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Tools For Teen Moms: Reducing Infant Obesity Risk

Tools for Teen Moms: Reducing Infant Obesity Risk

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02244424
Acronym
TFTM
Enrollment
164
Registered
2014-09-19
Start date
2014-06-30
Completion date
2016-09-30
Last updated
2019-03-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Adolescent Mothers, Infant Obesity

Keywords

Infant, Obesity, Adolescent, Social media, Prevention

Brief summary

The purpose of this social media group randomized trial (GRT) is to test the feasibility of our Baby Dayr for Teen Moms intervention to increase maternal responsiveness to infant cues and implement healthy feeding practices through development of a healthy feeding style. Aim 1: Evaluate the feasibility and acceptability of the Baby Dayr intervention administered to the target population as it relates to their acceptance and satisfaction with the content, format, delivery, and use of social media. Aim 2: Explore efficacy of the Baby Dayr intervention administered to adolescent mothers of infants 4 months of age or less as assessed by maternal responsiveness, feeding style, and feeding practices evaluated at the completion of the intervention using self-report methods.

Detailed description

Rapid weight gain during infancy is one of the strongest risk factors for obesity later in childhood. Weight gain in infancy is closely linked with feeding practices. Unhealthy mother-infant feeding practices contribute to rapid and/or excessive infant weight gain. Lower-income, adolescent, first-time mothers are less likely to engage in infant-centered feeding (ICF) which is characterized by maternal responsiveness (MR), healthy feeding styles (FS), and healthy feeding practices (FP). ICF is needed to reduce rapid/excessive weight gain during the first six months of life and to foster infant feeding self-regulation that is associated with healthy growth. ICF is a critical factor in reducing infant obesity risk and later adverse health conditions. Practical early intervention strategies are necessary to promote ICF among adolescent mothers to reduce obesity risk. We propose Baby Dayr, a novel social media intervention platform designed by the investigators which includes cell phone text message reminders, an infant feeding website, and Facebook to increase ICF through daily behavioral challenge activities (challenges) for this population. Because cell phones permit natural, frequent and non-intrusive contact as they are not time-or-place-dependent, they offer an innovative strategy for intervening with adolescent mothers. However, this approach is untested for its feasibility with this population regarding infant feeding practices. We propose an exploratory, longitudinal, randomized, two-group study design. The three specific aims are: 1) to establish preliminary efficacy of the intervention as assessed by infant growth evaluated pre-intervention, immediately post intervention, and when the infant is six months old; 2) establish preliminary efficacy of the Baby Dayr plus Maternal-Infant Health Program (MIHP) care vs. MIHP care only on infant-centered feeding (MR, FS, and FP) mediated by maternal knowledge and self-efficacy; and 3) establish the feasibility, acceptability, and satisfaction of a social media intervention (Baby Dayr) for low-income adolescent, first-time mothers by assessing: 1) rates of enrollment and completion of daily challenges, 2) acceptability ratings of Baby Dayr; and 3) satisfaction with Baby Dayr. Participants will be randomly assigned to the intervention (Baby Dayr and MIHP) (n = 40) or control group (MIHP care only) (n = 40). The intervention consists of six weeks of daily challenges and will be delivered starting when the infant is four to six weeks old. The study is innovative in its: 1) assessment of ICF to reduce rapid/excessive infant weight gain in the first six months of life with low-income, adolescent, first-time mother-infant dyads, and 2) combination of an infant-centered skill-building, educational, and coaching approach using social media that is accessible and suitable for adolescents. The proposed research is significant in that it will contribute to the science related to ICF and knowledge regarding use of a social media platform in an at-risk population that can lead to reducing the risk of infant obesity. Information gained from this study will be used to refine the intervention for use in a larger-scale, longitudinal, randomized, controlled trial to reduce obesity risk in infants of low-income, adolescent mothers.

Interventions

BEHAVIORALTools for Teen Moms

The Tools for Teen Moms intervention is a novel social media intervention platform designed by the investigators which includes cell phone text message reminders, and infant feeding website, and Facebook to increase infant-centered feeding through daily behavioral challenge activities (challenges) for this population. The intervention consists of 6 weeks of daily challenges and will be delivered within the infant's first 6 months of life.

