Less than a high school diploma
13%
Peer reviewed?
Yes
Wen, L. M., Baur, L. A., Simpson, J. M., Xu, H., Hayes, A. J., Hardy, L. L., Williams, M., & Rissel, C. (2015). Sustainability of effects of an early childhood obesity prevention trial over time: A further 3-year follow-up of the Healthy Beginnings trial. JAMA Pediatrics, 169(6), 543–551. https:// doi:10.1001/jamapediatrics.2015.0258
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Funding Sources
This research was supported by grants from the Australian National Health and Medical Research Council (ID numbers 393112 and 1003780). One of the co-authors was supported by a grant from the Australian National Health and Medical Research Council (ID number 571372).
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No |
Yes |
All child and maternal outcomes assessed when children were age 5 received a low rating because they had high attrition and did not satisfy the baseline equivalence requirement. Some findings on children’s dietary behaviors and TV-watching behaviors when they were age 3.5 received an indeterminate rating because HomVEE was not able to confirm measure reliability.
Findings that rate moderate or high in this manuscript
Child health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Child BMI | 2 years old | High | 0.25 | Statistically significant, p = 0.01 | 465 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Child BMI (standardized units) | 2 years old | High | 0.26 | Statistically significant, p = 0.01 | 465 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Child BMI | 3.5 years old | High | 0.03 | Not statistically significant, p = 0.73 | 415 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Child BMI (standardized units) | 3.5 years old | High | 0.07 | Not statistically significant, p = 0.49 | 415 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Child dietary behaviors: At least 2 servings per day of vegetables | 3.5 years old | High | 0.00 | Not statistically significant, p= 0.95 | 415 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Child dietary behaviors: At least 2 servings per day of fruit | 3.5 years old | High | 0.03 | Not statistically significant, p= 0.82 | 415 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample |
Child development and school readiness
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Child physical activity: Outdoor play at least 120 min/day | 3.5 years old | High | 0.05 | Not statistically significant, p= 0.65 | 415 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample |
Positive parenting practices
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Child TV watching: TV viewing time less than 60 min/day | 3.5 years old | High | 0.40 | Not statistically significant, p= 0.07 | 415 children | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample |
Maternal health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Maternal dietary behaviors: At least 2 servings per day of vegetables | 3.5 years old | High | 0.22 | Not statistically significant, p= 0.08 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Maternal dietary behaviors: At least 2 servings per day of fruit | 3.5 years old | High | 0.10 | Not statistically significant, p= 0.49 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Maternal dietary behaviors: Soft drinks, more than 7 cups per week | 3.5 years old | High | 0.08 | Not statistically significant, p= 0.51 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Maternal dietary behaviors: Fast food | 3.5 years old | High | 0.28 | Not statistically significant, p= 0.06 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Maternal dietary behaviors: Processed meat more than 3 times per week | 3.5 years old | High | 0.07 | Not statistically significant, p= 0.69 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Maternal physical activity: Total physical activity time at least 150 min/week | 3.5 years old | High | 0.07 | Not statistically significant, p= 0.59 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample | ||
| Maternal TV watching: Watching TV less than 120 min/day | 3.5 years old | High | 0.13 | Not statistically significant, p= 0.32 | 369 mothers | HBT Phase 2 vs. comparison RCT, Sydney, Australia, 2011-2014, full sample |
Study Participants
The Healthy Beginnings Trial (HBT) was a randomized controlled trial that recruited first-time mothers receiving prenatal care in one of two hospitals. The study began in 2007 and assigned 337 families to the Healthy Beginnings home visiting intervention—received in the first two years of a child’s life—and 330 families to the comparison group. The HBT Phase 2 study began in 2011 with a goal of investigating the long-term effects of the home visiting intervention when children were ages 3.5 and 5. Of those originally assigned, 465 (236 intervention, 229 comparison) agreed to participate in the Phase 2 study, and 369 (191 intervention, 178 comparison) remained in the study when their children were age 5. Fifty-five percent of enrolled children in the follow-up study were male, and 46 percent were female. More than half of the women (57 percent) were employed or on paid or unpaid parental leave. Twenty-five percent of households had an annual income of less than $40,000; 31 percent had an annual income of between $40,000 and $79,999; and 43 percent had an annual income of more than $80,000. Authors did not report collecting data on race or ethnicity but did say that 63 percent of women in the study were born in Australia.
Setting
The study took place in socially and economically disadvantaged areas of South Western Sydney, Australia.
Home Visiting Services
The Healthy Beginnings intervention was designed to improve family and behavioral risk factors for childhood obesity. The intervention consisted of eight home visits from community nurses delivering a staged home-based intervention, with one visit in the antenatal period and seven visits at one, three, five, nine, 12, 18, and 24 months after birth. Each visit lasted about one to two hours. Working with the mother and infant, the nurse addressed infant feeding practices, nutrition, play and activity (of both child and family), and social support.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Comparison Conditions
Families assigned to the comparison group were not eligible to receive Healthy Beginnings. The comparison group was eligible to receive typical antenatal services provided in Australia, which included at least one nurse visit for general support at home. The study provided materials promoting home safety at six and 12 months.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
This study included participants from the following locations:
- State not reported or international
International Locations
Australia