Effectiveness of home based early intervention on children's BMI at age 2: randomised controlled trial
Objectives: To assess the effectiveness of a home-based early intervention on children’s BMI at age two. Design: Randomised controlled trial Setting: The Healthy Beginnings Trial was conducted in socially and economically disadvantaged areas of Sydney, Australia during 2007-2010. Participants: A total of 667 first-time mothers and their infants. Intervention: The intervention consisted of eight home visits from specially trained community nurses delivering a staged home-based intervention, one in the antenatal period, and seven at 1, 3, 5, 9, 12, 18 and 24 months after birth. Timing of the visits was designed to coincide with early childhood developmental milestones. Main outcome measures: The primary outcome included children’s BMI (the healthy BMI ranges for children aged 2 years: between 14.12 and 18.41 for boys or between 13.90 and 18.02 for girls), The secondary outcomes included infant feeding practices, and TV viewing time when children were two years of age, according to a modified research protocol. The data collectors and data entry staff were blinded to treatment allocation, but the participating mothers were not blinded. Results: Four hundred and ninety seven mothers and their children (75%) completed the trial. An intention-to-treat analysis using all 667 participants recruited, and multiple imputation of BMI for the 170 lost to follow-up and the 14 missing showed that mean BMI was significantly lower in the intervention group (16.53 kg/m2) than the control group (16.82 kg/m2), with a difference of 0.29 (95% confidence interval [CI] -0.55 to -0.02, P=0.04). Conclusions: The home-based early intervention delivered by trained community nurses was effective in reducing mean BMI for children at age 2 years. Trial registration: The Healthy Beginnings Trial is registered with the Australian Clinical Trial Registry (ACTRNO12607000168459)
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Wen, L. Ming., Baur, L. A., Simpson, J. M., Rissel, C., Wardle, K. & Flood, V. M. 2012, 'Effectiveness of home based early intervention on children's BMI at age 2: randomised controlled trial', BMJ: British Medical Journal, vol. 344, no. e3732, pp. 1-11.