Development and Evaluation of an Early Childhood Obesity

Prevention Video

Mary Ann Chiasson, DrPHNNPHI Annual Conference

May 7, 2009

About Public Health Solutions

• Grant and contract management• Direct service provision

– WIC ~50,000 women & children– Reproductive health centers ~ 17,000– Health Insurance enrollment– Early intervention service coordination

• Technology services

• Research and Evaluation (IRB)

Research and Evaluation Unit

• 3 PhDs (epidemiology, sociology, demography) 2 MPHs + study staff

• Work as team

• Highly integrated with all other Public Health Solutions programs

• Internal & external R&E projects

• Academic affiliation

Evolution of the Intervention as an Example of Integration

2000 WIC staff concerned about early childhood obesity

2001 Brief survey on prevalence, food consumption, physical activity

2002 Detailed survey (2-4 yr olds)

~40% overweight/obese

BMI Age Trends NYC Neighborhood WIC Program, 2001

0

10

20

30

40

50

60

70

80

24-29 30-35 36-41 42-47 48-53 54-59

Age in months

Per

cen

tag

e

Normalweight

Underweight

Overweight& Obese

40%

Next Steps

2006 Funding from NYS Assembly2006 Intervention formative research

– Video…DVD format– English / Spanish– Intervention for families

2007 Infant feeding videos created

2008 Effect of intervention assessed

Evaluation Overview

• Goal – To evaluate the impact of video on maternal infant feeding knowledge & practices 3 & 6 months after viewing.

• Data – Intervention Group (IG) - 171 got DVD; Control Group (CG) - 197 usual WIC services. All had singleton infants < 5 months of age; spoke English or Spanish.

• Methods – Baseline survey at WIC centers; 3 & 6 month phone follow-up surveys.

WIC Breastfeeding Peer Counselors

Participant Birthplace (N=368)

8%

26%

24%5%

20%

17%

Dom RepMexicoEcuadorColombiaUSOther

DVD Use at 3-MonthFollow-up - Intervention Group

•85% watched the DVD

•66% watched more than once

•73% watched the whole DVD

•59% watched with someone else

Change in Knowledge* from Baseline to 3-Month Survey by Group

Group Increase in Knowledge*

p**

Intervention From 5.8 to 6.3

8.6%

.001

Control From 6.3 to 6.6

4.8%

.006

*Mean number of correct answers out of 9 questions **Wilcoxon Signed Ranks Test

4.2

5.4

4.1

4.9

0.0

1.0

2.0

3.0

4.0

5.0

6.0

3-Month Interview(ns)

6-Month Interview(p<.01)

Mo

nth

s

IGCG

Age at Introduction of Solids

*

*

Video Evaluation Conclusions

The Intervention group:

• watched DVD at home and shared it.

• had a greater improvement in knowledge of healthy infant feeding practices.

• showed a later introduction of solids practices at 6-month follow-up survey.

Video Dissemination

• Now have three versions - English/Spanish, English/Mandarin & English/Creole/French

• Distributed to ~35,000 new mothers in NYC (WIC, large health plan, Asian-American health centers)

• Goal - Statewide distribution to all new mothers

Ongoing Obesity Prevention Activities

Internal• Planning for large scale RCT with prenatal

mothers’ groups.

• Manuscript preparation

• Coordinated early childhood obesity prevention messages including breastfeeding support among all Public Health Solutions’ programs.

External• Co-PI with Columbia University on RWJF

evaluation of impact of NYS new WIC food package

Research & Evaluation