A social media peer-group intervention was engaging and significantly impacted certain feeding behaviors in families with infants at high risk of obesity.

BackgroundEvidence increasingly indicates that childhood obesity prevention efforts should begin as early as infancy. However, few interventions meet the needs of families whose infants are at increased obesity risk due to factors including income and maternal body mass index (BMI). Social media peer groups may offer a promising new way to provide these families with the knowledge, strategies, and support they need to adopt obesity prevention behaviors.ObjectiveThe aim of this study is to develop and pilot test a Facebook-based peer group intervention for mothers, designed to prevent pediatric obesity and promote health beginning in infancy.MethodsWe conducted in-depth semi-structured interviews with 29 mothers of infants and focus groups with 30 pediatric clinicians, to inform the development of a theory-based intervention. We then conducted a single-group pilot trial with 8 mothers to assess its feasibility and acceptability. All participants were recruited offline at pediatric primary care practices. Participants in the pilot trial joined a private Facebook group, moderated by a psychologist, with a weekly video-based curriculum, and also had the option to meet at a face-to-face event. Within the Facebook group, mothers were encouraged to chat, ask questions, and share photos and videos of themselves and babies practicing healthy behaviors. Consistent with the literature on obesity prevention, the curriculum addressed infant feeding, sleep, activity, and maternal well-being. Feasibility was assessed using the frequency and content of group participation by mothers, and acceptability was measured using online surveys and phone interviews.ResultsBased on preferences of mothers interviewed (mean BMI 35 kg/m2, all Medicaid-insured, mean age 27, all Black), we designed the intervention to include frequent posts with new information, videos showing parents of infants demonstrating healthy behaviors, and an optional face-to-face meeting. We developed a privacy and safety plan that met the needs of participants as well as the requirements of the local institutional review board (IRB), which included use of a “secret” group and frequent screening of participant posts. Clinicians, 97% (29/30) women and 87% (26/30) pediatricians, preferred no direct involvement in the intervention, but were supportive of their patients’ participation. In our 8-week, single group pilot trial, all participants (mean BMI 35 kg/m2, all Medicaid-insured, mean age 28, all Black) viewed every weekly video post, and interacted frequently, with a weekly average of 4.4 posts/comments from each participant. All participant posts were related to parenting topics. Participants initiated conversations about behaviors related to healthy infant growth including solid food introduction, feeding volume, and managing stress. All 8 pilot group participants reported that they found the group helpful and would recommend it to others.ConclusionsOur methodology was feasible and acceptable to low-income mothers of infants at high risk of obesity, and could be ad...

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During a 4-year period, four patients presented with transient disturbances in neurologic function that were diagnosed as seizures in two and transient ischemic attacks in the other two. Computed tomography (CT scan), both with and without contrast, was normal in all four patients. Isotopic brain scans (3 patients), cerebral angiograms (4 patients), and lumbar punctures (4 patients) were normal. Electroencephalograms (EEG) were normal in two patients and abnormal in two patients (consisting of focal slowing). Within 4.5 months, all patients developed symptoms and signs of a brain tumor, and in all four, CT scan now revealed a large mass lesion which at surgery was shown to be a malignant astrocytoma. These four patients constituted 4% of the total number of patients with malignant astrocytomas that were seen at the NYU Medical Center during this same time period. It is stressed that the CT scan may be normal early in the course of patients with brain tumors, particularly if they present with a transient disturbance in neurologic function. The first evidence of the tumor in such patients may be a slow-wave abnormality on the EEC. Patients who are suspected of having a brain tumor should, if the initial CT scan is normal, have the scan repeated later. ONTRAST-ENHANCED computed tomography (CT C scan) is the best method of diagnosing brain tumors. It is not generally appreciated, however, that the CT scan may be normal early in the course of a patient with a brain tumor, especially when the initial presentation of the tumor is that of transient neurologic disturbance (a seizure and/or a transient ischemic attack). This article reports our experience with four such patients. MethodsFour patients, during a 4-year period of time (1977 to 1980), were referred to the New York University Medical Center (NYUMC) for evaluation of a transient neurologic disturbance. The initial CT scans in all four of these patients were normal, while repeat CT scans a few months later revealed large mass lesions that histologically were shown to be malignant astrocytomas. Accepted for publication July 9, 1982. During the four years in which these patients were seen, a total of 162 patients with malignant astrocytomas were seen at the NYUMC. Thus, the four patients in this report constituted 4% of the total number of patients with malignant astrocytomas that were seen at the NYUMC.Assessment consisted of a detailed physical, neurologic, and laboratory examination including a hemogram, random and fasting blood sugars, calcium, phosphorous, blood urea nitrogen (BUN), and serum creatinine. CT scans with and without a single dose of iodinated contrast were performed on an EM1 head scanner Model #5005 (Cases 1, 3, and 4) or a General Electric CT/T scanner Model #MOO (Case 2). These scans were independently interpreted by two neuroradiologists (R.P.; A.G.). Electroencephalograms (EEGs) were performed on all patients and records were obtained with the patient awake, drowsy and asleep, and during hyperventilation and photic stimulation. Three ...