Randomized controlled trial of an early child obesity prevention intervention: Impacts on infant tummy time.
To describe infant activity at 3 months old and to test the efficacy of a primary care-based child obesity prevention intervention on promoting infant activity in low-income Hispanic families.



This study was a randomized controlled trial (n = 533) comparing a control group of mother-infant dyads receiving standard prenatal and pediatric primary care with an intervention group receiving "Starting Early," with individual nutrition counseling and nutrition and parenting support groups coordinated with prenatal and pediatric visits. Outcomes included infant activity (tummy time, unrestrained floor time, time in movement-restricting devices). Health literacy was assessed using the Newest Vital Sign.



Four hundred fifty-six mothers completed 3-month assessments. Infant activity results were: 82.6% ever practiced tummy time; 32.0% practiced tummy time on the floor; 34.4% reported unrestrained floor time; 56.4% reported ≥1 h/d in movement-restricting devices. Inadequate health literacy was associated with reduced tummy time and unrestrained floor time. The intervention group reported more floor tummy time (OR 2.16, 95% CI 1.44-3.23) and unrestrained floor time (OR 1.69, 95% CI 1.14-2.49) compared to controls. No difference in the time spent in movement-restricting devices was found.



Tummy time and unrestrained floor time were low. Primary care-based obesity prevention programs have potential to promote these activities.
Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA.
Rachel S
RS
Gross
Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.|Department of Population Health, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.
Alan L
AL
Mendelsohn
Department of Population Health, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.|Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.
H Shonna
HS
Yin
Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.
Suzy
S
Tomopoulos
Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.
Michelle B
MB
Gross
Research and Evaluation Unit, Public Health Solutions, New York, New York, USA.
Roberta
R
Scheinmann
Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York, USA.
Mary Jo
MJ
Messito
D000328:Adult; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009035:Mothers; D063766:Pediatric Obesity / Q000517:prevention & control*