Cognitive Stimulation and Maternal Feeding Styles in Families with Low Incomes: Impacts from a Randomized Clinical Trial.

IF 3 3区 医学 Q1 PEDIATRICS
Elizabeth B Miller, Katherine A Hails, Caitlin F Canfield, Pamela A Morris-Perez, Daniel S Shaw, Alan L Mendelsohn, Rachel S Gross
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引用次数: 0

Abstract

Objective: To examine associations between cognitive stimulation in the home at 6 months and maternal feeding styles at 24 months, direct intervention effects of Smart Beginnings (SB) on feeding styles, and potential indirect effects of SB on feeding styles via earlier intervention effects on cognitive stimulation.

Methods: Single-blind, two-site randomized clinical trial (RCT) of the SB intervention. SB integrates PlayReadVIP, a universal, pediatric primary care-based program, and Family Check-Up (FCU), a targeted secondary home-based parenting intervention. Mother-infant dyads (N = 327) were randomized at birth to standard pediatric care or the SB intervention. Linear regression analyses determined associations between cognitive stimulation at 6 months and maternal feeding styles at 24 months, a secondary data analysis. Direct intervention impacts on feeding styles, a secondary RCT outcome, were also assessed and mediation analyses explored intervention effects on feeding styles via earlier intervention impacts on cognitive stimulation.

Results: Cognitive stimulation was significantly associated with higher responsive and lower indulgent feeding styles. SB mothers were less likely to exhibit pressuring styles compared with controls (Effect Size [ES]=-0.12, P = 0.02). Although no direct intervention effects were found on responsive or indulgent feeding styles, indirect effects of SB were evident on these feeding styles through intervention-induced increases in cognitive stimulation in the SB group.

Conclusions: This study found positive linkages between cognitive stimulation in the home and later feeding styles. Additionally, the SB intervention was associated with less pressured feeding and indirect pathways mediated by intervention effects on cognitive stimulation. Implications for early childhood parenting interventions are discussed.

低收入家庭的认知刺激和母亲喂养方式:随机临床试验的影响。
目的研究6个月时家庭中的认知刺激与24个月时母亲喂养方式之间的关联、"聪明开端"(SB)对喂养方式的直接干预效果,以及SB通过早期对认知刺激的干预效果对喂养方式的潜在间接影响:研究设计:SB 干预的单盲、两地随机临床试验(RCT)。SB 将 PlayReadVIP(一项以儿科初级保健为基础的通用项目)和 Family Check-Up (FCU) (一项有针对性的二级家庭育儿干预项目)整合在一起。母婴二人组(327 人)在出生时被随机分配到标准儿科护理或 SB 干预中。线性回归分析确定了 6 个月时的认知刺激与 24 个月时的母亲喂养方式之间的关联,这是一项辅助数据分析。此外,还评估了干预对喂养方式的直接影响(这是 RCT 的次要结果),并通过中介分析探讨了早期干预对认知刺激的影响对喂养方式的干预效果:结果:认知刺激与较高的反应性和较低的放纵性喂养方式明显相关。与对照组相比,SB 母亲较少表现出施压型喂养方式(效应大小 [ES]=-0.12, p=0.02)。虽然没有发现干预措施对反应型或放纵型喂养方式产生直接影响,但通过干预措施引起的SB组认知刺激的增加,SB对这些喂养方式产生了明显的间接影响:本研究发现,家庭中的认知刺激与日后的喂养方式之间存在积极联系。此外,SB 干预还与压力较小的喂养方式有关,并通过对认知刺激的干预效果而产生间接影响。本研究对幼儿养育干预的意义进行了讨论。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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