ABSTRACT
BACKGROUND: Responsive infant feeding occurs when a parent recognizes the infant's cues of hunger or satiety and responds promptly to these cues. It is known to promote healthy dietary patterns and infant weight gain and is recommended as part of the Dietary Guidelines for Americans. However, the use of responsive infant feeding can be challenging for many parents. Research is needed to assist caregivers recognize infant hunger or satiety cues and overcoming barriers to using responsive infant feeding. OBJECTIVE: The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach, SS-OO-PP-RR ("super," Setting the Stage, Observation and Opportunities, Problem Solving and Planning, Reflection and Review), to promote responsive infant feeding. Guided by the Obesity-Related Behavioral Intervention Trials model, this study aims to test the feasibility and fidelity of the LEIFc intervention in a group of mother-infant dyads. METHODS: This pre-post quasi-experimental study with no control group will recruit mothers (N=30) in their third trimester (28 weeks and beyond) of pregnancy from community settings. Study visit 1 will occur prenatally in which written and video material on infant feeding and infant hunger and satiety cues is provided. Demographic information and plans for infant feeding are also collected prenatally via self-report surveys. The use of responsive infant feeding via subjective (survey) and objective (video) measures is recorded before (study visit 2, 1 month post partum) and after (study visit 5, 4 months post partum) intervention. Coaching on responsive infant feeding during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR approach at study visits 3 (2 months post partum) and 4 (3 months post partum). Infant feeding practices are recorded via survey, and infant weight and length are measured at each postpartum study visit. Qualitative data on the LEIFc intervention are provided by the interventionist and mother. Infant feeding videos will be coded and tabulated for instances of infant cues and maternal responses. Subjective measures of responsive infant feeding will also be tabulated. The use of responsive infant feeding pre-post intervention will be analyzed using matched t tests. Qualitative data will be examined to guide intervention refinement. RESULTS: This study initially began in spring 2020 but was halted because of the COVID-10 pandemic. With new funding, recruitment, enrollment, and data collection began in April 2022 and will continue until April 2023. CONCLUSIONS: After refinement, the LEIFc intervention will be tested in a pilot randomized controlled trial. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs that serve vulnerable populations-those that often have infant feeding practices that do not align with recommendations and are less likely to use responsive infant feeding. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44329.
ABSTRACT
Purpose The purpose of this study is to examine the impact of an intervention in which childcare providers (CCPs) are coached to support toddlers' gesture use during every day classroom routines. Method This study uses a multiple-baseline across strategies single-case experimental design to examine the impact of a coaching intervention on three CCPs' use of communication strategies with toddlers experiencing early childhood poverty. The CCPs were coached with a systematic framework called Setting the Stage, Observation and Opportunities to Embed, Problem-solving and Planning, Reflection and Review as they learned to implement three strategies to support toddlers' gesture use-modeling gestures with a short phrase, opportunities to gesture, and responding/expanding child gestures. CCPs were coached during book sharing and another classroom routine of their choice. Social validity data on the coaching approach and on the intervention strategies were gathered from postintervention interviews. Results The visual analysis and nonoverlap of all pairs' effect size indicates that the coaching intervention had a functional relation with CCPs' use of modeling gestures and responding/expanding gestures during book sharing, play, and circle time. Social validity data indicate that CCPs found the coaching framework supportive of their learning and feelings of self-efficacy, and that the intervention strategies supported their toddlers' communication. Conclusions The coaching framework was used to increase CCP strategy use during everyday classroom routines with toddlers. CCPs endorsed the coaching approach and the intervention strategies. This study adds to the literature supporting efforts to enhance children's earliest language learning environments. Supplemental Material https://doi.org/10.23641/asha.14044055.
