Obesity Clinical Trial
— THRIVEOfficial title:
A Novel Obesity Prevention Program for High-Risk Infants in Pediatric Primary Care: The THRIVE Randomized Controlled Trial
The goal of this clinical trial is to test a responsive parenting obesity prevention program with infants and caregivers of color (e.g., non-White; Hispanic/Latinx) and/or who are economically marginalized (i.e., publicly insured), delivered via Integrated Behavioral Health (IBH) in pediatric primary care. The main questions it aims to answer are: - 1) Is the obesity prevention intervention delivered via IBH in pediatric primary care feasible and acceptable to families of color and/or families who are economically marginalized? - 2) Will it prevent rapid weight gain during infancy? Participants will complete baseline (newborn), post-treatment (9 months), and follow-up assessments (12 months). Participants assigned to treatment will receive 4 prevention sessions as part of their typical well-child visit in pediatric primary care. Researchers hypothesize that infants in the obesity prevention intervention will have stable weight gain compared to infants in the control group (treatment as usual) will experience more rapid weight gain.
Status | Recruiting |
Enrollment | 144 |
Est. completion date | June 1, 2026 |
Est. primary completion date | May 30, 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 1 Day and older |
Eligibility | Inclusion Criteria: - born 2500 grams or greater - delivery occurring between 37 and 42 weeks gestation - English speaking - infant receiving care provided at our pediatric primary care setting - from a racial / ethnic minority group (i.e., non-white, or Hispanic or Latinx) and/or economically marginalized background (i.e., household income at or below 138% of federal poverty level; qualifying for Medicaid) Exclusion Criteria: - care in the Neonatal Intensive Care Unit (>7 days) - infant congenital anomaly or neonatal condition that affects feeding (e.g., cleft lip/palate, metabolic disease) - infant exposure to illicit drugs in utero [with the exception of tetrahydrocannabinol (THC)] - diminished or impaired caregiver cognitive functioning - family intent to move from the area within 1 year |
Country | Name | City | State |
---|---|---|---|
United States | Hopple Street Neighborhood Health Center | Cincinnati | Ohio |
Lead Sponsor | Collaborator |
---|---|
Children's Hospital Medical Center, Cincinnati | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Conditional Weight Gain | Conditional Weight Gain scores will be calculated using length and weight of the infants. Length and weight will be measured in triplicate by masked research-reliable trained assessors and with standardized anthropometric procedures and averaged at each time point. Infants will be weighed unclothed, in a dry diaper using a Scale-Tronix 4802D Infant scale that is calibrated every day. Infant length will be measured using a Pediatric Stadiometer by O'Leary (PED LB35-07-X). Conditional weight gain is calculated as standardized residuals from the linear regression of anthropometric data (e.g., weight and length) on birthweight, with age and sex entered as covariates. Scores closer to 0 are ideal, with scores higher than 0 indicating more rapid weight gain and scores below 1 indicating slower weight gain. Primary outcomes will include conditional weight gain scores at the 9-month post-treatment time point. | At infant age 9-months (post-treatment) | |
Secondary | Conditional Weight Gain | Conditional Weight Gain scores will be calculated using length and weight of the infants. Length and weight will be measured in triplicate by masked research-reliable trained assessors and with standardized anthropometric procedures and averaged at each time point. Infants will be weighed unclothed, in a dry diaper using a Scale-Tronix 4802D Infant scale that is calibrated every day. Infant length will be measured using a Pediatric Stadiometer by O'Leary (PED LB35-07-X). Conditional weight gain is calculated as standardized residuals from the linear regression of anthropometric data (e.g., weight and length) on birthweight, with age and sex entered as covariates. Scores closer to 0 are ideal, with scores higher than 0 indicating more rapid weight gain and scores below 1 indicating slower weight gain. | At infant age 12 months (follow-up) | |
Secondary | The Baby Eating Behavior Questionnaire | Used to measure infant appetite and contains 5 subscales that assess enjoyment of food, food responsiveness, slowness in eating, and satiety responsiveness, and general appetite. Subscales of the BEBQ have good reliability and the measured appetite traits track throughout infancy and toddlerhood and are related to greater weight gain. Items are scored on a Likert scale ranging from 1 to 5 with higher average scores on each scale indicating more enjoyment of food, food responsiveness, slowness in eating, and satiety responsiveness, respectively. | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | The Infant Feeding Style Questionnaire | An 83-item measure of parent feeding beliefs, behaviors, and style with the following subscales: laissez-faire, restrictive, pressuring, responsive and indulgent. Internal reliability measures for the subscales ranged from 0.75 to 0.95. Several sub-constructs, responsive to satiety cues, pressuring with cereal, indulgent pampering and indulgent soothing, were inversely related to infant weight-for-length z-score, meaning higher scores indicate greater risk for obesity. | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | The Food Frequency Questionnaire | A validated parent-report measure that assesses infant dietary intake within the previous 7 days. The FFQ measures duration of breast-feeding status, timing of introduction of solid foods, consumption of fruits and vegetables, consumption of proteins, consumption of energy-dense-nutrient-poor foods, and consumption of sugar sweetened beverages. The FFQ correlates well with