The Baby Bites Text Messaging Project with randomized controlled trial: texting to improve infant feeding practices.

Background: Rapid weight gain and overweight in infancy are associated with childhood obesity. Thus, effective, accessible interventions to promote healthy infant feeding practices to prevent early obesity are essential. Methods: This mixed-methods study involved diverse parents of infants in an urban, low-income pediatric clinic. Qualitative interviews explored parental attitudes towards feeding, early obesity, and communication with the pediatrician. A pilot, randomized controlled trial (RCT) informed by feedback provided by clinic parents compared text messages delivered for 12 months promoting healthy feeding practices to usual care to prevent early pediatric obesity. A computer-generated randomization schedule with balanced distribution for sex was used to place infants into groups. Weight-for-length percentiles and z-scores and feeding practices were measured at 0-2 weeks (baseline), 2-4 months, 6-9 months, and 12 months. Interviews were recorded, transcribed, and coded using thematic analysis. Weight for length percentile, Weight for length z scores, and feeding practices were compared between groups using repeated measures mixed analysis of variance (ANOVA). Results: Participants in the interviews were 15 parents of infants less than 1 month old. RCT participants were 38 parents of newborns (17 control; 21 intervention). Most parents in the qualitative evaluation viewed breastfeeding positively but also discussed barriers. Most also wanted practical information regarding infant feeding. There were no differences in weight-for-length percentile (F=0.52; P=0.60) or z-scores (F=0.7922; P=0.79), breastfeeding persistence χ2[1] =1.45, P=0.23, or age of introduction of solids in the intervention (statistical analysis not possible due to low counts) compared to the control group; however, low response to surveys limited the study's power. Conclusions: Text messaging has potential to extend the healthcare provider's communication beyond clinic. However, texting interventions should be flexible to mitigate barriers such as loss of phone service and challenges customizing messages to parent needs.

Parent preferences for text messages containing infant feeding advice.

BACKGROUND: Text-messaging is beneficial in health promotion. Research on impact of message framing (gain- versus loss-framed) has had variable results, depending on type of behavior targeted. There is no research on framing of text-messaging to promote healthful infant feeding practices. METHODS: The purpose of this cross-sectional survey was to examine whether parents of infants aged three months or younger viewed gain- or loss-framed text messages as more helpful and which style was viewed as more likely to affect feeding practices. A secondary purpose was to determine what time of day and frequency of messaging was preferred. Parents were recruited from an urban pediatric medical clinic. PsychData was used to administer the survey. Parents rated message pairs targeting constructs of the Health Belief Model using a five-point Likert scale. Paired t- tests compared overall ratings for helpfulness and likelihood of messages affecting feeding practices between gain- and loss-framed messages. Descriptive and frequency analyses were applied to demographics and questions regarding preferred timing for receiving messages. RESULTS: A total of 34 parents (3 fathers and 31 mothers, mean age 26±5.5 years) completed the survey, with 41% enrolled in WIC and 29% in SNAP. There was no overall difference in helpfulness or likelihood of messages affecting feeding practices between gain- and loss-framed messages. Message style did not affect likelihood of adopting a feeding practice. However, gain framed messages relating to benefits and self-efficacy for breastfeeding were viewed more positively (mean =2.32; P=0.034; mean =1.79; P=0.041, respectively). The greatest proportion of parents (38%) preferred receiving messages once per week, and 50% preferred morning messages. CONCLUSIONS: Framing of text messages appeared to have little effect on parents' acceptance of messages related to infant feeding practices. Parents were receptive to receiving messages from their infant's healthcare provider once per week, in the morning.

A Qualitative Exploration of Less Acculturated Mexican Mothers' Safety Perceptions of Herbs, Medicines, and Cleaners in the Home.

Childhood poisoning is a leading public health concern in our society. The death rate from unintentional poisonings among children has increased by 80% from 2000 to 2009. Immigrant children are also at-risk. A qualitative study, consisting of a pile sort, was conducted among immigrant Mexican mothers to determine their safety perceptions of commonly used medicines, herbs, and cleaners. Participants (N = 35) were selected for semi-structured interviews from a pediatric primary care clinic in the Dallas/Fort Worth Metroplex. Some mothers over-estimated their children's ability to discern the dangers of substances, relied heavily on sensory skills of children, and perceived a medicine as safe after successful use in the past. Other mothers were more cognizant of allergic reactions, ingestion, and the need to store substances carefully. Brief interventions that incorporate culturally-appropriate safety messages are needed to assist Mexican mothers in creating a safe home environment.

Relations of sex, age, perceived fitness, and aerobic activity with social physique anxiety in adults sixty years and older.

Self-reported physical activity, and perceived fitness were examined to assess their effects on social physique anxiety in a sample of older individuals (N= 249; M age=70.4 yr., SD=8.2). Participants reported their fitness as "average" to "above average." There were no significant effects of perceived fitness or age on social physique anxiety scores. The women had significantly higher social physique anxiety scores than the men.

Health information needs of d/Deaf adolescent females: a call to action.

Adolescent health and health literacy are critical health topics recognized in Healthy People 2020. Evidence indicates that adolescents who are d/Deaf have unique health-related needs, yet health communication efforts have not reached them. Despite the Internet's exponential growth and the growth of online health information-seeking behavior among adolescents, reliable information devoted specifically to d/Deaf adolescents who communicate primarily in ASL is rare. D/deaf adolescent females face numerous challenges accessing web-based health information to enhance their decision making about important health issues such as body image, physical activity and nutrition, puberty, and relationships. A strong need exists for interdisciplinary professionals to investigate the health interests and online health information-seeking behaviors of this group in order to effectively plan, implement, and evaluate a web-based health repository that delivers content in ASL. This Call to Action represents a first step in addressing that need.

Childhood cancer and environmental toxins: the debate continues.

Despite its rarity and advances in treatment and supportive care, cancer remains the leading cause of death from disease in children under 15. While the field of pediatric oncology has seen some advances in diagnostic and treatment techniques, researchers continue to face numerous hurdles in determining causative factors associated with childhood cancer. One of the most hotly contested issues in this area is the possible link between childhood cancer and environmental toxins. This article presents an interview with three pediatric oncologists and an environmental research toxicologist to help provide insight into the relationship between environmental exposures and childhood cancer.