Reservation-based American Indian (AI) children suffer the highest rates of childhood obesity in the United States. This project will provide evidence to support the integration of childhood obesity prevention modules into government-funded home-visiting programs. It will also identify the role of water insecurity in sugar-sweetened beverage (SSB) intake. The specific aims of the study are to: 1) assess the impact of a home-visiting module, Family Spirit Nurture (FSN), on SSB introduction/frequency and optimal complementary and responsive feeding practices between 3 and 9 months post-partum, and 2) assess the impact of water insecurity on SSB consumption among infants between 3 and 6 months post-partum. The study will be a randomized 1:1 controlled trial with 136 mother-infant dyads. AI mothers and children ages 1-3 months living <50 miles from the Northern Navajo Medical Center in Shiprock, NM, on the Navajo Nation will be enrolled in the study. Mothers will be randomized to FSN or a control condition and complete evaluations at baseline (<3) and 4, 6, and 9 months post-partum. Outcome measures include maternal feeding and nutrition knowledge; introduction/frequency of infant SSB consumption; complementary and responsive feeding practices collected via self-assessment or structured interview; and BMI z-score, obtained through medical chart reviews.
Examining Home-Visiting Strategies to Prevent Obesity Among American Indians, Focusing on Early Childhood Outcomes and Water Insecurity
Effect of a Home-Visiting Intervention to Reduce Early Childhood Obesity Among Native American Children
The objective of this study was to assess the impact of a brief home-visiting approach, Family Spirit Nurture (FSN), on sugar-sweetened beverage (SSB) consumption, responsive parenting and infant feeding practices, and optimal growth through 12 months post partum. This study was a 1:1 randomized clinical trial comparing FSN with an … More
Breastfeeding protects against overweight and obesity, asthma, eczema, and type-II diabetes, and has long-term health benefits for women. The health benefits of breastfeeding are so valuable that in 1981, the World Health Organization established the International Code of Marketing of Breast-Milk Substitutes (WHO Code) that prohibits marketing infant formula to … More
Drinking water access in California schools: Room for improvement following implementation of school water policies
This study aimed to investigate how access to free drinking water in California public schools changed after implementation of 2010 federal and state school water policies. Repeated cross-sectional surveys were conducted with administrators in a random sample of California public schools, stratified by school type and urban-centric geography, from 2010 … More