Abstract
BackgroundThe World Health Organization recommends 30 min of tummy time daily for improved motor development and reduced likelihood of plagiocephaly. As only 30% of infants meet this recommendation, parents require strategies and support to increase this proportion.MethodsThe aim of this study was to determine the feasibility, acceptability, and potential efficacy of a group intervention to promote tummy time. The design is a cluster randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Five groups of healthy infants (N = 35, baseline mean (SD) age 5.9 (2.8) weeks) and their mothers attending local mother’s groups (Australia) were randomly allocated to the intervention or control group. The intervention group received group tummy time classes in addition to usual care. The control group received usual care with their child and family health nurse. Primary outcomes were intervention feasibility and acceptability. Secondary outcomes were tummy time duration (accelerometry), adherence to physical activity guidelines, head shape, and motor development. Measures were taken at baseline, post-intervention, and when infants were 6 months of age. Analyses were by linear mixed models and Cohen’s d statistic.ResultsRecruitment, retention, and collection of objective data met feasibility targets. Acceptability was also met with intervention mothers reporting the information, goal planning, and handouts significantly more useful and relevant than control group mothers (p < 0.01). Moderate effect sizes were also found at post-intervention for tummy time duration, adherence to physical activity guidelines and infant ability in prone and supine favoring the intervention group (intervention infants had a mean of 30 min and 30% adherence to guidelines (95% CI 0 to 60.6 min) compared to the control infants who had a mean of 16.6 min and 13% adherence to the guidelines (95% CI 0 to 42.1 min, Cohen’s d = 0.5). Limitations were the small sample size, 4-week intervention, limited accelerometer use, and a homogenous sample of participants.ConclusionGroup tummy time classes delivered in a mother’s group setting were shown to be feasible and acceptable. A larger randomized controlled trial is warranted.Trial registrationANZCTR, ACTRN12617001298303p. Registered 11 September 2017
Highlights
The World Health Organization recommends 30 min of tummy time daily for improved motor development and reduced likelihood of plagiocephaly
The use of GENEActiv to measure tummy time was acceptable to 80% of mothers overall; 45% reported the accelerometer required input throughout the day to keep it positioned correctly
Overview This study investigated the feasibility and acceptability of group tummy time classes to mothers and their infants who were attending their local area health service mother’s groups
Summary
The World Health Organization recommends 30 min of tummy time daily for improved motor development and reduced likelihood of plagiocephaly. The World Health Organization (WHO) recommends infants are physically active several times a day in a variety of ways for the greatest health benefits. This includes at least 30 min in a prone position (tummy time) spread throughout the day while they are awake and supervised [1]. Interventions aimed to increase awareness, translation and implementation of infant physical activity guidelines are required to determine which strategies and types of support given to parents/carers are feasible, acceptable, and efficacious. Assisting parents and carers to meet the recommended targets will ensure the achievement of optimal health and development outcomes for their children
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