Strengthening integration of clinical and public health systems to prevent maternal-child obesity in the First 1,000Days: A Collective Impact approach.

Tiffany Blake-Lamb, Alexy Arauz Boudreau, Sarah Matathia, Etna Tiburcio, Meghan E Perkins, Brianna Roche, Milton Kotelchuck, Derri Shtasel, Sarah N Price, Elsie M Taveras

Journal: Contemporary clinical trials 2019;65():46-52

PMID: 29225195

Free Full Text on PubMed Central View on PubMed

Abstract

INTRODUCTION

Obesity interventions may be most effective if they begin in the earliest stages of life, support changes across family, clinical, and public health systems, and address socio-contextual factors.

METHODS

The First 1000Days is a systematic program starting in early pregnancy lasting through the first 24months of infancy to prevent obesity among low-income mother-infant pairs in three community health centers in Massachusetts. The program uses a Collective Impact approach to create the infrastructure for sustained, system-wide changes for obesity prevention across early life clinical and public health services, including Obstetrics, Pediatrics, Adult Medicine, Behavioral Health, Nutrition, Community Health, the Women, Infants and Children (WIC) program, and the Maternal, Infant and Childhood Home Visiting program. Program components include 1) staff and provider training; 2) enhanced gestational weight gain and infant overweight tracking; 3) universal screening of adverse health behaviors and socio-contextual factors; 4) universal patient navigation to support individual behavior change and social needs, while strengthening integration of clinical and public health services; 5) individualized health coaching for mother-infant pairs at high risk of obesity; and 6) educational materials to support behavior change.

RESULTS

A quasi-experimental evaluation design will examine changes, between 2015 and 2019, in gestational weight gain and prevalence of infant overweight from 0 to 24months of age.

CONCLUSIONS

The First 1000Days program will examine the effectiveness of an early life obesity prevention program for mother-infant pairs. If successful, the program could provide a model for chronic disease prevention and health promotion among vulnerable families starting in early life.

Address: Kraft Center for Community Health, Massachusetts General Hospital, 125 Nashua St, Suite 860, Boston, MA 02114, United States; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States.; Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States.; Kraft Center for Community Health, Massachusetts General Hospital, 125 Nashua St, Suite 860, Boston, MA 02114, United States; Department of Family Medicine, DotHouse Health, 1353 Dorchester Avenue, Dorchester, MA, United States.; Kraft Center for Community Health, Massachusetts General Hospital, 125 Nashua St, Suite 860, Boston, MA 02114, United States; Division of Public and Community Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, United States.; Kraft Center for Community Health, Massachusetts General Hospital, 125 Nashua St, Suite 860, Boston, MA 02114, United States; Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, United States. Electronic address: [email protected].

DOI: 10.1016/j.cct.2017.12.001

Link outs

Free resources

Full Text Sources:

Medical:

https://clinicaltrials.gov/search?term=AREA%5BRefe...

Other Literature Sources:

https://scite.ai/reports/29225195

Subscription / membership required

Full Text Sources:

MeSH Terms: Body Weights and Measures, Community Health Centers, Diet, Exercise, Female, Food Assistance, Gestational Weight Gain, Health Behavior, Health Education, Health Promotion, Health Status, Humans, Infant, Infant, Newborn, Inservice Training, Interdisciplinary Communication, Massachusetts, Mental Health, Mentors, Mothers, Pediatric Obesity, Poverty, Pregnancy, Pregnancy Trimester, First, Prenatal Care, Program Evaluation, Public Health, Public Health Administration, Racial Groups, Research, Sedentary Behavior, Social Support, Socioeconomic Factors, Systems Integration