Effect of a care-coordinated responsive parenting intervention on obesogenic risk behaviours among mother-infant dyads enrolled in WIC.

Background: Integrating health care and social care presents opportunities to deliver responsive parenting (RP) interventions for childhood obesity prevention.

Objectives: This analysis examined the effect of an integrated RP intervention on infant obesogenic risk behaviours.

Methods: This secondary analysis included 228 mother-infant dyads in the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study, a pragmatic randomized clinical trial that integrated care between paediatric clinicians and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) nutritionists to encourage RP. Mothers were randomized to a 6-month RP intervention or standard care. The Early Healthy Lifestyle risk assessment tool was completed at infant ages 2 and 6 months. Logistic regression examined study group effects on obesogenic risk behaviours, while t-tests assessed study group effects on a total obesogenic risk behaviour score. Models adjusted for milk type and parity.

Results: RP mothers were less likely to report nighttime feedings at 2 (adjusted odds ratio [aOR] 0.21, 95% confidence interval [CI] 0.07-0.62) and 6 months (aOR 0.36, 95% CI 0.16-0.81); pressure to finish the bottle (aOR 0.53, 95% CI 0.30-0.93) and using screens when feeding/playing at 2 months (aOR 0.34, 95% CI 0.17-0.67); and putting their infant to bed after 8:00 PM at 6 months (aOR 0.46, 95% CI 0.21-0.97). RP mothers had significantly lower obesogenic risk behaviour scores at 2 months (p = 0.009) but not at 6 months (p = 0.06) compared to standard care.

Conclusions: The WEE Baby Care intervention decreased some obesogenic risk behaviours among WIC mother-infant dyads. Integrated care in health and social settings can be used to provide patient-centred RP guidance to improve early obesogenic risk behaviours in high-risk populations.