A Community-Based Short Message Service Intervention to Improve Mothers' Feeding Practices for Obesity Prevention: Quasi-Experimental Study.

Hong Jiang,Xiaoying Ma,Mu Li,Xu Qian,Li Ming Wen,Louise Baur,Gengsheng He

doi:10.2196/13828

Abstract

BackgroundThe prevalence of childhood obesity is increasing in China, and the effect of mobile phone short message service (SMS) interventions to prevent early childhood obesity needs to be evaluated.ObjectiveThe objective of this study was to assess the effect of an SMS intervention on the prevention of obesity in young children.MethodsA quasi-experimental design SMS intervention was carried out in 4 community health centers (CHCs) in Shanghai, China. A total of 2 CHCs were assigned to the intervention group, and 2 CHCs were assigned to the control group. Mothers in the intervention group received weekly SMS messages on breastfeeding and infant feeding from the third trimester to 12 months postpartum. The primary outcomes were children’s body mass index (BMI), BMI z-score, and weight-for-length z-score at 12 and 24 months. Factors associated with higher BMI and weight-for-length z-score at 24 months were also assessed.ResultsA total of 582 expectant mothers were recruited at the beginning of the third gestational trimester. 477 (82.0%) and 467 (80.2%) mothers and their children were followed up to 12 and 24 months postpartum, respectively. There were no significant differences in children’s BMI, BMI z-score, and weight-for-length z-score at 12 and 24 months between the 2 groups. Factors associated with higher BMI, BMI z-score, and weight-for-length z-score at 24 months included higher birth weight, introduction of solid foods before 4 months, and taking a bottle to bed at 12 months.ConclusionsThe SMS intervention did not show a significant effect on children’s BMI, BMI z-score, or weight-for-length z-score at 12 and 24 months. Introduction of solid foods before 4 months and taking a bottle to bed at 12 months were significantly and positively correlated with a higher BMI, BMI z-score, and weight-for-length z-score at 24 months. Further studies with more rigorous design are needed to evaluate the effect of SMS interventions on preventing early childhood obesity.

Highlights

BackgroundChildhood obesity is a major public health concern globally
Further studies with more rigorous design are needed to evaluate the effect of short message service (SMS) interventions on preventing early childhood obesity
Of the 641 expectant mothers recruited from the 4 community health center exclusive breastfeeding (EBF) (CHC) during their first visit, 582 were eligible at the beginning of the third trimester, 281 in the intervention group and 301 in the control group

Summary

Introduction

BackgroundChildhood obesity is a major public health concern globally. In China, the prevalence of obesity in children and adolescents aged 0 to 18 years increased from 0.4% in 1985 to 7.5% in 2010, a more than 18-fold increase in 25 years [1]. There has been an increased interest in research on early childhood obesity interventions in recent years, including home- or caregiver-based interventions [4,5], interactive training modules for parents, and environmental change to promote healthy eating and active playing [6,7]. Such interventions have reportedly led to improvements in infant feeding practices (eg, increased duration of breastfeeding and a decrease in soft drink consumption) and a reduction in TV viewing while eating [8,9]. The prevalence of childhood obesity is increasing in China, and the effect of mobile phone short message service (SMS) interventions to prevent early childhood obesity needs to be evaluated

Methods

Results

Discussion

Conclusion