title: A community-based intervention to prevent obesity beginning at birth among American Indian children: study design and rationale for the PTOTS study.
abstract: Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that American Indian (AI) children have higher rates of overweight and obesity than children of other races/ethnicities. The Prevention of Toddler Obesity and Teeth Health Study (PTOTS) is a community-partnered randomized controlled trial designed to prevent obesity beginning at birth in AI children. PTOTS was developed to test the effectiveness of a multi-component intervention designed to: promote breastfeeding, reduce sugar-sweetened beverage consumption, appropriately time the introduction of healthy solid foods, and counsel parents to reduce sedentary lifestyles in their children. A birth cohort of 577 children from five AI tribes is randomized by tribe to either the intervention (three tribes) or the comparison condition (two tribes). The strengths and weaknesses of PTOTS include a focus on a critical growth phase, placement in the community, and intervention at many levels, using a variety of approaches.
authors.affiliation: Center for Health Research, Kaiser Permanente-Northwest/Hawaii/Southeast, 3800 N. Interstate Avenue, Portland, OR 97227, USA. Njeri.Karanja@kpchr.org
authors.forename: Njeri
authors.initials: N
authors.lastname: Karanja
authors.forename: Mikel
authors.initials: M
authors.lastname: Aickin
authors.forename: Tam
authors.initials: T
authors.lastname: Lutz
authors.forename: Scott
authors.initials: S
authors.lastname: Mist
authors.forename: Jared B
authors.initials: JB
authors.lastname: Jobe
authors.forename: Gerardo
authors.initials: G
authors.lastname: Maupomé
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
mesh_terms: D001628:Beverages / Q000009:adverse effects / Q000592:standards; D001942:Breast Feeding; D053198:Child Nutrition Sciences / Q000193:education*; D055812:Community-Based Participatory Research; D019422:Dietary Sucrose / Q000009:adverse effects; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000208:ethnology / Q000517:prevention & control*; D010290:Parents / Q000193:education*; D015995:Prevalence; D014481:United States / Q000453:epidemiology
chemical_list: D019422:Dietary Sucrose