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Table 1 FSN Intervention Components

From: Family Spirit Nurture (FSN) – a randomized controlled trial to prevent early childhood obesity in American Indian populations: trial rationale and study protocol

 

Period (Frequency)

Responsive Parenting & Responsive Feeding

Infant and Young Child Feeding (IYCF) and PA

Maternal & Child Well-being and Home Environment

28 weeks gestation

Prenatal (biweekly)

• Introduction: fetal & child growth, development, & behaviors

• Prenatal nutrition & PA

• Breastfeeding basics

• Planning for a healthy delivery

34 weeks gestation

Prenatal (biweekly)

• Introduction: responsive parenting/ feeding

• Prenatal nutrition & PA goal-setting

• Breastfeeding promotion

• Baby care basics/ making a safe home for play

Birth

Neonatal (weekly)

• Normal growth, feeding, & sleeping patterns

• Recognition of hunger/ satiety cues

• Feeding support visit

• Importance of exclusive breastfeeding (or formula feeding if breastfeeding not possible)

• Family planning options

• Daily routines for healthy living

1 month post-partum

Early infancy 1 (weekly)

• Understanding baby’s needs & behaviors

• Managing fussy behavior

• Responding quickly & appropriately to behavior cues

• Discussing reduced screen time

• Promotion of exclusive breastfeeding (or formula feeding if breastfeeding not possible)

• Feeding during illness

• Child opportunities to explore through touch, movement, sight, & sound (tummy time)

• Resisting drug use

• Conflict/ communication skills with baby’s father and/or family/ household members

• Involving fathers and other caregivers in baby’s care

3 months post-partum

Early infancy 2 (biweekly)

• Play & communication activities

• Looking/ smiling at child during feeding

• Responding to baby’s cues and gestures

• Establishing healthy sleep routines

• Reducing exposure to screen time

• Promotion of exclusive breastfeeding (or formula feeding if breastfeeding not possible)

• Gross & fine motor play

• Continued tummy time

• Monitoring patterns/ reducing screen time

• Skills for healthy living: handling stress, positive thinking, addressing home food, beverage, & PA environment

6 months post-partum

Mid-infancy (monthly)

• Play & communication activities (talking, singing, imitation)

• Providing consistent routine

• Eating with few distractions

• Finger foods for child to touch

• Continued breastfeeding and/or formula feeding, along with complementary feeding (sequence)

• Types/ textures of complementary foods

• Increasing healthy diet variety

• Gross & fine motor play

• Revisiting family planning/ sexual health (STI knowledge & testing)

• Safe & reliable play spaces

• Meal planning

9 months post-partum

Late infancy (monthly)

• Play & communication activities (“bye-bye”, imitation)

• Singing to child during daily activities

• Eating with child (modeling healthy eating)

• Updating routines as needed

• Helping infant transition to healthy family lifestyle (diet & PA)

• Ensuring infant is hungry at meals (avoid SSBs, snacks, desserts)

• Continued breastfeeding and/or formula feeding

• Skills for healthy living: saying “no”, healthy relationships, problem-solving, positive thinking, accessing resources for a positive food & beverage environment

12 to 18 months post-partum

Toddlerhood (monthly)

• Monitoring toddler routines

• Maintaining consistent routines (sleeping, eating)

• Play & communication activities (reading, playing games)

• Modeling healthy eating

• Self-feeding

• Avoiding food as a reward

• Giving toddler fixed “healthy” choices (e.g. banana or orange)

• Transitioning to a cup

• Dealing with food refusal and pickiness

• Promoting PA/ reduced screen time

• Involving toddler in food shopping & preparation

• Providing daily opportunities for gross motor play

• Budgeting for family’s needs

• Confident & effective parenting (consistent rules)

• Toddler care practices/ making a safe home for play

• Safe/ consistent alternative caregivers