1. Development and Evaluation of an Early Childhood Obesity Prevention Video Mary Ann Chiasson, DrPH NNPHI Annual Conference May 7, 2009

2. About Public Health Solutions Grant and contract management Direct service provision –WIC ~50,000 women & children –Reproductive health centers ~ 17,000 –Health Insurance enrollment –Early intervention service coordination Technology services Research and Evaluation (IRB)

3. Research and Evaluation Unit 3 PhDs (epidemiology, sociology, demography) 2 MPHs + study staff Work as team Highly integrated with all other Public Health Solutions programs Internal & external R&E projects Academic affiliation

4. Evolution of the Intervention as an Example of Integration 2000WIC staff concerned about early childhood obesity 2001Brief survey on prevalence, food consumption, physical activity 2002Detailed survey (2-4 yr olds) ~40% overweight/obese

5. BMI Age Trends NYC Neighborhood WIC Program, 2001 40%

6. Next Steps 2006Funding from NYS Assembly 2006Intervention formative research –Video…DVD format –English / Spanish –Intervention for families 2007Infant feeding videos created 2008Effect of intervention assessed

8. Evaluation Overview Goal – To evaluate the impact of video on maternal infant feeding knowledge & practices 3 & 6 months after viewing. Data – Intervention Group (IG) - 171 got DVD; Control Group (CG) - 197 usual WIC services. All had singleton infants < 5 months of age; spoke English or Spanish. Methods – Baseline survey at WIC centers; 3 & 6 month phone follow-up surveys.

9. WIC Breastfeeding Peer Counselors

10. Participant Birthplace (N=368)

11. DVD Use at 3-Month Follow-up - Intervention Group 85% watched the DVD 66% watched more than once 73% watched the whole DVD 59% watched with someone else

12. Change in Knowledge* from Baseline to 3-Month Survey by Group GroupIncrease in Knowledge* p** InterventionFrom 5.8 to 6.3 8.6%.001 ControlFrom 6.3 to 6.6 4.8%.006 *Mean number of correct answers out of 9 questions **Wilcoxon Signed Ranks Test

13. Age at Introduction of Solids * *

14. Video Evaluation Conclusions The Intervention group: watched DVD at home and shared it. had a greater improvement in knowledge of healthy infant feeding practices. showed a later introduction of solids practices at 6-month follow-up survey.

15. Video Dissemination Now have three versions - English/Spanish, English/Mandarin & English/Creole/French Distributed to ~35,000 new mothers in NYC (WIC, large health plan, Asian- American health centers) Goal - Statewide distribution to all new mothers

16. Ongoing Obesity Prevention Activities Internal Planning for large scale RCT with prenatal mothers’ groups. Manuscript preparation Coordinated early childhood obesity prevention messages including breastfeeding support among all Public Health Solutions’ programs. External Co-PI with Columbia University on RWJF evaluation of impact of NYS new WIC food package

18. Research & Evaluation