A Novel Obesity Prevention Program for High-Risk Infants in Primary Care

Conditional Weight Gain

Conditional Weight Gain scores will be calculated using length and weight of the infants. Length and weight will be measured in triplicate by masked research-reliable trained assessors and with standardized anthropometric procedures and averaged at each time point. Infants will be weighed unclothed, in a dry diaper using a Scale-Tronix 4802D Infant scale that is calibrated every day. Infant length will be measured using a Pediatric Stadiometer by O'Leary (PED LB35-07-X). Conditional weight gain is calculated as standardized residuals from the linear regression of anthropometric data (e.g., weight and length) on birthweight, with age and sex entered as covariates. Scores closer to 0 are ideal, with scores higher than 0 indicating more rapid weight gain and scores below 1 indicating slower weight gain. Primary outcomes will include conditional weight gain scores at the 9-month post-treatment time point.

Conditional Weight Gain

Conditional Weight Gain scores will be calculated using length and weight of the infants. Length and weight will be measured in triplicate by masked research-reliable trained assessors and with standardized anthropometric procedures and averaged at each time point. Infants will be weighed unclothed, in a dry diaper using a Scale-Tronix 4802D Infant scale that is calibrated every day. Infant length will be measured using a Pediatric Stadiometer by O'Leary (PED LB35-07-X). Conditional weight gain is calculated as standardized residuals from the linear regression of anthropometric data (e.g., weight and length) on birthweight, with age and sex entered as covariates. Scores closer to 0 are ideal, with scores higher than 0 indicating more rapid weight gain and scores below 1 indicating slower weight gain.

The Baby Eating Behavior Questionnaire

Used to measure infant appetite and contains 5 subscales that assess enjoyment of food, food responsiveness, slowness in eating, and satiety responsiveness, and general appetite. Subscales of the BEBQ have good reliability and the measured appetite traits track throughout infancy and toddlerhood and are related to greater weight gain. Items are scored on a Likert scale ranging from 1 to 5 with higher average scores on each scale indicating more enjoyment of food, food responsiveness, slowness in eating, and satiety responsiveness, respectively.

The Infant Feeding Style Questionnaire

An 83-item measure of parent feeding beliefs, behaviors, and style with the following subscales: laissez-faire, restrictive, pressuring, responsive and indulgent. Internal reliability measures for the subscales ranged from 0.75 to 0.95. Several sub-constructs, responsive to satiety cues, pressuring with cereal, indulgent pampering and indulgent soothing, were inversely related to infant weight-for-length z-score, meaning higher scores indicate greater risk for obesity.

The Food Frequency Questionnaire

A validated parent-report measure that assesses infant dietary intake within the previous 7 days. The FFQ measures duration of breast-feeding status, timing of introduction of solid foods, consumption of fruits and vegetables, consumption of proteins, consumption of energy-dense-nutrient-poor foods, and consumption of sugar sweetened beverages. The FFQ correlates well with weighted diaries in infancy. It measures intake across a diverse range of liquid and solid food groups. As infants are gradually introduced to solid foods and become less reliant on milk, the completion time of the measure may increase (requires 5-10 mins to complete).