Considering Childhood Obesity through an Investigation of Maternal/Infant Factors and the Acceptability of a Text Message-Based Intervention.

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2018-05
Authors
Gibby, Cheryl L. K.
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Nutrition
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Addressing childhood obesity in low-income groups in Hawai‘i and Puerto Rico requires examination of maternal and infant risk factors and evaluation of related interventions to advance preventive measures. This dissertation, entitled “Considering childhood obesity: an investigation of maternal/infant factors and the acceptability of a text message-based intervention,” includes a general overview of the dissertation, a literature review describing previous studies on factors contributing to childhood obesity and text message-based interventions, three stand-alone manuscripts, a concluding chapter that includes additional comments and future considerations, and appendices containing documents pertinent to the intervention and other information. The three stand-alone manuscripts present studies on a text message-based intervention aimed at promoting breastfeeding and preventing excessive weight gain in infants enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Hawai‘i and Puerto Rico. The studies 1) assess the acceptability of the intervention; 2) examine the association between maternal pregravid body mass index (BMI) and breastfeeding discontinuation; and 3) examine the association between gestational weight gain and rate of infancy weight gain. Main findings include the following: 1) the text message-based intervention was acceptable to participants based upon qualitative and quantitative measures; 2) breastfeeding discontinuation was not associated with pregravid BMI, but Native Hawaiian or Other Pacific Islanders (adjusted odds ratio [AOR]=7.12; 95% confidence interval [CI]=1.34, 37.97; p=0.02) and older women (AOR=4.21; 95% CI=1.13, 15.72; p=0.03) showed significantly higher odds of discontinuing breastfeeding before four to six months postpartum; and 3) excessive and inadequate gestational weight gain was associated with decreased proportional odds of rapid infancy weight gain versus on-track (AOR=0.23; 95% CI=0.08, 0.70; p=0.01) or slow (AOR=0.29; 95% CI=0.09, 0.94; p=0.04) infant weight gain. These findings may inform childhood obesity prevention strategies and programs.
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Childhood Obesity, Text Message, Breastfeeding, Gestational Weight Gain, Pregravid BMI, Rapid Infancy Weight Gain
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