title: A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants to prevent childhood obesity.
abstract: With an increasing prevalence of obesity in young children globally, there is an urgent need for the development of effective early interventions. A previous Healthy Beginnings Trial using a nurse-led home visiting program has demonstrated that providing mothers with evidence-based advice can improve maternal practice regarding obesity prevention, and can reduce Body Mass Index (BMI) in the first few years of life. However, the costs for scale-up of home visiting limit its population reach. This trial aims to determine the efficacy of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants in improving infant feeding practices and preventing the early onset of childhood overweight and obesity.
  
  
  
  We propose a 3-arm randomised controlled trial (RCT) with a consecutive sample of 1056 mothers with their newborn children in New South Wales (NSW) Australia. Pregnant women who are between weeks 28 and 34 of their pregnancy will be invited to participate in the CHAT trial. Informed consent will be obtained, and after baseline data collection, participants will be randomly allocated to the telephone intervention, text messaging intervention, or the control group. The intervention comprises telephone consultations or text messages, together with 6 intervention packages being mailed at specific times from the third trimester of pregnancy until 12 months post birth. The main trial outcome measures include a) duration of breastfeeding, b) timing of introduction of solids, c) nutrition behaviours, physical activity and television viewing, and d) weight and BMI z-score at 12 and 24 months, e) cost-effectiveness, as well as f) feasibility and acceptability of the interventions.
  
  
  
  The results will ascertain whether early intervention using telephone consultation or text messaging together with staged mailed intervention resources can be feasible and effective in improving infant feeding practices, physical activity and reducing children's BMI in the early years of life. If proven to be feasible, effective as well as cost-effective, the trial results will inform a series of recommendations for policy and practice related to promoting healthy infant feeding and physical activity in young children in the first years of life.
  
  
  
  The CHAT Trial is registered with the Australian Clinical Trial Registry ( ACTRN12616001470482p ). It was registered on October 21, 2016.
authors.affiliation: Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia. lmwen@email.cs.nsw.gov.au.|Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia. lmwen@email.cs.nsw.gov.au.|Charles Perkins Centre, University of Sydney, Camperdown, Australia. lmwen@email.cs.nsw.gov.au.
authors.forename: Li Ming
authors.initials: LM
authors.lastname: Wen
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.|Charles Perkins Centre, University of Sydney, Camperdown, Australia.|Office of Preventive Health, Ministry of Health, Camperdown, NSW, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Rissel
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.|Charles Perkins Centre, University of Sydney, Camperdown, Australia.|Discipline of Child & Adolescent Health, University of Sydney, Camperdown, Australia.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Baur
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Hayes
authors.affiliation: Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.
authors.forename: Huilan
authors.initials: H
authors.lastname: Xu
authors.affiliation: Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.|Charles Perkins Centre, University of Sydney, Camperdown, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Whelan
authors.affiliation: Health Promotion Unit, South Eastern Sydney Local Health District, Camperdown, NSW, Australia.
authors.forename: Myna
authors.initials: M
authors.lastname: Hua
authors.affiliation: Community Health Services, Sydney Local Health District, Camperdown, NSW, Australia.
authors.forename: Miranda
authors.initials: M
authors.lastname: Shaw
authors.affiliation: Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.|Charles Perkins Centre, University of Sydney, Camperdown, Australia.
authors.forename: Philayrath
authors.initials: P
authors.lastname: Phongsavan
mesh_terms: D000328:Adult; D001315:Australia; D001942:Breast Feeding / Q000706:statistics & numerical data; D002662:Child Health Services; D003152:Community Health Nursing; D015444:Exercise; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009035:Mothers / Q000193:education*; D063766:Pediatric Obesity / Q000517:prevention & control*; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D012944:Social Support; D013689:Telephone / Q000706:statistics & numerical data*
keywords: BMI; Breastfeeding; Childhood obesity; Health promotion; Infant feeding practice; Intervention; Randomised controlled trial; Telephone consultation; Text messaging