Sponsors

Michigan State University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)

Eligibility

Sex/Gender
FEMALE
Age
14 Years to 19 Years
Healthy volunteers
No

Inclusion criteria

* Self-identified, English-speaking * Low-income, adolescent * First-time mothers between the ages of 14 and 19 * With daily web access and access to a cell phone that includes text messaging capabilities * Family income ≤ 185% of federal poverty * Term birth (37≤42 weeks, 2500≤3750 grams birth weight) * Mothers and infants with no special nutrients or feeding needs * Infants less than six weeks old at study enrollment who have not started eating solid foods * Adolescent mothers must be a primary caretaker of the infant who feeds her infant at least once a day, and who is willing to participate in a six-week intervention with data collection at three defined time points (T1, T2, and T3)

Exclusion criteria

* Male caregivers * Mothers and infants with diagnosed feeding/eating disorders * Significant perinatal or postnatal complications * Post partum depression or other mental health problems * Adolescent mothers who do not share in the feeding responsibility of their infants * Adolescents without daily web access nor a cell phone with text messaging capabilities

Design outcomes

Primary

MeasureTime frameDescription
Change in Infant GrowthBaby is less than 2 months; baby is 3 months; baby is 6 monthsRecumbent infant length (inches) and weight (pounds/ounces) measured at three separate time points. While recumbent infant length was collected in inches and weight collected in pounds/ounces, these measures were converted into z-score measurements for the outcome measurement of change in infant growth. Standardized weight scores are measures of relative weight adjusted for child age and sex. The z-score indicates the number of standard deviations away from a reference population in the same age range and with the same sex. A z-score of 0 is equal to the mean. Negative numbers indicated weight values lower than the mean and the positive numbers indicate weight values higher than the mean.

Countries

United States

Participant flow

Recruitment details

Teen mothers of infants were recruited. Teen mothers participated in the intervention. Infants were included for collection of demographic and weight data. Thus the actual number of participants is doubled to account for both the mothers and infants as participants. Protocol Enrollment number then is 164 ( 82 teen mothers and 82 infants).

Participants by arm

ArmCount
Tools for Teen Moms Intervention Group
Tools for Teen Moms intervention group will receive daily challenges focusing on: 1) Maternal-Infant Feeding Interaction; and 2) Feeding Practices Challenges.
102
MIHP Standard Care
MIHP care consists of voluntary home visits: one week postpartum, at six weeks, and six months, and on-going as needed provided by a RN, licensed social worker, RD, infant mental health specialist and/or paraprofessional. Content includes a flexible plan of care with visits based on identified domains for both the mother and the infant.
62
Total164

