Manuscript Details

Anzman-Frasca, S., Paul, I. M., Moding, K. J., Savage, J. S., Hohman, E. E., & Birch, L. L. (2018). Effects of the INSIGHT obesity preventive intervention on reported and observed infant temperament. Journal of Developmental and Behavioral Pediatrics: JDBP, 39(9), 736-743.  https://doi.org/10.1097/DBP.0000000000000597

Peer Reviewed

Model(s): Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT)
Study Registration: ClinicalTrials.gov
High rating
Study reviewed under: Handbook of Procedures and Standards, Version 2
Study design characteristics contributing to rating
Design Attrition Baseline equivalence Confounding factors? Valid, reliable measures?
Randomized controlled trial Low

Not assessed for randomized controlled trials with low attrition

No

Yes
Notes from the review of this manuscript

Information on sample sizes was obtained from Paul et al. (2014). Information on reliability of outcome measures was based on correspondence with the author. The authors reported several findings that are not eligible for review because they do not examine the impact of the intervention on an eligible outcome.

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
Infant Behavior Questionnaire-Revised (IBQ-R): Distress to limitations 1 year old High
0.33 Statistically significant, p <.05 240 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Falling reactivity 1 year old High
0.36 Statistically significant, p <.01 240 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Fear 1 year old High
0.02 Not statistically significant, p= 0.86 240 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Negativity 16 weeks old High
0.24 Not statistically significant, p <.10 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Negativity 1 year old High
0.26 Statistically significant, p <.05 240 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Regulation 16 weeks old High
0.07 Not statistically significant, p = 0.58 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Regulation 1 year old High
0.11 Not statistically significant, p= 0.39 240 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Infant Behavior Questionnaire-Revised (IBQ-R): Sadness 1 year old High
0.13 Not statistically significant, p= 0.29 240 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Negativity score during toy removal (toy removal frustration task) 1 year old High
0.00 Not statistically significant, p= 0.99 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Negativity score during toy return (toy removal frustration task) 1 year old High
0.00 Not statistically significant, p= 0.96 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Other regulation during toy removal (toy removal frustration task) 1 year old High
0.12 Not statistically significant, p= 0.36 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Other regulation during toy return (toy removal frustration task) 1 year old High
0.17 Not statistically significant, p= 0.22 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Self-soothing by orienting (toy removal frustration task) 1 year old High
0.07 Not statistically significant, p= 0.39 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Self-soothing by self-comforting (toy removal frustration task) 1 year old High
0.28 Statistically significant, p <.05 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Self-soothing strategy (any) during toy removal (toy removal frustration task) 1 year old High
0.00 Not statistically significant, p= 1.00 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Self-soothing strategy (any) during toy return (toy removal frustration task) 1 year old High
0.30 Statistically significant, p <.05 230 children INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant

Note: Tables do not include findings that HomVEE rated low or indeterminate, or found to be ineligible for review.

This study included participants with the following characteristics at enrollment:

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Asian
3%
Black or African American
3%
Hispanic or Latino
5%
White
93%
Unknown
1%

Maternal Education

Bachelor's degree or higher
68%
Unknown
33%

Other Characteristics

Data not available

This study included participants from the following locations:

  • Pennsylvania
Study Participants

Study participants were mother and infant dyads recruited after delivery in one Pennsylvania hospital. To be eligible, dyads had to include full-term, singleton births, with infants of normal birth weight. Mothers were English-speaking, primiparous, and at least 20 years old. A total of 291 dyads were randomly assigned to either the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) intervention (145 dyads) or a comparison intervention (146 dyads). Mother–infant dyads were randomly assigned to the INSIGHT intervention or the comparison intervention two weeks after birth, and outcomes were measured until the children’s first birthday. In the study, 93 percent of mothers were White, 3 percent were Black, 3 percent were Asian, and 1 percent reported another race. Five percent of mothers were Hispanic or Latino. One-third had a high school diploma or some college education, and two-thirds were college graduates.

Setting

The study took place in Hershey, Pennsylvania.

Intervention condition
Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT)

Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.

Comparison Conditions

Families assigned to the comparison condition were not eligible to receive intervention services through the INSIGHT program. However, these families received a similar number of home visits as the INSIGHT group (when infants were 3 to 4, 16, 28, and 40 weeks old) and annual clinic-based visits at 1, 2, and 3 years old. The home visits were focused solely on home safety topics, including crib safety. When infants were 2 weeks old, participants received a mailed packet with information on infant feeding.

Subgroups examined

• Boys • Girls

Author Affiliation

The authors are affiliated with several universities—including the University of Buffalo and Pennsylvania State University—and are developers of the INSIGHT program.

Funding Sources

This research was supported by Award Numbers R01DK088244 and UL1TR000127 from the National Institutes of Health and 2011-67001-30117 from the U.S. Department of Agriculture. The research was also supported by the Children’s Miracle Network at Penn State Health Children's Hospital and the Penn State Clinical and Translational Science Institute.