TY - JOUR
T1 - Effects of the Sleep SAAF responsive parenting intervention on rapid infant weight gain
T2 - A randomized clinical trial of African American families
AU - Lavner, Justin A.
AU - Savage, Jennifer S.
AU - Stansfield, Brian K.
AU - Beach, Steven R.H.
AU - Marini, Michele E.
AU - Smith, Jessica J.
AU - Sperr, Megan C.
AU - Anderson, Tracy N.
AU - Hernandez, Erika
AU - Moore, Amy M.
AU - Caldwell, Alice Little
AU - Birch, Leann L.
N1 - Funding Information:
The authors thank Farlyn Hudson for recruiting participants; Itia Lee, Glenise Dixon, Sonya Manderville-Lawton, and Shynetta Briggs for leading data collection; Kenya Calhoun, Shirlinda Logan, Sheila McKinnie, Monica Payton, Janaé Rollins; Shirley Tarver, Lavon Wells, and Marsha Williams for delivering the study interventions; Mei Ling Ong, Ph.D. and Ariel Hart for their assistance with data management; Lauren VanderBroek Stice, Ph.D. for assisting with intervention training; Reda Bassali, M.D. for serving as the Data Safety Monitor for the study; the staff in the mother/baby nursery at AUMC for their support of recruitment efforts; Gene Brody, Ph.D. for informing study design; and the staff of the Center for Family Research at the University of Georgia for their assistance with project management. We also thank the families for participating in this research. This work was supported by the National Institutes of Health [grant number R01DK112874 to Justin A. Lavner and Leann L. Birch] and by a Harrington Faculty Fellowship from the University of Texas at Austin to Justin A. Lavner. The funding body did not play a role in the design of the study, data collection efforts, or in writing the manuscript. The content of this article is solely the responsibility of the authors and does not necessarily represent official views of the National Institutes of Health.
Funding Information:
This work was supported by the National Institutes of Health [grant number R01DK112874 to Justin A. Lavner and Leann L. Birch] and by a Harrington Faculty Fellowship from the University of Texas at Austin to Justin A. Lavner. The funding body did not play a role in the design of the study, data collection efforts, or in writing the manuscript. The content of this article is solely the responsibility of the authors and does not necessarily represent official views of the National Institutes of Health.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Responsive parenting (RP) interventions reduce rapid infant weight gain but their effect for underserved populations is largely unknown. The Sleep SAAF (Strong African American Families) study is a two-arm randomized clinical trial for primiparous African American mother-infant dyads that compares an RP intervention to a child safety control over the first 16 weeks postpartum. Here we report on intervention effects on rapid infant weight gain and study implementation. Families were recruited from a mother/baby nursery shortly after delivery. Community Research Associates (CRAs) conducted intervention home visits at 3 and 8 weeks postpartum, and data collection home visits at 1, 8, and 16 weeks postpartum. To examine rapid infant weight gain, conditional weight gain (CWG) from 3 to 16 weeks, the primary outcome, and upward crossing of 2 major weight-for-age percentile lines were calculated. Among the 212 mother-infant dyads randomized, 194 completed the trial (92% retention). Randomized mothers averaged 22.7 years, 10% were married, and 49% participated in the Supplemental Nutrition Assistance Program (SNAP). Adjusting for covariates, mean CWG was lower among RP infants (0.04, 95% CI [-0.33, 0.40]) than among control infants (0.28, 95% CI [-0.08, 0.64]), reflecting non-significantly slower weight gain (p = 0.15, effect size d = 0.24). RP infants were nearly half as likely to experience upward crossing of 2 major weight-for-age percentile lines (14.1%) compared to control infants (24.2%), p = 0.09, odds ratio = 0.52 (95% CI [0.24, 1.12]). Implementation data revealed that participating families were engaged in the intervention visits and intervention facilitators demonstrated high fidelity to intervention materials. Findings show that RP interventions can be successfully implemented among African American families while suggesting the need for modifications to yield stronger effects on infant weight outcomes.
AB - Responsive parenting (RP) interventions reduce rapid infant weight gain but their effect for underserved populations is largely unknown. The Sleep SAAF (Strong African American Families) study is a two-arm randomized clinical trial for primiparous African American mother-infant dyads that compares an RP intervention to a child safety control over the first 16 weeks postpartum. Here we report on intervention effects on rapid infant weight gain and study implementation. Families were recruited from a mother/baby nursery shortly after delivery. Community Research Associates (CRAs) conducted intervention home visits at 3 and 8 weeks postpartum, and data collection home visits at 1, 8, and 16 weeks postpartum. To examine rapid infant weight gain, conditional weight gain (CWG) from 3 to 16 weeks, the primary outcome, and upward crossing of 2 major weight-for-age percentile lines were calculated. Among the 212 mother-infant dyads randomized, 194 completed the trial (92% retention). Randomized mothers averaged 22.7 years, 10% were married, and 49% participated in the Supplemental Nutrition Assistance Program (SNAP). Adjusting for covariates, mean CWG was lower among RP infants (0.04, 95% CI [-0.33, 0.40]) than among control infants (0.28, 95% CI [-0.08, 0.64]), reflecting non-significantly slower weight gain (p = 0.15, effect size d = 0.24). RP infants were nearly half as likely to experience upward crossing of 2 major weight-for-age percentile lines (14.1%) compared to control infants (24.2%), p = 0.09, odds ratio = 0.52 (95% CI [0.24, 1.12]). Implementation data revealed that participating families were engaged in the intervention visits and intervention facilitators demonstrated high fidelity to intervention materials. Findings show that RP interventions can be successfully implemented among African American families while suggesting the need for modifications to yield stronger effects on infant weight outcomes.
KW - African Americans
KW - Childhood obesity
KW - Infancy
KW - Prevention
KW - Rapid weight gain
KW - Responsive parenting
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U2 - 10.1016/j.appet.2022.106080
DO - 10.1016/j.appet.2022.106080
M3 - Article
C2 - 35577176
AN - SCOPUS:85131464159
SN - 0195-6663
VL - 175
JO - Appetite
JF - Appetite
M1 - 106080
ER -