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up2010

Baseline characteristics

CharacteristicTools for Teen Moms Intervention GroupMIHP Standard CareTotal
Age, Continuous17.53 years
STANDARD_DEVIATION 1.3
17.61 years
STANDARD_DEVIATION 1.41
17.56 years
STANDARD_DEVIATION 1.33
Birth length (cm)50.98 cm
STANDARD_DEVIATION 2.71
50.70 cm
STANDARD_DEVIATION 2.88
50.88 cm
STANDARD_DEVIATION 2.77
Birth weight (kg)3.21 kg
STANDARD_DEVIATION 0.4
3.21 kg
STANDARD_DEVIATION 0.43
3.21 kg
STANDARD_DEVIATION 0.41
Breastfeeding status at baseline
Breastfed in the past
15 Participants9 Participants24 Participants
Breastfeeding status at baseline
Currently Breastfeeding
18 Participants16 Participants34 Participants
Breastfeeding status at baseline
Never Breastfed
18 Participants6 Participants24 Participants
Employment Status
Full time (at least 35 hours/week)
3 Participants0 Participants3 Participants
Employment Status
Not working
45 Participants27 Participants72 Participants
Employment Status
Working part-time
3 Participants4 Participants7 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
18 Participants14 Participants32 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
33 Participants17 Participants50 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Highest level of education completed
10th grade
11 Participants0 Participants11 Participants
Highest level of education completed
11th grade
16 Participants13 Participants29 Participants
Highest level of education completed
12th grade
6 Participants2 Participants8 Participants
Highest level of education completed
6th grade
0 Participants0 Participants0 Participants
Highest level of education completed
7th grade
2 Participants1 Participants3 Participants
Highest level of education completed
8th grade
2 Participants2 Participants4 Participants
Highest level of education completed
9th grade
2 Participants2 Participants4 Participants
Highest level of education completed
Completed some college credits
1 Participants3 Participants4 Participants
Highest level of education completed
High school diploma or GED
11 Participants7 Participants18 Participants
Highest level of education completed
Missing
0 Participants1 Participants1 Participants
Infant age at enrollment1.21 months
STANDARD_DEVIATION 0.48
1.18 months
STANDARD_DEVIATION 0.54
1.20 months
STANDARD_DEVIATION 0.5
Infant Baseline length (cm)54.75 cm
STANDARD_DEVIATION 2.99
55.05 cm
STANDARD_DEVIATION 3.61
54.86 cm
STANDARD_DEVIATION 3.22
Infant Baseline weight (kg)4.30 kg
STANDARD_DEVIATION 0.75
4.27 kg
STANDARD_DEVIATION 0.78
4.29 kg
STANDARD_DEVIATION 0.76
Infant sex
Female
25 Participants14 Participants39 Participants
Infant sex
Male
26 Participants17 Participants43 Participants
Marital Status
In a Relationship
29 Participants17 Participants46 Participants
Marital Status
Married
4 Participants3 Participants7 Participants
Marital Status
Not in a Relationship
18 Participants11 Participants29 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
2 Participants0 Participants2 Participants
Race (NIH/OMB)
Black or African American
22 Participants12 Participants34 Participants
Race (NIH/OMB)
More than one race
2 Participants2 Participants4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
24 Participants17 Participants41 Participants
Region of Enrollment
United States
51 teen mother participants31 teen mother participants82 teen mother participants
Sex: Female, Male
Female
51 Participants31 Participants82 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants
Solid feeding status at baseline
Fed anything other than breastmilk or formula
Missing
0 Participants0 Participants0 Participants
Solid feeding status at baseline
Fed anything other than breastmilk or formula
No
51 Participants30 Participants81 Participants
Solid feeding status at baseline
Fed anything other than breastmilk or formula
Yes
0 Participants1 Participants1 Participants
Solid feeding status at baseline
Given tastes of solid food from mother's finger
Missing
1 Participants0 Participants1 Participants
Solid feeding status at baseline
Given tastes of solid food from mother's finger
No
49 Participants29 Participants78 Participants
Solid feeding status at baseline
Given tastes of solid food from mother's finger
Yes
1 Participants2 Participants3 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
0 / 1020 / 62
serious
Total, serious adverse events
0 / 1020 / 62

Outcome results

Primary

Change in Infant Growth

Recumbent infant length (inches) and weight (pounds/ounces) measured at three separate time points. While recumbent infant length was collected in inches and weight collected in pounds/ounces, these measures were converted into z-score measurements for the outcome measurement of change in infant growth. Standardized weight scores are measures of relative weight adjusted for child age and sex. The z-score indicates the number of standard deviations away from a reference population in the same age range and with the same sex. A z-score of 0 is equal to the mean. Negative numbers indicated weight values lower than the mean and the positive numbers indicate weight values higher than the mean.

Time frame: Baby is less than 2 months; baby is 3 months; baby is 6 months

Population: 82 participants were included in analysis at Time 1, 79 at Time 2, and 67 at Time 3. This is due to participants lost to follow-up.

ArmMeasureGroupValue (MEAN)Dispersion
Tools for Teen Moms Intervention GroupChange in Infant GrowthTime 1 (infant 2-8 weeks of age)-0.46 Weight for age Z-scoreStandard Deviation 0.9
Tools for Teen Moms Intervention GroupChange in Infant GrowthTime 2 (infant about 3 months)-0.33 Weight for age Z-scoreStandard Deviation 0.95
Tools for Teen Moms Intervention GroupChange in Infant GrowthTime 3 (infant about 6 months)-0.22 Weight for age Z-scoreStandard Deviation 1.17
MIHP Standard CareChange in Infant GrowthTime 1 (infant 2-8 weeks of age)-0.44 Weight for age Z-scoreStandard Deviation 0.86
MIHP Standard CareChange in Infant GrowthTime 2 (infant about 3 months)-0.46 Weight for age Z-scoreStandard Deviation 0.93
MIHP Standard CareChange in Infant GrowthTime 3 (infant about 6 months)-0.21 Weight for age Z-scoreStandard Deviation 0.83

Source: ClinicalTrials.gov · Data processed: Mar 5, 2026