Starting Early: Primary Care-Based Obesity Prevention Beginning in Pregnancy

Abstract

Reduce early child obesity by improving parent feeding styles and practices with a primary-care based prevention program beginning in pregnancy. Low SES Latina pregnant women, mother-infant dyads. The high prevalence of obesity in young children, especially among low socioeconomic status (SES) and Latino groups, highlights the need for preventive interventions beginning early in life. Parent feeding styles and practices produce dietary patterns, present by age 2 years, that promote obesity. Women and children are seen frequently for primary care during pregnancy and the first years of life; representing an opportunity for intervention. Primary care interventions have improved parenting, child development and injury prevention; but have not been tried for early obesity prevention. Starting Early (SE) uses elements from other interventions to improve feeding styles and practices. Randomized controlled trial comparing SE to standard care. Enrollment of 500 pregnant women in third trimester from prenatal clinic in an urban hospital clinic; intervention through child age 3 years. Three main components of SE: 1) individual, group nutrition counseling coordinated with every primary care visit, 2) nutrition video developed by area WIC provider, 3) low literacy handouts adapted from multi-site early obesity prevention intervention. Surveys: feeding styles, practices at baseline, 3, 10, 19, 24 and 36 months. Chart review: maternal, child weights, lengths/heights, lab assessments for diabetes, anemia. Analyze differences between intervention and control groups. SE represents a unique opportunity to leverage the frequency of primary care visits to improve parent feeding styles and practices and prevent obesity at a critical early stage of life.