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| ID | Type | Description | Link |
|---|---|---|---|
| 1R01HD092483-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Antelope Valley Partners for Health | OTHER |
| Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | NIH |
| Cedars-Sinai Medical Center | OTHER |
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Existing obesity prevention efforts have had limited success among underserved, low-income children. This study capitalizes on the strengths of a nationwide ongoing Home Visitation Program (HVP), which serves at-risk, low-income, ethnically/racially diverse mothers and their infants, to test the effectiveness of delivering obesity prevention as part of their weekly, in-home services. The study will evaluate whether the integration of an obesity prevention enhancement module into existing HVP services, reduces the risk and incidence of obesity and associated risk factors in mothers and infants, compared to the provision of standard home visitation services. The study also focuses on the role of maternal factors (maternal diet, physical activity, food insecurity and feeding practices) and social factors (social network support) as mechanisms operating on infant outcomes.
More than 40% of children enrolled in federally funded programs are overweight or obese by age 5. Unfortunately, extant obesity efforts have had a limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) delivery methods limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty, housing instability, and access to care, which interfere with healthy lifestyle changes. To address these gaps, we have integrated simple, evidence-based nutrition and physical activity components as part of the services already delivered by our home visitation partner, Healthy Families America, with the long-term goal to deploy these efforts to Home Visitation Programs (HVPs) nationwide. Annually, over 500 publicly and privately funded HVPs provide nationwide services to more than 650,000 low-income, underserved infants and their families. The home visiting structure is not only an unparalleled model for scalable and sustainable childhood obesity prevention, but it also provides a unique opportunity to understand factors related to the intergenerational transmission of obesity in families who are most at risk.
Over the last four years, our transdisciplinary team of researchers, home visiting stakeholders, families, and community stakeholders has integrated evidence-based nutrition and physical activity components into an engaging obesity prevention curriculum delivered in English and Spanish as an enhancement module to the services of our HVP partner. Our pilot work supports the successful integration, feasibility, and preliminary efficacy of integrating obesity prevention as part of HVP services. The proposed study tests the large-scale and sustained impact of home-based obesity prevention on infant's and mothers' obesity outcomes, and studies key mechanisms of maternal and social transmission on infants' obesity risk.
Specifically, 300 low-income mothers/infants enrolled in Healthy Families America's HVP will be recruited and enrolled in the study. Based on standard HVP procedures, mothers/infants will be matched to highly trained home visitors based on their ethnicity/race and language preferences. Home visitors, in turn, will be randomly assigned to deliver the standard HVP curriculum only or the standard HVP curriculum + obesity prevention as part of their weekly home visits, for the first 12 months of HVP services. Comprehensive assessments of mothers/infants will be conducted at enrollment and after 6 and 12 months of intervention.
Aim 1 (maternal and infant outcomes). Test the direct effects of obesity prevention on infants and mothers' weight, metabolic risks, diet/energy intake, and physical activity. This will be accomplished by comparing changes in body weight, metabolic markers, and eating and activity-related behaviors between infants/mothers across study arms (HVP only vs. HVP+obesity prevention). These results will indicate whether HVP is an effective infrastructure for primary and secondary obesity prevention.
Aim 2 (maternal transmission). Test whether breastfeeding and maternal diet and activity, feeding practices, and food insecurity mediate the effect of obesity prevention on infants' outcomes. This aim will test mechanisms of maternal transmission on infants' obesity risks.
Aim 3 (social transmission). Aim 3 is two-pronged. Aim 3a tests the direct effect of HVP+obesity prevention (vs. HVP only) on the characteristics of the social and community networks that surround mothers and infants (i.e., the density, composition, and quality of health support networks). Aim 3b tests whether the characteristics of social networks mediate the effects of obesity prevention on maternal and infant outcomes. These findings will indicate if the delivery of in-home obesity prevention efforts can alter and/or activate social network mechanisms.
Secondary Aim. Conduct a real-life economic analysis (costs, cost-savings, and non-monetary benefits) of integrating obesity prevention into existing HVPs.
