Diet Habit, Feeding Behavior, Overweight and Obesity, Physical Activity, Sleep, Social Determinants of Health
Conditions
Keywords
Overweight, Obesity, Maternal-child, Social Determinants of Health
Brief summary
The First 1000 Days (conception to age 2) is a crucial period for the development and prevention of obesity and its adverse consequences in mother-child pairs and their families. The overall aim of the First 1000 Days program is to work across early-life systems to prevent obesity, promote healthy routines and behaviors, address social determinants of health, and reduce health disparities among vulnerable children and families at community health centers in the Boston, MA area. The study aims to simultaneously implement and evaluate an obesity prevention program across early life systems to reduce the prevalence of obesity risk factors within racial/ethnic minority families, close the gap in maternal-child health disparities, and assess and address social determinants of health.
Interventions
BEHAVIORALFirst 1,000 Days Program Site
Program components will include 1) Enhancements to and improved use of electronic health records to improve the quality of preventive services and screening for social determinants of health; 2) Staff and provider training; 3) Consistent behavior change messaging; 4) Patient education via print materials, text messaging and short videos; and 5) Strengthening the integration of clinical and public health services to support behavior change and address social determinants of health.
Sponsors
The Boston Foundation
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Massachusetts General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
The First 1,000 Days program is a systems-level program that will reach all expectant mothers and families with 0-2 year olds receiving care at Boston-area community health centers. Mothers and infants at two similar non-intervention Boston-area health centers will be used as a comparison sample. Maternal and infant obesity-related clinical information is routinely recorded during patient visits in the EHR used at both the intervention and comparison sites. Sample size enrollment reflects maternal-infant dyads.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* All pregnant women receiving prenatal care at select community health centers in the Boston, MA area * All families of children aged 0-2 years receiving pediatric care at select community health centers in the Boston, MA area
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Infant Weight-for-Length Z-Score | Child age 6 months | Age- and sex-specific weight-for-length z-score |
| Maternal Gestational Weight Gain | First prenatal care visit to 36 weeks gestation | Weight gained during pregnancy |
| Infant Weight-for-Length Z-score | Child age 12 months | Age- and sex-specific weight-for-length z-score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from 1st trimester maternal sedentary time to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | Hours per day of screentime |
| Change from 1st trimester depression to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | Edinburgh Postnatal Depression Scale |
| Change from 1st trimester maternal food insecurity to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | 2-question validated scale |
| Change from 1st trimester maternal diet to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | Average weekly intake |
| Change from 1st trimester pregnancy-related anxiety to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | 5-question validated scale |
| Change from 1st trimester enrollment in food assistance programs to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | Yes/No response options for program enrollment in WIC and SNAP |
| Change from 1st trimester maternal housing insecurity to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | 2-question validated scale |
| Change from 1st trimester maternal physical activity to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | Days per week physically active for at least 30 minutes per day |
| Change from 1st trimester maternal sleep duration to 3rd trimester | An average of 18 weeks (1st trimester to 3rd trimester) | Average hours per day |
Outcome results
None listed