183368 Results of a community pilot intervention to prevent obesity beginning in infancy

Monday, October 27, 2008

Tam Lutz, MPH, MHA , Northwest Tribal EpiCenter, Northwest Portlad Area Indian Health Board, Portland, OR
Cheryl Ritenbaugh, PhD, MPH , Department of Family and Community Medicine, Arizona State University, Tucson, AZ
Mikel Aickin, PhD , Program in Integrative Medicine and Department of Family and Community Medicine, University of Arizona, Tucson, AZ
Gerardo Maupome, DDS, PhD , Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, IN
Njeri Karanja, PhD, RD , Kaiser Permanente Center for Health Research, Portland, OR
Obesity has early antecedents. Food and physical activity preferences in children occur early, but few studies have explored ways to prevent obesity beginning in infancy. TOTS was a community-partnered study to test an intervention to prevent obesity in AI children beginning at birth. TOTS compared a community-wide intervention (CW) to a similar approach (CW+F) supplemented with family interventions delivered by lay health workers (LHW) through home visits. 205 women were enrolled before their infants were born. Tribe X (n=63 children) received the CW intervention and tribes Y&Z (n=142 children) received the CW+F intervention. CW interventions were designed to raise awareness, change public health practice, tribal policy, provide health education and change environments associated with breastfeeding, sugared beverages, and water consumption. LHW delivered interventions through 7 home visits. They were trained to use principles of behavior change including motivational interviewing and goal setting to help families increase breastfeeding, reduce the consumption of sugared beverages, and choose water as an alternative to the sugared beverages. Change in BMI Z scores (new WHO standards) from birth to 24 months was estimated for each tribe using matched children from the pediatric nutrition surveillance system to adjust for secular trends. BMI Z-scores at 24 months of age increased in all tribes, but the increase was less in CW+F tribes. Differences in height and weight for age were not significant. Results suggest that outreach techniques of using LHW and interventions that target simple behaviors can mitigate rapid increases in BMI without compromising growth in AI toddlers.

Learning Objectives:
List three early antecendents of Obesity. Explore the methods used in the TOTS study. Articulate what the findings of the TOTS study may suggest.

Keywords: Child Health, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as the Project Director for the five active years of this study. I am also a doctoral student at UNC Chapel Hill, fellow of the Native American Research Centers for Health, and member of the Native Researchers Network.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.