weighted diaries in infancy. It measures intake across a diverse range of liquid and solid food groups. As infants are gradually introduced to solid foods and become less reliant on milk, the completion time of the measure may increase (requires 5-10 mins to complete). | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | Baby Day Diary | Measures 3 consecutive days of infant feeding, sleeping, and fussy events. The BDD has been extensively validated and administered to families in infant obesity clinical trials. This measure has been adapted to capture frequency (i.e., mean number of feedings per day) and volume of feedings (i.e., mean number of ounces per feeding and solid food consumption) in addition to 24-h sleep frequency and duration across a three day period. Investigators are using the Daily Connectâ„¢ app to reduce burden, have the capability to remind parents to complete the logs, and download data more easily. For 3 consecutive days, parents will indicate all infant feeding, sleep, and fussy events. Modified Food Frequency Questionnaire during active treatment: For feeding events, parents will detail whether the infant was fed breast milk, formula, or solids, as well as the number of consumed ounces of formula or breast milk if offered by the bottle. | During active treatment at infant age: 2 months, 4 months, and 6 months | |
Secondary | Baby Basic Needs Questionnaire | A 13-item measure assessing parent's use of food to soothe their infant comes from one factor with good internal consistency on The BBNQ asks parents to rate on two different 5-point Likert scales, how likely they would be to use food to soothe in different situations and the perceived effectiveness of using food to soothe in each situation. Higher food-to-soothe scores indicate greater use of food to soothe to quiet, or manage a distressed child in response to a variety of contexts, without regard for whether hunger is the source of infant distress. | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | The Baby Care Questionnaire | A 30-item measure of parenting beliefs and practices reflecting structure (regularity of routines) and attunement (recognition of baby cues). Items ask about sleeping, eating, and crying. Items are rated on a 4-point Likert-type scale ranging from strongly disagree (1) to strongly agree (4). Total scores are derived for structure and attunement with higher scores indicating more structure and more attunement. | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | Infant Behavior Questionnaire - Revised - Very Short Form | A 37-item measure of infant temperament that is scored using 3 subscales: positive affectivity/surgency, negative emotionality, and orienting capacity. Scores range from 0 to 7, with higher scores representing greater positive affect, negative emotionality and orienting and regulatory capacity. | At Infant Age: 9 months (post-treatment) | |
Secondary | Brief Infant Sleep Questionnaire - Revised | A 20-item norm-referenced and validated caregiver-report measure of 4 subscales: infant sleep, parent perception of sleep, parent behavior, and total score. Scales on each subscale and total score are scaled from 0-100 using norm-based referencing. BISQ-R total score is an average of 3 subscales with higher scores denoting better sleep quality, more positive perception of infant sleep, and parent behaviors that promote healthy sleep. | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | Maternal Self Efficacy | A 10-item measure of feelings of efficacy in infant care, including soothing, feeding, understanding baby cues, and communicating with baby. Items are endorsed using a Likert scale and a total score is derived. The total score will be used and ranges from 10 to 40 with higher scores representing greater Maternal Self-Efficacy. | At infant age 1 month (baseline), 9 months (post-treatment), and 12 months (follow-up) | |
Secondary | The Philadelphia Urban Adverse Childhood Experiences (ACES) | A 22-item measure of caregiver experiences of violence and adversity in childhood. It encompasses the original 10 ACEs and other experiences of trauma and violence associated with growing up in an urban community (e.g., discrimination, unsafe neighborhood). Item-level and total ACEs scores (original) and (Philadelphia ACEs) will be examined in analyses. | At infant age 1 month (baseline) | |
Secondary | Edinburgh Postnatal Depression Scale (EPDS) | A 10-item questionnaire was developed to identify women who have postpartum depression and has subsequently been validated as a two-factor measure of postpartum anxiety and depression. The overall assessment is done by total score, which is determined by adding together the scores for each of the 10 items. Higher scores indicate more depressive symptoms. | At infant age 1 month (baseline) | |
Secondary | Movement Behavior Questionnaire | A 9-item validated rapid assessment parent-report measure assessing movement behaviors in babies who have yet to reach their walking milestone. The MBQ measures tummy time or active play, restrained time, screen time, and sleep. Scores will be calculated for each individual item by determining the total number of minutes ((hours x 60) + minutes) per day that the baby engages in each type of behavior. Higher scores indicate more time in that activity. | At infant age 1 month (baseline, at infant age 9 months (post-treatment), at infant age 12 months (follow-up) | |
Secondary | Meals in our Household Questionnaire | A 47-item validated parent-report measure assessing problematic child mealtime behaviors, use of food as a reward, parental concern about child's diet, and spousal stress related to child's mealtime behaviors. Higher scores indicate more problematic mealtime behaviors, more use of food as a reward, more parental concern about child's diet, and more spousal stress related to child's mealtime behaviors, respectively. | At infant age 12 months (follow-up) |
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