This proposal addresses the impetus to develop interventions targeting at-risk infants before obesity is established. Although maternal-infant interventions are much-needed, they present implementation and dissemination challenges, including limitations on compliance and retention, and limited potential for scalability and sustainability. Our proposed strategy overcomes these challenges through an innovative solution that merges evidence-based nutrition and activity components into an existing, ongoing federally-funded infrastructure. The proposed research is timely as the Institute of Medicine, the United States Department of Agriculture, and Health and Human Services (DHHS) extend their recommendations to address key factors influencing obesity risk in children from birth to 24 months of age.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard HVP Curriculum | Active Comparator | Participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. |
|
| Obesity Prevention | Experimental | Participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Standard HVP Curriculum | Behavioral | Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. |
| Measure | Description | Time Frame |
|---|---|---|
| Mother BMI | Body mass index (BMI) at each assessment | Baseline, 6 months, 12 months |
| Infant Weight | weight in pounds | Baseline, 6 months, 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Fruit Intake Frequency | Assessed using modified food frequency measures from the National Health and Nutrition Examination Survey (NHANES). | Baseline, 6 months, 12 months |
| Vegetable Intake Frequency |
| Measure | Description | Time Frame |
|---|---|---|
| Maternal Food Security | The U.S. Adult Food Security Survey Module will be used to evaluate hunger and food sufficiency to meet the basic needs of families. | Baseline, 6 months, 12 months |
| Maternal Social Isolation |
*Important: Mother (or caregiver) and child dyads are enrolled together. Both must meet inclusion criteria to participate.
Inclusion Criteria:
Mothers:
Children:
Exclusion Criteria:
Mothers:
Infants:
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| Name | Affiliation | Role |
|---|---|---|
| Kayla de la Haye, PhD | University of Southern California | Principal Investigator |
| Sarah-Jeanne Salvy, PhD | Cedars-Sinai Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Southern California | Los Angeles | California | 90089-9239 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30578850 | Derived | de la Haye K, Fluke M, Laney PC, Goran M, Galama T, Chou CP, Salvy SJ. In-home obesity prevention in low-income infants through maternal and social transmission. Contemp Clin Trials. 2019 Feb;77:61-69. doi: 10.1016/j.cct.2018.12.010. Epub 2018 Dec 19. |
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Development, execution, and data collection for this study is completed with a Principle Investigator at Cedars-Sinai Medical Center. Data will be shared with Dr. Salvy and her staff as appropriate. With documented permission of the IRB, a PI may develop a de-identified database, codebook, and mechanism by which data can be shared with qualified investigators. Interested Investigators will complete a request form stating the aims of their analyses, analytic plan, available resources for completing a project, timeline, and goals (i.e. manuscripts or grant applications). The PIs and their research team will review requests to determine whether the analyses constitute an innovative exploration of the data, whether the team has resources to complete the request, and whether data will be adequately protected and managed. If issues arise, the PIs and research team will negotiate a fair resolution with interested investigators and NIH staff.
Data will be available within 6 months of study completion.
Data access requests will be reviewed, and requestors will be required to sign a Data Access Agreement.
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The enrollment number represents the number of mother-infant dyads.
Mother-child dyads were recruited into the study. Home visitors who delivered the program in the intervention and control arms were not enrolled into the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Standard HVP Curriculum- Mothers | Mother and their children participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. |
| FG001 | Obesity Prevention - Mothers | Mother and their children participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. |
| FG002 | Standard HVP Curriculum - Children | Mother and their children participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. |
| FG003 | Obesity Prevention - Children | Mother and their children participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Baseline data obtained for 76 mother-child dyads (152 participants total)
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| ID | Title | Description |
|---|---|---|
| BG000 | Standard HVP Curriculum-Mothers | Participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Mother BMI | Body mass index (BMI) at each assessment | Some participants did not compete all study assessments. | Posted | Mean | Standard Deviation | kg/m^2 | Baseline, 6 months, 12 months |
|
4 years
Adverse event information was systematically collected and reported to IRB.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Standard HVP Curriculum-Mothers | Participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Breach of Confidentiality | Social circumstances | Systematic Assessment |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Kayla De La Haye, PhD, Research Scientist | USC Center for Economic and Social Research | 323-442-8228 | delahaye@usc.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 28, 2021 | Jun 3, 2024 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Feb 2, 2021 | Jun 3, 2024 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D063766 | Pediatric Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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Parallel Assignment Randomization occurs at the level of home visitors who deliver the home visitation program curriculum. Home visitors will be randomized to deliver the home visitation program curriculum with (Experimental comparator) or without (Active Comparator) the obesity prevention enhancement module. Mother-child dyads enrolled in home visitation programs, and who agree to participate in the study, will receive the intervention arm delivered by their home visitor.
