Abstract: Preliminary Findings from the Family Spirit Nurture Home-Visiting Trial on Sugar Sweetened Beverage Consumption and Infant Feeding Practices (Society for Prevention Research 27th Annual Meeting)
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447 Preliminary Findings from the Family Spirit Nurture Home-Visiting Trial on Sugar Sweetened Beverage Consumption and Infant Feeding Practices

Schedule:
Thursday, May 30, 2019
Pacific D/L (Hyatt Regency San Francisco)
* noted as presenting author
Summer Rosenstock, PhD, Assistant Scientist, The Johns Hopkins University, Baltimore, MD
Allison Ingalls, MPH, Research Associate II, The Johns Hopkins University, Baltimore, MD
Reese Cuddy, MPH, Research Associate, The Johns Hopkins University, Albuqueque, NM
Nicole Neault, MPH, Program Manager, The Johns Hopkins University, Albuqueque, NM
Lisa Cohoe, NA, Research Program Assistant, The Johns Hopkins University, Shiprock, NM
Leonela Nelson, BS, Research Program Assistant, The Johns Hopkins University, Shiprock, NM
Raymond Reid, MD, Study Physician, The Johns Hopkins University, Shiprock, NM
Allison Barlow, PhD, Director, The Johns Hopkins University, Baltimore, MD
Introduction: Native American (NA) children have the highest rates of early childhood obesity of any racial/ethnic group in the US. Sugar sweetened beverages (SSBs), the largest contributor of sugar to US children’s diets, have been linked to increased obesity risk and morbidities over the life course. The Prevention of Early Childhood Obesity (PECO) trial tests the impact of the Family Spirit Nurture (FSN) home-visiting approach to reduce maternal/child SSB consumption and improve infant feeding practices in the first year of life, while examining if household water insecurity moderates intervention impact.

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.

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