P = 0.07) compared with the control group. There were no significant differences between-groups over time on the Trail Making test or Stroop test Conclusions Overall, there was some evidence of improved cognitive scores over time among low-income children provided with micronutrient fortified foods relative to the control group. It is possible that these nutrient-dense, fortified foods may be cognitively protective in this population and future larger studies should examine these associations Funding Sources This study was funded by an unrestricted gift from the 43ForKids Foundation.

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Consumption of Dietary Guidelines for Americans Types and Amounts of Vegetables Increases Subjective Happiness: A Randomized Controlled Trial

Current Developments in Nutrition ◽

10.1093/cdn/nzab056_004 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1266-1266

Author(s):

Angela De Leon ◽

Lisa Jahns ◽

James Roemmich ◽

Shanon Casperson

Keyword(s):

Vegetable Consumption ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Dietary Guidelines ◽

Attention Control ◽

Control Group ◽

Subjective Happiness ◽

Dietary Guidelines For Americans ◽

Attention Control Group

Abstract Objectives The health benefits of diets rich in fruits and vegetables (FV) are well established and form the basis of the Dietary Guidelines for Americans (DGA). Furthermore, FV consumption may also exert a positive effect on psychological well-being. This study aimed to assess changes in global subjective happiness when consuming DGA recommended types and amounts of vegetables. It was hypothesized that increased vegetable consumption would increase happiness. Methods This study investigated secondary outcomes of a randomized, parallel, non-blinded controlled trial with a 1:1 allocation ratio to a provided vegetable intervention or attention control group. Men and women aged 18–65 yr, body mass index ≥ 25 kg/m,2 with low habitual vegetable consumption (<1 serving/day) were recruited for this community-based study. The vegetable intervention consisted of an 8-week feeding phase during which participants were provided with vegetables in DGA recommended types and amounts. The attention control group was not provided vegetables but completed the same testing schedule as the vegetable intervention group. The Subjective Happiness Scale (SHS) was used to assess individual perceived happiness before and after the intervention. SHS scores were analyzed using a mixed model analysis of variance both with and without baseline SHS scores as a covariate. Results A significant interaction between treatment and visit (P = 0.005) revealed greater happiness at week 8 than at baseline in the vegetable intervention group but no change in the attention control group. When adjusted for baseline scores, a significant effect of treatment (P = 0.005) was found with greater happiness scores in the vegetable intervention group compared to the attention control group post intervention (P < 0.001). Conclusions Greater subjective happiness was observed after increasing vegetable consumption to meet DGA recommendations. Funding Sources USDA-ARS #5450–51,530-057–00D.

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¡Sí, Yo Puedo Vivir Sano con Diabetes! A Self-Management Randomized Controlled Pilot Trial for Low-Income Adults with Type 2 Diabetes in Mexico City

Current Developments in Nutrition ◽

10.1093/cdn/nzaa074 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Robin Whittemore ◽

Mireya Vilar-Compte ◽

Selene De La Cerda ◽

Roberta Delvy ◽

Sangchoon Jeon ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mexico City ◽

Low Income ◽

Self Efficacy ◽

Pilot Trial ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Over Time

Abstract Background Type 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system. Objectives We aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City. Methods Participants were recruited at public primary healthcare centers (Seguro Popular), and randomly allocated to treatment (n = 26) or wait-list control groups (n = 21) with data collected at 3 and 6 mo. The program included 7 weekly sessions and 6 mo of daily text/picture messages. Descriptive statistics and a generalized linear mixed model with intent-to-treat analysis were calculated. Results Participants were 55.5 ± 8.8 y of age (mean ± SD), 68% female, 88.6% overweight/obese, and 57% lived in food-insecure households. Mean ± SD T2D duration was 11.9 ± 7.8 y and HbA1c was 9.2% ± 1.5%. There was 89% attendance at sessions and 6.4% attrition across both groups at 6 mo. Group-by-time effects were seen in self-monitoring of blood glucose (P < 0.01) and diabetes self-efficacy (P < 0.04); and a trend for lower HbA1c was seen in the intervention group at 6 mo (P = 0.11). Significant improvements in dietary behavior (P < 0.01) were demonstrated in the intervention group over time, but this did not reach statistical significance compared with the control group. Conclusions The program was associated with clinically significant improvements in T2D self-management, self-efficacy, and HbA1c over time. Thus, T2D self-management skills, including diet, were improved in a vulnerable metropolitan population. This trial was registered at clinicaltrials.gov as NCT03159299.

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