The TOTS community intervention to prevent overweight in American Indian toddlers beginning at birth

A feasibility and efficacy study

Njeri Karanja, Tam Lutz, Cheryl Ritenbaugh, Gerardo Maupome, Joshua Jones, Thomas Becker, Mikel Aickin

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Excess weight gain in American Indian/Alaskan native (AI/AN) children is a public health concern. This study tested (1) the feasibility of delivering community-wide interventions, alone or in combination with family-based interventions, to promote breastfeeding and reduce the consumption of sugar-sweetened beverages; and (2) whether these interventions decrease Body Mass Index (BMI)-Z scores in children 18-24 months of age. Three AI/AN tribes were randomly assigned to two active interventions; a community-wide intervention alone (tribe A; n = 63 families) or community-wide intervention containing a family component (tribes B and C; n = 142 families). Tribal staff and the research team designed community-tailored interventions and trained community health workers to deliver the family intervention through home visits. Feasibility and acceptability of the intervention and BMI-Z scores at 18-24 months were compared between tribe A and tribes B & C combined using a separate sample pretest, posttest design. Eighty-six percent of enrolled families completed the study. Breastfeeding initiation and 6-month duration increased 14 and 15%, respectively, in all tribes compared to national rates for American Indians. Breastfeeding at 12 months was comparable to national data. Parents expressed confidence in their ability to curtail family consumption of sugar-sweetened beverages. Compared to a pretest sample of children of a similar age 2 years before the study begun, BMI-Z scores increased in all tribes. However, the increase was less in tribes B & C compared to tribe A (-0.75, P = 0.016). Family, plus community-wide interventions to increase breastfeeding and curtail sugar-sweetened beverages attenuate BMI rise in AI/AN toddlers more than community-wide interventions alone.

Original languageEnglish (US)
Pages (from-to)667-675
Number of pages9
JournalJournal of Community Health
Volume35
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

North American Indians
Feasibility Studies
American Indian
Population Groups
Parturition
ethnic group
community
Breast Feeding
Beverages
Body Mass Index
House Calls
Aptitude
Weight Gain
parents
public health
confidence
Public Health
Parents
staff
worker

Keywords

  • Breastfeeding
  • Infants
  • Obesity prevention
  • Sugar-sweetened beverages
  • Toddlers

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)

Cite this

The TOTS community intervention to prevent overweight in American Indian toddlers beginning at birth : A feasibility and efficacy study. / Karanja, Njeri; Lutz, Tam; Ritenbaugh, Cheryl; Maupome, Gerardo; Jones, Joshua; Becker, Thomas; Aickin, Mikel.

In: Journal of Community Health, Vol. 35, No. 6, 12.2010, p. 667-675.

Research output: Contribution to journalArticle

Karanja, Njeri ; Lutz, Tam ; Ritenbaugh, Cheryl ; Maupome, Gerardo ; Jones, Joshua ; Becker, Thomas ; Aickin, Mikel. / The TOTS community intervention to prevent overweight in American Indian toddlers beginning at birth : A feasibility and efficacy study. In: Journal of Community Health. 2010 ; Vol. 35, No. 6. pp. 667-675.
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