Involvement of Non-Parental Caregivers in Obesity Prevention Interventions among 0-3-Year-Old Children: A Scoping Review

Stakeholder Perceptions of Digital Nutrition Education Modules on Infant Feeding in Home Visiting Programs

OBJECTIVE

Evaluate the usability and acceptability of a digital infant feeding module for use in a home visiting program.

METHODS

Home visitors (n = 11) and mothers (n = 10) completed a qualitative interview while viewing a digital nutrition education module on infant feeding. Quantitative data were collected using the mHealth App Usability Questionnaire. Qualitative data were analyzed using inductive thematic analysis.

RESULTS

Most participants (90%) reported that they would very likely use the module as part of home visits. mHealth App Usability Questionnaire subscale scores supported usability on a scale of 0-7 with ease of use (6.9 ± 0.40), interface and satisfaction (6.9 ± 0.30), and usefulness (6.8 ± 0.50). Barriers to usability included technology access and phone compatibility.

CONCLUSIONS AND IMPLICATIONS

The digital infant feeding module was deemed usable and acceptable by home visiting stakeholders. Future research is needed to determine the impact of brief digital educational modules on parental feeding behaviors and child health outcomes.

Home Visitation as an Intervention Opportunity to Prevent Childhood Obesity Within the First 2000 Days: A Scoping Review

BACKGROUND

Home visitation programs are uniquely positioned to reach young children during the first 2000 days of life (ages 0 to 5 years), a critical time period to prevent childhood obesity.

OBJECTIVE

This scoping review aimed to identify early childhood obesity prevention interventions implemented within home visitation during the first 2000 days of life, summarize outcomes assessed, and examine if and how nonmaternal caregivers and technology were included.

METHODS

Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, 3 databases (PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature) were searched from January 1980 to June 2023 for obesity prevention interventions that utilized home visitation as a treatment modality, targeted children aged 5 years or younger, reported on child weight outcomes, were experimental or quasiexperimental designs with a control or comparison arm, and had full-text available in English. The quality and risk of bias of included studies were rated using the Academy of Nutrition and Dietetics' Quality Criteria Checklist for Primary Research.

RESULTS

Of the 871 identified articles, 21 met inclusion criteria, and all reported at least 1 obesogenic behavioral outcome in the intervention group compared with the control group. Intervention duration ranged from 4 months to 3 years, and frequency of home visits varied from weekly, biweekly, monthly, or a designated number of home visits within a defined time frame. Three interventions partnered with an established home visiting program, but home visits in all interventions were conducted by either professional or paraprofessional individuals. Nine of the 21 studies targeted other caregivers in addition to the mother, and 12 of 21 incorporated a form of technology.

CONCLUSIONS

Several different early childhood obesity prevention interventions have been implemented within home visitation during the first 2000 days of life. Future research is needed to investigate the effectiveness of these interventions on weight- and behavior-related outcomes, as well as explore the influences of the interventionist type, program duration, inclusion of nonmaternal caregivers, and use of technology on childhood obesity-related outcomes.

Validity and Reliability of the Chinese Version of the Edinburgh Postnatal Depression Scale for Fathers of Newborns

Studies often use the Edinburgh Postnatal Depression Scale (EPDS) or the Beck Depression Inventory-II (BDI-II) as a screening tool for depression in new mothers or fathers following the birth of an infant, but no studies have evaluated EPDS as a predictor of postnatal depression for new fathers in a Chinese population. This study aimed to test the validity and reliability of a Chinese version of the EPDS for fathers of newborns in Taiwan. The study included 368 parents with newborns ≤2 months of age and without any health problems. Construct and criterion-related validities were assessed and Cronbach's alpha was used for measuring internal consistency reliability. The receiver operating characteristic (ROC) curve analyzed the optimal cutoff score for the EPDS. Scores for the Chinese EPDS were significantly higher for fathers who were >34 years of age, employed in a professional occupation, and participated in feeding their infant (p < .05). Mean scores among the fathers for the EPDS and BDI-II were significantly correlated (r = .64, p < .001). The Cronbach's alpha was .83 for the EPDS; ROC curve analysis revealed the optimal cutoff of the EPDS was ≥8 points and the area under the ROC curve was 0.91. The EPDS had good validity and reliability and should therefore be considered suitable for the evaluation of postnatal depression in fathers of newborn infants in Taiwan.

A Systematic Review of Research on Non-Maternal Caregivers' Feeding of Children 0-3 Years

Although people other than mothers participate in feeding, few interventions include non-maternal caregivers, especially those promoting healthy development among children aged 0-3 years. Understanding the role and influence of non-maternal caregivers is essential for the development and effectiveness of early childhood feeding interventions; yet, no reviews have examined non-maternal caregivers of children aged 0-3 years. This study assessed what is known about non-maternal caregivers' feeding of children aged 0-3. We systematically reviewed 38 empirical quantitative, qualitative, and mixed methods studies, cataloged in PubMed and Web of Science and published between 1/2000-6/2021. The studies showed that non-maternal caregivers engage in child feeding and their attitudes and behaviors affect child outcomes. Like mothers, non-maternal caregivers vary in the extent to which their knowledge and attitudes support recommended feeding practices and the extent to which they exhibit responsive feeding styles and practices. Children of broad ages were included in the studies; future research should include infant/toddler-only samples to allow for better assessment of age-specific feeding constructs. The studies also revealed issues specific to non-maternal caregivers that are unlikely to be addressed in interventions developed for mothers. Thus, the review highlighted features of non-maternal caregiving of children 0-3 years that could be addressed to support feeding and child outcomes.