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Kracht CL, Neshteruk CD, Moding KJ, Rolke LJ, Wagner BE, Kielb E, Ferrante MJ, Robinson C, Keinsley J, Colella J, Speirs KE, Luecking CT. Community-based diet and obesity-related policy, system, and environmental interventions for obesity prevention during the first 1000 days: A scoping review. Obes Rev 2024; 25:e13815. [PMID: 39159998 PMCID: PMC12014204 DOI: 10.1111/obr.13815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/19/2024] [Accepted: 07/25/2024] [Indexed: 08/21/2024]
Abstract
Community-based policy, systems, and environmental interventions have the potential to reduce modifiable risk factors for obesity early in life. The purpose of this scoping review was to characterize the breadth, generalizability, and methodological quality of community-based diet and obesity-related policy, system, and environmental interventions during the first 1000 days of life, from pregnancy to 24 months of age. Eight databases were searched, and 83 studies (122 references) were included. Data were extracted for breadth (intervention characteristics), generalizability (reach, effectiveness, adoption, implementation, and maintenance), and study quality (Downs and Black Checklist). Systems and environmental approaches were common (> 80%), relative to policy approaches (39%). The majority (60-69%) occurred in the prenatal period and early infancy (0-3 months), assessed breastfeeding or child growth/obesity (53% for both), and included people with lower income (80%) or racial and/or ethnic minority groups (63%). Many interventions reported positive outcomes (i.e., in the expected direction) for child diet, breastfeeding, and feeding practices (> 62%). Few reported intervention maintenance or spanned the full 1000 days. Most studies were classified as good (32%) or fair (56%) methodological quality. The interventions mainly addressed pregnancy and early infancy. Rigorous and representative investigation is needed to improve intervention reach, sustainability, and application in toddlerhood.
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Affiliation(s)
- Chelsea L. Kracht
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Cody D. Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Kameron J. Moding
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Laura J. Rolke
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Brooke E. Wagner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Elizabeth Kielb
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Mackenzie J. Ferrante
- Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Cayla Robinson
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Jason Keinsley
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Jordan Colella
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Katherine E. Speirs
- Human Development and Family Science, John and Doris Norton School of Human Ecology, University of Arizona, Tucson, AZ, USA
| | - Courtney T. Luecking
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
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Ball R, Duncanson K, Ashton L, Bailey A, Burrows TL, Whiteford G, Henström M, Gerathy R, Walton A, Wehlow J, Collins CE. Engaging New Parents in the Development of a Peer Nutrition Education Model Using Participatory Action Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:102. [PMID: 35010363 PMCID: PMC8750105 DOI: 10.3390/ijerph19010102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
This study investigated the implementation model and research methods of a peer education program for new parents focused on infant feeding and nutrition. Two hundred and sixty-nine parents with an infant aged birth to two years old were invited to become co-researchers in a Participatory Action Research (PAR) study over three years. Data included focus group and online participant meeting transcripts, social media data, correspondence between the implementation team and peer educators, and field notes. All data were consolidated regularly and discussed by project participants and the research team. After each PAR cycle, structured content analysis was conducted, informing the next iteration of the implementation model and research methods. Participating parents were highly engaged in child feeding peer-to-peer education, but felt more effective and comfortable being considered as a child-feeding information resource sharer or 'champion' rather than a formal peer educator. Similarly, quantitative data collection was only effective when it was integrated seamlessly into the implementation model. PAR methodology suited the diversity and dynamic real-life study setting, facilitating substantial improvements to the peer nutrition intervention model and data collection methods. Our study demonstrated that a genuine collaboration between health professionals and participants to implement research in practice can achieve both intervention outcomes and research aims.
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Affiliation(s)
- Richard Ball
- Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia; (A.B.); (G.W.); (R.G.); (A.W.); (J.W.)
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.D.); (L.A.); (T.L.B.); (M.H.); (C.E.C.)
| | - Kerith Duncanson
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.D.); (L.A.); (T.L.B.); (M.H.); (C.E.C.)
- Health Education and Training Institute (HETI), 1 Reserve Road, St. Leonards, NSW 2065, Australia
| | - Lee Ashton
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.D.); (L.A.); (T.L.B.); (M.H.); (C.E.C.)
- Priority Research Centre for Physical Activity and Nutrition, School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Andrew Bailey
- Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia; (A.B.); (G.W.); (R.G.); (A.W.); (J.W.)
| | - Tracy L. Burrows
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.D.); (L.A.); (T.L.B.); (M.H.); (C.E.C.)
| | - Gail Whiteford
- Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia; (A.B.); (G.W.); (R.G.); (A.W.); (J.W.)
- School of Community Health, Charles Sturt University, Port Macquarie, NSW 2444, Australia
| | - Maria Henström
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.D.); (L.A.); (T.L.B.); (M.H.); (C.E.C.)
- Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Huddinge, Sweden
| | - Rachel Gerathy
- Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia; (A.B.); (G.W.); (R.G.); (A.W.); (J.W.)
| | - Alison Walton
- Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia; (A.B.); (G.W.); (R.G.); (A.W.); (J.W.)
| | - Jennifer Wehlow
- Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia; (A.B.); (G.W.); (R.G.); (A.W.); (J.W.)
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.D.); (L.A.); (T.L.B.); (M.H.); (C.E.C.)
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