Background-Conducting longitudinal research studies with low-income and/or minority participants present a unique set of challenges and opportunities.Purpose-To outline the specific strategies employed to successfully recruit and retain participants in a longitudinal study of nutritional anticipatory guidance during early childhood, conducted with a low-income, ethnically diverse, urban population of mothers. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. reporting, emphasis on participant convenience, incentives, frequent contact with participants, expanded budget, clinical staff buy-in, a dedicated phone line, and the use of research project branding and logos. Methods-We NIH Public AccessResults-Barriers to enrollment were not encountered in this project, despite recruiting from a low-income population with a large proportion of African-American families. Process evaluation with clinic staff demonstrated the perception of the MOMS staff was very positive Participant retention rate was 75% and 64% at 6 months and 12 months post-recruitment, respectively. We attribute retention success largely to a coordinated effort between the research team and the infrastructure support at the clinical sites, as well as project branding and a dedicated phone line.Conclusions-Successful participant recruitment and retention approaches need to be specific and consistent with clinical staff buy in throughout the project.

WHAT'S KNOWN ON THIS SUBJECT: Childhood obesity occurs in 20% of children before they enter kindergarten. Treatment is difficult, making prevention desirable, but little is known about effective methods using anticipatory guidance to prevent obesity in pediatric primary care. WHAT THIS STUDY ADDS:This study provides a comparison of 2 approaches versus usual care using anticipatory guidance to improve infant feeding during the first year of life, and demonstrates positive specific feeding behavior differences at 1 year in the intervention groups. METHODS: This is a cluster randomized trial. A total of 292 mother/ infant dyads were enrolled at their first well-child visit to 3 urban pediatric clinics in Columbus, Ohio. Intervention-specific brief advice and 1-page handouts were given at each well visit. In addition to infant weights and lengths, surveys about eating habits and infant feeding practices were completed at baseline and 12 months. RESULTS:Baseline data revealed a group with high rates of maternal overweight (62%) and obesogenic habits. At 12 months, the maternalfocused group gave their infants less juice (8.97 oz vs 14.37 oz, P , .05), and more daily servings of fruit (1.40 vs 0.94, P , .05) and vegetables (1.41 vs 1.03, P , .05) compared with BF mothers. Ounce of Prevention mothers also gave less juice (9.3 oz, P , .05) and more fruit servings (1.26 P , .05) than BF.CONCLUSIONS: Brief specific interventions added to well-child care may affect obesogenic infant feeding behaviors of mothers and deserves further study as an inexpensive approach to preventing childhood obesity. Pediatrics 2012;130:e507-e517 AUTHORS:

Latino immigrant presence in urban neighborhoods has been linked with reduced neighborhood cohesion in social disorganization-based ethnic heterogeneity hypotheses and enhanced cohesion in immigration revitalization approaches. Using the 2000-2002 Los Angeles Family and Neighborhood Survey and the 1994-1995 Project on Human Development in Chicago Neighborhoods Community Survey, we explore the association between Latino immigrant concentration and both levels of, and agreement about, neighborhood collective efficacy. Findings from multilevel models with heteroskedastic variance indicate that Latino immigrant concentration exhibits a nonlinear association with collective efficacy. At low levels, increases in Latino immigrant concentration diminish collective efficacy, consistent with a heterogeneity hypothesis. The negative association between Latino immigrant concentration and collective efficacy declines in magnitude as immigrant concentration increases and, particularly in LA, becomes positive beyond a threshold, consistent with an immigration revitalization effect. We also find an inverse nonlinear pattern of association with the variance of collective efficacy. At low levels, increasing Latino immigrant concentration increases the variance of collective efficacy (reflecting more disagreement), but beyond a threshold, this association becomes negative (reflecting increasing agreement). This pattern is observed in both LA and Chicago. The prevalence of social interaction and reciprocated exchange within neighborhoods explains a modest proportion of the Latino immigrant concentration effect on mean levels of collective efficacy in Chicago, but does little to explain effects on the mean in LA or effects on the variance in either LA or Chicago. These findings offer insight into the complex role Latino immigrant presence plays in shaping neighborhood social climate.

The prevalence of NEC in patients undergoing the hybrid procedure is comparable to that reported for neonates undergoing the Norwood procedure. Earlier gestational age is a significant risk factor for NEC in patients who undergo the hybrid Stage I procedure. Multidisciplinary approaches to better understand abdominal complications and to develop feeding regimens in neonates undergoing the hybrid approach to complex CHD are needed to improve outcomes and decrease morbidities.