Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Study protocol

The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial

Authors: Karen Campbell, Kylie Hesketh, David Crawford, Jo Salmon, Kylie Ball, Zoë McCallum

Published in: BMC Public Health | Issue 1/2008

Login to get access

Abstract

Background

Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours (poor diet, low physical activity and high sedentary behaviour) from their inception. These factors include the rapidly increasing prevalence of fatness throughout childhood, the instigation of obesity-promoting behaviours in infancy, and the tracking of these behaviours from childhood through to adolescence and adulthood. The Infant Feeding Activity and Nutrition Trial (INFANT) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents. The intervention, conducted with parents over the infant's first 18 months of life, will use existing social networks (first-time parent's groups) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours, and reduced sedentary behaviours in infancy.

Methods/Design

This cluster-randomised controlled trial, with first-time parent groups as the unit of randomisation, will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents' group at Maternal and Child Health Centres. Using a two-stage sampling process, local government areas in Victoria, Australia will be randomly selected at the first stage. At the second stage, a proportional sample of first-time parent groups within selected local government areas will be randomly selected and invited to participate. Informed consent will be obtained and groups will then be randomly allocated to the intervention or control group.

Discussion

The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge this will be the first randomised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating, physical activity and reduced sedentary behaviours. If proven to be effective, INFANT may protect children from the development of obesity and its associated social and economic costs.

