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United States Department of Agriculture

Agricultural Research Service

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Research Project: Startsmart

Location: Southeast Area

2011 Annual Report


1a.Objectives (from AD-416)
This project aims to develop, implement, and evaluate the effectiveness of a culturally tailored, prenatal and early childhood, nutrition, healthy behaviors, and breastfeeding promotion program, delivered within the participant’s home by community home visitors and a lactation expert, on anthropometric, dietary, and health behavior outcomes of both mother and baby 24 and 36 months post-delivery compared to control site mothers.


1b.Approach (from AD-416)
This intervention will be adapted from the INFANT trial conducted in Melbourne, Australia. The intervention will be modified for home-dissemination, education level, and for cultural appropriateness. There will be an intervention and control site. Moms that are pregnant or have a child less than two months of age will be eligible for recruitment into StartSmart. Moms that are pregnant, at the time of recruitment, will receive both the breastfeeding promotion and nutrition intervention components. Moms enrolled post-natal will only receive the nutrition intervention component. Moms recruited at the control site will receive routine care. Outreach workers will present interactive lessons, 15-20 minutes in length, every three months during the intervention period (3-23 months). Key concepts covered during StartSmart lessons will include reducing barriers related to breast-feeding, parental feeding styles, introduction of solid foods and sweetened beverages, nutrition basics, parental modeling of healthy behaviors, meal planning on a budget, and identifying and reducing sedentary behaviors. Outcomes measures and intervention effectiveness will be evaluated through direct assessment of anthropometrics, self-report questionnaires, and in-person/phone-based dietary recalls. The primary outcome will be child BMI z-score at 24 and 36 months of age in intervention vs. control children. Secondary outcomes will include dietary knowledge, psycho-social factors related to breastfeeding and healthy eating, healthy parental feeding styles, modeling of healthy behaviors, identifying and reducing time spent in sedentary behaviors and dietary intake will be compared between groups at child month 24 and 36 months.


3.Progress Report

This is the final report for this project. LSU in cooperation with USDA/ARS, Delta Health Alliance (DHA), Mississippi Valley State University (MVSU), Mississippi State University (MSU), and Cary Christian Center (CCC) aided in the development of the breastfeeding survey and materials used in the StartSmart program. Ninety moms from 5 Lower Mississippi Delta counties were recruited and consented into the StartSmart program and served as either an intervention or control mom. The DHA project facilitator and USDA Principal Investigator trained 11 community outreach workers to implement the intervention program and collect study-related data. Seventy-seven home-based lessons were provided by outreach staff at the intervention sites (47 moms received the breastfeeding lesson; 28 moms received the 3 month lesson titled Baby’s First Spoonful: Introduction to Solid Foods; and 2 moms received the 6 month lesson: Beverage Basics, Reading the Food Label, and Physical Activity) and data was collected on 96 occasions from the expecting and/or new moms residing in the Lower Mississippi Delta region. We are currently entering and cleaning all the data collected before termination of the project into a database developed in collaboration with Mid-South Area Information Technology (IT) staff. ADODR used site visit, email and telephone conferences to monitor activities of the project.


Last Modified: 10/20/2014
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