Poor dietary habits and obesity-risk begin early in infancy. Infants from underserved and minority backgrounds experience disparate rates of poor nutritional outcomes and subsequent health disparities related to obesity. Each infant and their family experiences a unique set of risk factors and barriers to healthy eating. However, obesity prevention programs that are culturally and contextually relevant for underserved families and adapted based on the needs of individual families are lacking. The current study will develop an obesity prevention program, Healthy Eating for My Infant (HEMI), using a community-engaged approach involving community members in development and delivery of the program. HEMI targets healthy infant feeding through six monthly sessions with infants 3-8 months old. The program will be delivered as a supplement to an already existing evidence-based home visiting program, Every Child Succeeds (ECS), serving families with primarily low income and ethnic/racial minority backgrounds. Treatments modules include: 1) two standardized sessions focused on child nutrition recommendations, responsive feeding, and child mealtime behaviors, 2) two tailored sessions selected from a list of modules based on individual family need and preference, and 3) two sessions with a peer counselor who has valuable lived-experience expertise and personal firsthand knowledge regarding everyday life in their community that can be of benefit to families. Through a group level assessment (GLA), community stakeholders (e.g., ECS leadership, community partners, home visitors, and families) will identify themes regarding ECS caregivers? needs, resources, and barriers related to healthy infant eating and feeding, including the influence of trauma history. These themes will be used in an action planning session with community members to develop a plan for HEMI content that is relevant and helpful for families. While the specific content of adaptive modules will be determined based on the GLA and action planning phase, treatment modules could address topics such as the influence of maternal mental health and past trauma history on feeding behaviors, emotional eating and eating in the absence of hunger, addressing child nutrition and feeding in the context of many other life demands, preparing time and cost-efficient home meals, and engaging other caregivers to promote healthy eating. A pilot randomized control trial of HEMI will be completed with 15 treatment and 15 control families enrolled in the ECS program. This trial will examine the feasibility of implementation and gather family and peer counselor feedback on treatment satisfaction and relevance. Effectiveness of the program for reducing rates of Body Mass Index > 85th percentile and improving child diet (assessed via interview-administered 24-hr dietary recalls) at post-treatment will also be examined. Development of an adaptive and effective obesity prevention program meeting the needs of underserved infants is critical for addressing health disparities in infant eating and obesity.
Infants from underserved and minority backgrounds are at increased risk for obesity and poor feeding and nutrition outcomes, but obesity prevention programs tailored specifically to the needs of these infants are lacking. The current study takes a community-engaged approach to development and delivery of an adaptively tailored obesity prevention program delivered via home visiting to target infant eating and feeding (Healthy Eating for My Infant; HEMI). HEMI will address the specific barriers to health behaviors among an at-risk population with treatment content tailored to the specific needs of individual families with the goal of impacting lifelong disparities in obesity risk and development of healthy habits.