Methods: PECO is a 1:1 randomized controlled trial of the FSN home-visiting intervention in a rural NA reservation-based sample. The brief 6-lesson intervention, delivered to mother/infant dyads (N=134) 3-6 months postpartum (pp), focuses on eliminating household SSBs and promoting optimal complementary and responsive feeding practices. Mother/infant dyads are followed to 12 months pp. Between-group differences in maternal/infant SSB consumption, breastfeeding duration, and mothers' complementary and responsive feeding practices were tested using Chi2 or t-tests as appropriate. Results were also stratified by water security status. Mixed effects models, adjusting for repeated measures, examined changes in primary outcomes over time.
Results: At baseline, 37.2% households were water insecure. Baseline maternal SSB consumption was significantly higher among water insecure vs. water secure moms (43.96 vs. 24.90 cups/week, p=0.011). Maternal SSB consumption was lower overall among intervention moms at 6 months pp (Control: 25.32 vs. Intervention:13.5 cups/week, p=0.007). However, the between-group difference in maternal SSB consumption was confined to water secure moms at 6 months (Control: 27.61, Intervention: 12.46, p=0.007). At 6 months pp, infant SSB consumption was low; between-group differences were insignificant (Control: 4.7%, Intervention: 3.8%, p=0.831). Intervention mothers reported engaging in more responsive feeding at 6 months pp compared to controls (Control: 3.32, Intervention: 3.54, p=0.026). Breastfeeding initiation was high in both study groups (>85%). Significantly more intervention moms breastfed through 6 months (Control 35.3%, Intervention: 57.4%, p=0.020). This difference was confined to water secure moms and also associated with higher education.
Conclusion: Preliminary results indicate that FSN is a promising home-visiting intervention for reducing maternal SSB consumption and improving infant feeding practices. Water insecurity appears to be a barrier to intervention impact on reduction of obesity risk factors. Longer follow-up is needed to discern FSN impact on children’s SSB consumption and healthy weight status.