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
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