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|
| Obesity Prevention | Behavioral | Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. |
|
Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES)
| Baseline, 6 months, 12 months |
| Fried Food Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Baseline, 6 months, 12 months |
| Soda Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Baseline, 6 months, 12 months |
| Fruit Juice Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Baseline, 6 months, 12 months |
| Mother Movement Frequency | Assessed using modified activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Baseline, 6 months, 12 months |
| Frequency of Infant Supervised Active Movement (Activity) | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Baseline, 6 months, 12 months |
Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) short form scale for social isolation.
| Baseline, 6 months, 12 months |
| Maternal Instrumental Support | Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) short form scale for instrumental support. | Baseline, 6 months, 12 months |
| Maternal Emotional Support | Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) short form scale for emotional support. | Baseline, 6 months, 12 months |
| Social Network Health Norms | The characteristics of the social actors (people) and relationships that surround mothers will be assessed using egocentric social network methods and social network analysis (SNA) to compute the health behavior and weight norms. | Baseline, 6 months, 12 months |
| Social Network Support | The characteristics of the social actors (people, organizations) and relationships that surround mothers will be assessed using egocentric social network methods and social network analysis (SNA) to compute the density of relationships that provide health-related social support. | Baseline, 6 months, 12 months |
| Household Activity Environment | Household environment assessing availability, accessibility, and visibility of activity items will be assessed using a modified Home Food Assessment (HFA) and Home - Inventory Describing Eating and Activity Development (H-IDEA), relating to the target activity behaviors. | Baseline, 6 months, 12 months |
| Household Food Environment | Household environment assessing availability, accessibility, and visibility of food items will be assessed using a modified Home Food Assessment (HFA) and Home - Inventory Describing Eating and Activity Development (H-IDEA), relating to the target eating behaviors. | Baseline, 6 months, 12 months |
| Habit Strength of Maternal Eating, Activity, and Feeding Behaviors | Habit strength will be assessed using the Self-Reported Habit Index (SRHI) specific to target eating and activity behaviors. | Baseline, 6 months, 12 months |
| Demographic History | Self-reported demographic history (gender, age, race, household income, etc) will be collected. Acculturation is measured using the Demographic Index of Cultural Exposure (DICE). | Baseline |
| Medical History | Self-reported medical history (prescription medications, child and parent/caregiver illnesses, etc.) will be collected | Baseline, 6 months, 12 months |
| Depression | The Edinburgh Postnatal Depression Scale (EPDS) will be used to determine maternal depression. Each of the 10 items has 4 optional responses with a set coding frame. Scores are summed and can range from 0 to 30. Values over 11 are indicative of risk for postnatal depression. | Baseline, 6 months, 12 months |
| Mother's Blood Pressure | Blood pressure will be collected prior to all blood draws | Baseline, 12 months |
| BG001 | Obesity Prevention-Mothers | Participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. |
| BG002 | Standard HVP Curriculum-Children | Participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. |
| BG003 | Obesity Prevention-Children | Participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. |
| BG004 | Total | Total of all reporting groups |
| Years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| OG001 | Obesity Prevention | Participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: The content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. |
|
|
| Primary | Infant Weight | weight in pounds | Missing data | Posted | Mean | Standard Deviation | pounds | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Fruit Intake Frequency | Assessed using modified food frequency measures from the National Health and Nutrition Examination Survey (NHANES). | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Vegetable Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Fried Food Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Soda Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Fruit Juice Intake Frequency | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Mother Movement Frequency | Assessed using modified activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Secondary | Frequency of Infant Supervised Active Movement (Activity) | Assessed using modified food and activity frequency measures from the National Health and Nutrition Examination Survey (NHANES) | Posted | Count of Participants | Participants | Baseline, 6 months, 12 months |
|
|
|
| Other Pre-specified | Maternal Food Security | The U.S. Adult Food Security Survey Module will be used to evaluate hunger and food sufficiency to meet the basic needs of families. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Maternal Social Isolation | Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) short form scale for social isolation. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Maternal Instrumental Support | Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) short form scale for instrumental support. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Maternal Emotional Support | Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) short form scale for emotional support. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Social Network Health Norms | The characteristics of the social actors (people) and relationships that surround mothers will be assessed using egocentric social network methods and social network analysis (SNA) to compute the health behavior and weight norms. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Social Network Support | The characteristics of the social actors (people, organizations) and relationships that surround mothers will be assessed using egocentric social network methods and social network analysis (SNA) to compute the density of relationships that provide health-related social support. