Development and Evaluation of an Early Childhood Obesity
Prevention Video
Mary Ann Chiasson, DrPHNNPHI Annual Conference
May 7, 2009
About Public Health Solutions
• Grant and contract management• Direct service provision
– WIC ~50,000 women & children– Reproductive health centers ~ 17,000– Health Insurance enrollment– Early intervention service coordination
• Technology services
• Research and Evaluation (IRB)
Research and Evaluation Unit
• 3 PhDs (epidemiology, sociology, demography) 2 MPHs + study staff
• Work as team
• Highly integrated with all other Public Health Solutions programs
• Internal & external R&E projects
• Academic affiliation
Evolution of the Intervention as an Example of Integration
2000 WIC staff concerned about early childhood obesity
2001 Brief survey on prevalence, food consumption, physical activity
2002 Detailed survey (2-4 yr olds)
~40% overweight/obese
BMI Age Trends NYC Neighborhood WIC Program, 2001
0
10
20
30
40
50
60
70
80
24-29 30-35 36-41 42-47 48-53 54-59
Age in months
Per
cen
tag
e
Normalweight
Underweight
Overweight& Obese
40%
Next Steps
2006 Funding from NYS Assembly2006 Intervention formative research
– Video…DVD format– English / Spanish– Intervention for families
2007 Infant feeding videos created
2008 Effect of intervention assessed
Evaluation Overview
• Goal – To evaluate the impact of video on maternal infant feeding knowledge & practices 3 & 6 months after viewing.
• Data – Intervention Group (IG) - 171 got DVD; Control Group (CG) - 197 usual WIC services. All had singleton infants < 5 months of age; spoke English or Spanish.
• Methods – Baseline survey at WIC centers; 3 & 6 month phone follow-up surveys.
WIC Breastfeeding Peer Counselors
Participant Birthplace (N=368)
8%
26%
24%5%
20%
17%
Dom RepMexicoEcuadorColombiaUSOther
DVD Use at 3-MonthFollow-up - Intervention Group
•85% watched the DVD
•66% watched more than once
•73% watched the whole DVD
•59% watched with someone else
Change in Knowledge* from Baseline to 3-Month Survey by Group
Group Increase in Knowledge*
p**
Intervention From 5.8 to 6.3
8.6%
.001
Control From 6.3 to 6.6
4.8%
.006
*Mean number of correct answers out of 9 questions **Wilcoxon Signed Ranks Test
4.2
5.4
4.1
4.9
0.0
1.0
2.0
3.0
4.0
5.0
6.0
3-Month Interview(ns)
6-Month Interview(p<.01)
Mo
nth
s
IGCG
Age at Introduction of Solids
*
*
Video Evaluation Conclusions
The Intervention group:
• watched DVD at home and shared it.
• had a greater improvement in knowledge of healthy infant feeding practices.
• showed a later introduction of solids practices at 6-month follow-up survey.
Video Dissemination
• Now have three versions - English/Spanish, English/Mandarin & English/Creole/French
• Distributed to ~35,000 new mothers in NYC (WIC, large health plan, Asian-American health centers)
• Goal - Statewide distribution to all new mothers
Ongoing Obesity Prevention Activities
Internal• Planning for large scale RCT with prenatal
mothers’ groups.
• Manuscript preparation
• Coordinated early childhood obesity prevention messages including breastfeeding support among all Public Health Solutions’ programs.
External• Co-PI with Columbia University on RWJF
evaluation of impact of NYS new WIC food package
Research & Evaluation