Trial registration

Current Controlled Trials ISRCTN81847050
Appendix
Available only for authorised users
Literature
1.
World Health Organisation: Obesity: preventing and managing the global epidemic : Report of the WHO consultation. Book Obesity: preventing and managing the global epidemic : Report of the WHO consultation. (Editor ed.^eds.). 1999, City: World Health Organisation
2.
Lobstein T, Baur L, Uauy R, TaskForce. IIO: Obesity in children and young people: a crisis in public health. Obes Rev. 2004, 5: 4-104. 10.1111/j.1467-789X.2004.00133.x.CrossRefPubMed
3.
Magarey AM, Daniels LA, Boulton TJC: Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Medical Journal of Australia. 2001, 174: 561-564.PubMed
4.
Vaska V, Volkmer R: Increasing prevalence of obesity in South Australian 4-year-olds: 1995–2002. J Paediatr Child Health. 2004, 40: 353-355. 10.1111/j.1034-4810.2004.00401.x.CrossRefPubMed
5.
Dietz WH: Childhood weight affects adult morbidity and mortality. J Nutr. 1998, 128: 411S-414S.PubMed
6.
Must A, Strauss RS: Risks and consequences of childhood and adolescent obesity. Book Risks and consequences of childhood and adolescent obesity (Editor ed.^eds.). City. 1999
7.
Hesketh K, Wake M, Waters E, Carlin J, Crawford D: Stability of body mass index in Australian children: a prospective cohort study across the middle childhood years. Public Health Nutr. 2004, 7: 303-309. 10.1079/PHN2003537.CrossRefPubMed
8.
Crawford D, Timperio A, Telford A, Salmon J: Parental concerns about childhood obesity and the strategies employed to prevent unhealthy weight gain in children. Public Health Nutrition. 2006, 9: 889-895. 10.1017/PHN2005917.CrossRefPubMed
9.
Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ: Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2005, CD001871-3
10.
Campbell K, Crawford D: Family food environments as determinants of preschool aged children's eating behaviours: implication for obesity prevention policy. Australian Journal of Nutrition and Dietetics. 2001, 58: 19-25.
11.
Harnack L, Stang J, Story M: Soft drink consumption among US children and adolescents: nutritional consequences. J Am Diet Assoc. 1999, 99: 436-441. 10.1016/S0002-8223(99)00106-6.CrossRefPubMed
12.
Fox MK, Reidy K, Novak T, Ziegler P: Sources of energy and nutrients in the diets of infants and toddlers. J Am Diet Assoc. 2006, 106: S28-42.PubMed
13.
Webb KL, Lahti-Koski M, Rutishauser I, Hector DJ, Knezevic N, Gill T, Peat JK, Leeder SR: Consumption of 'extra' foods (energy-dense, nutrient-poor) among children aged 16–24 months from western Sydney, Australia. Public Health Nutr. 2006, 9: 1035-1044.CrossRefPubMed
14.
Mannino ML, Lee Y, Mitchell DC, Smiciklas-Wright H, Birch LL: The quality of girls' diets declines and tracks across middle childhood. Int J Behav Nutr Phys Act. 2004, 1: 5-10.1186/1479-5868-1-5.CrossRefPubMedPubMedCentral
15.
Lytle LA, Seifert S, Greenstein J, McGovern P: How do children's eating patterns and food choices change over time? Results from a cohort study. Am J Health Promot. 2000, 14: 222-228.CrossRefPubMed
16.
Certain L-K, Kahn R-S: Prevalence, correlates, and trajectory of television viewing among infants and toddlers. Pediatrics. 2002, 109: 634-642. 10.1542/peds.109.4.634.CrossRefPubMed
17.
Campbell KJ, Crawford DA, Ball K: Family food environment and dietary behaviors likely to promote fatness in 5–6 year-old children. Int J Obes (Lond). 2006, 30: 1272-1280. 10.1038/sj.ijo.0803266.CrossRef
18.
Salmon J, Campbell KJ, Crawford DA: Television viewing habits associated with obesity risk factors: a survey of Melbourne schoolchildren. Med J Aust. 2006, 184: 64-67.PubMed
19.
Salmon J, Timperio A, Cleland V, Venn A: Trends in children's physical activity and weight status in high and low socio-economic status areas of Melbourne, Victoria, 1985–2001. Aust N Z J Public Health. 2005, 29: 337-342. 10.1111/j.1467-842X.2005.tb00204.x.CrossRefPubMed
20.
Canadian Fitness and Lifestyle Research Institute: Physical Activity Monitor. Book Physical Activity Monitor (Editor ed.^eds.). City. 2000
21.
Mikkila V, Rasanen L, Raitakari OT, Pietinen P, Viikari J: Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr. 2005, 93: 923-931. 10.1079/BJN20051418.CrossRefPubMed
22.
Janz KF, Burns TL, Levy SM: Tracking of activity and sedentary behaviors in childhood: the Iowa Bone Development Study. Am J Prev Med. 2005, 29: 171-178. 10.1016/j.amepre.2005.06.001.CrossRefPubMed
23.
Dietz W: Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998, 101: 518-525.PubMed
24.
Campbell KJ, Hesketh KD: Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obesity reviews (Online Early Articles). 2007, 8 (4): 324-38. 10.1111/j.1467-789X.2006.00305.
25.
Epstein LH: Family-based behavioural intervention for obese children. Int J Obes Relat Metab Disord. 1996, 20 (Suppl 1): S14-21.PubMed
26.
Sallis JF, Nader PR, Broyles SL, Berry CC, Elder JP, McKenzie TL, Nelson JA: Correlates of physical activity at home in Mexican-American and Anglo-American preschool children. Health Psychol. 1993, 12: 390-398. 10.1037/0278-6133.12.5.390.CrossRefPubMed
27.
Davison KK, Campbell KJ: Opportunities to prevent obesity in children within families: An ecological approach. Obesity Prevention in the 21st Century: Public Health Approaches to Tackle the Obesity Pandemic. Edited by: Crawford DA, Jeffery RM. 2005, Oxford University Press
28.
Krahnstoever Davison K, Francis LA, Birch LL: Reexamining obesigenic families: parents' obesity-related behaviors predict girls' change in BMI. Obes Res. 2005, 13: 1980-1990.CrossRefPubMed
29.
Cooke LJ, Wardle J, Gibson EL, Sapochnik M, Sheiham A, Lawson M: Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children. Public Health Nutr. 2004, 7: 295-302. 10.1079/PHN2003527.CrossRefPubMed
30.
Pellegrini AD, Smith PK: Physical activity play: the nature and function of a neglected aspect of playing. Child Dev. 1998, 69: 577-598. 10.2307/1132187.CrossRefPubMed
31.
