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A Social Media Peer Group for Mothers To Prevent Obesity from Infancy: The Grow2Gether Randomized Trial

Fiks, Alexander G., Gruver, Rachel S., Bishop-Gilyard, Chanelle T., Shults, Justine, Virudachalam, Senbagam, Suh, Andrew W., Gerdes, Marsha, Kalra, Gurpreet K., DeRusso, Patricia A., Lieberman, Alexandra, Weng, Daniel, Elovitz, Michal A., Berkowitz, Robert I., Power, Thomas J.
Childhood obesity 2017 v.13 no.5 pp. 356-368
body mass index, childhood obesity, curriculum, feeding behavior, infancy, infant growth, infants, low income households, mothers, parenting, pregnant women, questionnaires, randomized clinical trials, risk, sleep, social networks, surveys
Background: Few studies have addressed obesity prevention among low-income families whose infants are at increased obesity risk. We tested a Facebook peer-group intervention for low-income mothers to foster behaviors promoting healthy infant growth.Methods: In this randomized controlled trial, 87 pregnant women (Medicaid insured, BMI ≥25 kg/m²) were randomized to the Grow2Gether intervention or text message appointment reminders. Grow2Gether participants joined a private Facebook group of 9–13 women from 2 months before delivery until infant age 9 months. A psychologist facilitated groups featuring a curriculum of weekly videos addressing feeding, sleep, parenting, and maternal well-being. Feasibility was assessed using the frequency and content of participation, and acceptability using surveys. Maternal beliefs and behaviors and infant growth were assessed at birth, 2, 4, 6, and 9 months. Differences in infant growth between study arms were explored. We conducted intention-to-treat analyses using quasi-least-squares regression.Results: Eighty-eight percent (75/85) of intervention participants (42% (36/85) food insecure, 88% (75/85) black) reported the group was helpful. Participants posted 30 times/group/week on average. At 9 months, the intervention group had significant improvement in feeding behaviors (Infant Feeding Style Questionnaire) compared to the control group (p = 0.01, effect size = 0.45). Intervention group mothers were significantly less likely to pressure infants to finish food and, at age 6 months, give cereal in the bottle. Differences were not observed for other outcomes, including maternal feeding beliefs or infant weight-for-length.Conclusions: A social media peer-group intervention was engaging and significantly impacted certain feeding behaviors in families with infants at high risk of obesity.