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Household Activity Environment | Household environment assessing availability, accessibility, and visibility of activity items will be assessed using a modified Home Food Assessment (HFA) and Home - Inventory Describing Eating and Activity Development (H-IDEA), relating to the target activity behaviors. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Household Food Environment | Household environment assessing availability, accessibility, and visibility of food items will be assessed using a modified Home Food Assessment (HFA) and Home - Inventory Describing Eating and Activity Development (H-IDEA), relating to the target eating behaviors. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Habit Strength of Maternal Eating, Activity, and Feeding Behaviors | Habit strength will be assessed using the Self-Reported Habit Index (SRHI) specific to target eating and activity behaviors. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Demographic History | Self-reported demographic history (gender, age, race, household income, etc) will be collected. Acculturation is measured using the Demographic Index of Cultural Exposure (DICE). | Not Posted | Baseline | Participants |
| Other Pre-specified | Medical History | Self-reported medical history (prescription medications, child and parent/caregiver illnesses, etc.) will be collected | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Depression | The Edinburgh Postnatal Depression Scale (EPDS) will be used to determine maternal depression. Each of the 10 items has 4 optional responses with a set coding frame. Scores are summed and can range from 0 to 30. Values over 11 are indicative of risk for postnatal depression. | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Mother's Blood Pressure | Blood pressure will be collected prior to all blood draws | Not Posted | Baseline, 12 months | Participants |
| 0 |
| 35 |
| 0 |
| 35 |
| 2 |
| 35 |
| EG001 | Obesity Prevention-Mothers | Participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. | 0 | 42 | 0 | 42 | 1 | 42 |
| EG002 | Standard HVP Curriculum-Children | Child participants will receive the standard Healthy Families America (HFA) home visitation curriculum delivered by trained home visitors. The HFA model meets the Department of Health and Human Services criteria for an "evidence-based early childhood home visiting service delivery model". HFA services begin prenatally and continue until children are 2-5yo. The curriculum focuses on strengthening parent-child relationships and family functioning, promoting positive child development, and linkage to community resources. Accredited home visitors are matched to families on cultural background and language, to provide culturally sensitive services. Home visitors receive weekly supervision, ongoing developmental training, and have limited caseloads (10-15 families) to meet their families' needs. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. | 0 | 35 | 0 | 35 | 2 | 35 |
| EG003 | Obesity Prevention-Children | Child participants will receive the standard Healthy Families America home visitation curriculum with the obesity prevention enhancement module, delivered by trained home visitors. Families are matched to home visitors based on their ethnicity/race and language preferences. The obesity prevention program targets 4 key behaviors (physical activity, fruit and vegetable consumption, sugary beverages, fried foods) aimed at reducing obesity risks in mothers and their children. Participants will also be provided opportunities to meet in groups with other participating mothers/infants to enhance social networks that support healthy eating and physical activity. Standard HVP Curriculum: Treatment in the control arm includes the content and services typically provided by the home visitation partner, which is focused on strengthening children's cognitive skills, early literacy skills, social/emotional and physical development. Obesity Prevention: Obesity prevention curriculum program targets 4 key behaviors (physical activity, increasing fruit and vegetable consumption, decreasing sugary beverages, and decreasing fried foods) aimed at reducing obesity risk in mothers and children. The module will also include weekly activity opportunities to develop social networks that foster healthy eating and physical activity. | 0 | 42 | 0 | 42 | 1 | 42 |
| Data Deletion | Social circumstances | Systematic Assessment | Survey data mistakenly deleted from server |
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| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| 6 Month |
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| 12 Months |
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| 1 to 6 times a week |
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| Missing |
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| 6 months |
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| 12 months |
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| 1 to 6 times a week |
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| 1 or more times a day |
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| 6 months |
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| 12 months |
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| 1 to 6 times a week |
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| 1 or more times a day |
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| Missing |
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| 6 months |
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| 12 months |
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| 1 to 6 times a week |
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| 1 or more times a day |
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| Missing |
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| 6 months |
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| 12 months |
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| 1 to 6 times a week |
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| 1 or more times a day |
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| Missing |
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| 6 months |
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| 12 months |
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| 8 or more times a day |
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| Missing |
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| 6 months |
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| 12 months |
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| 1 or 2 times a day |
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| 3 or more times a day |
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| 6 months |
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| 12 months |
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