Sallis JF, Prochaska JJ, Taylor WC: A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000, 32: 963-975. 10.1097/00005768-200005000-00014.CrossRefPubMed
32.
Sallis JF, Patterson TL, McKenzie TL, Nader PR: Family variables and physical activity in preschool children. J Dev Behav Pediatr. 1988, 9: 57-61. 10.1097/00004703-198804000-00001.CrossRefPubMed
33.
Salmon J, Timperio A, Telford A, Carver A, Crawford D: Association of family environment with children's television viewing and with low level of physical activity. Obes Res. 2005, 13: 1939-1951.CrossRefPubMed
34.
Goldfeld SR, Wright M, Oberklaid F: Parents, infants and health care: utilization of health services in the first 12 months of life. J Paediatr Child Health. 2003, 39: 249-253. 10.1046/j.1440-1754.2003.00146.x.CrossRefPubMed
35.
Graham V, Gibbons K, Marraffa C, Henry L: 'Filling the gap' – Children aged two years or less: Sources of nutrition information used by families and maternal and child health nurses. Australian Journal of Nutrition and Dietetics. 1999, 56: 209-214.
36.
Dietz WH, Gortmaker SL: Preventing obesity in children and adolescents. Annu Rev Public Health. 2001, 22: 337-353. 10.1146/annurev.publhealth.22.1.337.CrossRefPubMed
37.
Birch LL, Davison KK: Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatric clinics of North America. 2001, 48: 893-907. 10.1016/S0031-3955(05)70347-3.CrossRefPubMed
38.
Green M, Palfrey JS, Clark EM, Anastasi JM, Arlington VA, (Eds.): Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents. 2002, National Centre for Education in Maternal and Child Health, 2
39.
Nelson CS, Wissow LS, Cheng TL: Effectiveness of anticipatory guidance: recent developments. Curr Opin Pediatr. 2003, 15: 630-635. 10.1097/00008480-200312000-00015.CrossRefPubMed
40.
Adam HM, Stern EK, Stein RE: Anticipatory guidance: a modest intervention in the nursery. Pediatrics. 1985, 76: 781-786.PubMed
41.
Harvey-Berino J, Rourke J: Obesity prevention in preschool native-American children: a pilot study using home visiting. Obes Res. 2003, 11: 606-611.CrossRefPubMed
42.
Gardner MR, Deatrick JA: Understanding interventions and outcomes in mothers of infants. Issues Compr Pediatr Nurs. 2006, 29: 25-44. 10.1080/01460860500523756.CrossRefPubMed
43.
Scott D, Brady S, Glynn P: New mother groups as a social network intervention: consumer and maternal and child health nurse perspectives. Aust J Adv Nurs. 2001, 18: 23-29.PubMed
44.
Mullis F: Active parenting: an evaluation of two Adlerian parent education programs. J Individ Psychol. 1999, 55: 359-364.
45.
Satter E: Feeding dynamics: helping children to eat well. J Pediatr Health Care. 1995, 9: 178-184. 10.1016/S0891-5245(05)80033-1.CrossRefPubMed
46.
Butte N, Cobb K, Dwyer J, Graney L, Heird W, Rickard K: The Start Healthy Feeding Guidelines for Infants and Toddlers. J Am Diet Assoc. 2004, 104: 442-454. 10.1016/j.jada.2004.01.027.CrossRefPubMed
47.
Harvey-Berino J, Rourke J: Obesity prevention in preschool native-american children: a pilot study using home visiting. Obes Res. 2003, 11: 606-611.CrossRefPubMed
48.
Knezevic N, Webb KL, Allen J, Mihrshahi S, Peat J, Leeder S: Vegetable and fruit intakes of 18 month old children participating in the Childhood Asthma Prevention Study. Dietitians Association of Australia 20th National Conference; Melbourne. Edited by Australia DAo. 2001
49.
Ireland P, Jolley D, Giles G: Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pacific J Clin Nutr. 1994, 3: 19-31.
50.
Blanton C, Moshfegh AJ, Baer DJ, Kretsch MJ: The USDA Automated Multiple-Pass Method Accurately Estimates Group Total Energy and Nutrient Intake. J Nutr. 2006, 136: 2594-2599.PubMed
51.
AIHW: Active Australia Survey: A guide for analysis and reporting. Book Active Australia Survey: A guide for analysis and reporting (Editor ed.^eds.). 2003, City: AIHW
52.
Anderson D, Diane E, Field PA, Collins EPL, John GN: Estimates of young children's time with television: A methodological comparison of parent reports with time-lapse video home observation. Child Dev. 1985, 56: 1345-1357. 10.2307/1130249.CrossRefPubMed
53.
Salmon J, Owen N, Crawford D, Bauman A, Sallis JF: Physical activity and sedentary behavior: A population-based study of barriers, enjoyment and preference. Health Psychol. 2003, 22: 178-188. 10.1037/0278-6133.22.2.178.CrossRefPubMed
54.
Parmenter K, Wardle J: Development of a general nutrition knowledge questionnaire for adults. Eur J Clin Nutr. 1999, 53: 298-308. 10.1038/sj.ejcn.1600726.CrossRefPubMed
55.
Birch LL, Fisher JO, Grimm-Thomas K, Markey CN, Sawyer R, Johnson SL: Confirmatory factor analysis of the child feeding questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite. 2001, 36: 201-210. 10.1006/appe.2001.0398.CrossRefPubMed
56.
Hughes SO, Power TG, Orlet Fisher J, Mueller S, Nicklas T: Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite. 2005, 44: 83-92. 10.1016/j.appet.2004.08.007.CrossRefPubMed
57.
Hardin JW, Hilbe JM: Generalized Estimating Equations. 2003, Boca Raton: Chapman & Hall/CRC
Metadata
Title
The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial
Authors
Karen Campbell
Kylie Hesketh
David Crawford
Jo Salmon
Kylie Ball
Zoë McCallum
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-103

Other articles of this Issue 1/2008

BMC Public Health 1/2008 Go to the issue

Research article

What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners

Research article

Prevalence and social environment of cigarette smoking in Cyprus youth

Research article

Reasons for not using smoking cessation aids

Correspondence

"We're not short of people telling us what the problems are. We're short of people telling us what to do": An appraisal of public policy and mental health

Research article

Prevalence of high frequency hearing loss consistent with noise exposure among people working with sound systems and general population in Brazil: A cross-sectional study

Study protocol

Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors