Well Baby Group Care: Evaluation of a Promising Intervention for Primary Obesity Prevention in Toddlers

Abstract

WBG, a replicable model integrated into primary care visits, affords a unique opportunity to intervene consistently and early, providing families in at-risk communities with increased provider time, intensive education, and ongoing support. Further study of group well-child care for primary obesity prevention is warranted to confirm the effectiveness of the model.

A Qualitative Study of Women's Recall of Content and Skills Developed in Group Prenatal and Well‐Baby Care 2 Years Later

“…Repeated reinforcement of key messages, practicing new skills, and providing long‐term support may change women's efficacy and outcome expectancies and therefore help some women adopt and sustain healthy improvements in a diverse range of health behaviors. These strategies may be effective; participation in the group well‐baby care arm was associated with an 88% reduction (adjusted odds ratio, 0.12; 95% CI, 0.02‐0.93; P = .04) in the risk of toddlers being overweight or obese at age 2 years in a recent study of our model of care (N = 47) …”

“…Group prenatal care and group well‐baby care are promising strategies for better addressing family needs and improving clinical and social outcomes. Studies to date have shown that the immediate outcomes associated with group prenatal and well‐baby care are at least as good, if not better, than those associated with individual care and include greater satisfaction, higher breastfeeding initiation rates, lower rates of preterm birth, and lower rates of overweight and obesity in children participating in group pediatric care at 15 months and 24 months . However, whether the knowledge and skills gained in group prenatal or group well‐baby care are used long term is unknown.…”

“…Women who participate in group prenatal care, as well as other women with infants younger than 2 months of age, are eligible for group well‐baby care. As previously described, women attend an average of 6 group prenatal care sessions and 7 group well‐baby care sessions in our institution. As our model is a continuum of care from group prenatal to well‐baby care, women who attend both group prenatal and well‐baby care receive substantial content over 2 years that allows time for reinforcement of key messages and skills.…”

“…Studies to date have shown that the immediate outcomes associated with group prenatal and well-baby care are at least as good, if not better, than those associated with individual care 11 and in-clude greater satisfaction, [14][15][16] higher breastfeeding initiation rates, [14][15][16] lower rates of preterm birth, [14][15][16] and lower rates of overweight and obesity in children participating in group pediatric care at 15 months 17 and 24 months. 18 However, whether the knowledge and skills gained in group prenatal or group well-baby care are used long term is unknown. Only a few studies have followed group participants over time after the last group session; these studies reported lower rates of overweight and obesity at 6 months in children participating in group well-baby care, 18 higher rates of utilization of family planning services at 12 months in women participating in group prenatal care, 19 and lower rates of social conflict and depression at 12 months in women with higher levels of stress who participated in group prenatal care 20 compared with similar populations receiving individual care.…”

Outcomes of an early childhood obesity prevention program in a low‐income community: a pilot, randomized trial

“…Thus, the greatest opportunity for obesity prevention is in early life before behavioural patterns are established. Programs to prevent the development of obesity have had variable success . Recent reviews described the paucity of effective obesity prevention programs and obesity prevention studies for children under the age of 3 years …”