Online Program

Innovative approach for assessing compliance with a complex longitudinal infant feeding protocol

Monday, November 4, 2013

Kerry James, MPH, Epidemiology Center, Public Health Research Group, Social & Scientific Systems, Inc, Durham, NC
Jonathan Lewis, MS, Westat, Inc, Durham, NC
Eileen Ford, MS, RD, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
Virginia Stallings, MD, Jean A. Cortner Endowed Chair in Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA
Walter Rogan, MD, MPH, Pediatric Epidemiology Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
A web-based feeding assessment tool was developed to incorporate an infant's age in days, weight, days since last measurement, daily energy requirements (kcal), fluid intake (oz), and formula/milk type into a computational algorithm to assess compliance with a complex longitudinal infant feeding protocol. The protocol required repeat assessments of eligibility every two weeks up to the age of three months, and monthly to either 7 or 9 months of age. The tool distinguishes minor departures from the feeding protocol, and signals the field staff when departures from the feeding protocol violated eligibility rules. The tool has been used at regular intervals with 300 participants from birth to 9 months of age and has yielded assessments for over 2,000 time points. Use of the tool standardizes the administration of the feeding assessment interview and reduces human error in determining eligibility based on a complex algorithm. The feeding assessment tool, together with the study management system in which it is embedded, were developed using the Microsoft .Net 3.5 framework, C# and Microsoft SQL Server, and was professionally hosted to maintain security and ensure availability. Access to the system and its components are regulated through a web-based Common Authentication Framework (CAF) Manager. This web-based tool enhanced study compliance within narrow feeding protocol and can be adapted to various feeding protocols, especially those with an interest in supplementation patterns in breastfeeding studies.

Learning Areas:


Learning Objectives:
Describe a web-based method for monitoring infant feeding patterns Provide summary statistics of feeding assessment data from a longitudinal study (2010-2013). Describe the monitoring algorithm in detail and provide examples of responses from mothers Identify any limitations of this tool as well as suggestions for improvement

Keyword(s): Breastfeeding

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the lead study manager at the Coordinating Center of the Infant Feeding and Early Development (IFED) study, for which this assessment tool was developed. With consultation with the field team at the Children's Hospital of Philadelphia (CHOP), I developed the specifications for the feeding assessment tool with programmers at Westat. I have been monitoring the results of the tool since the launch of the study in 2010.
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.

Back to: 3189.0: Nutrition and Children