Abstract
Objective
To evaluate the Healthy Eating through Group Well-Child Care (GWCC) intervention,
a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and
primary care partnership which seeks to promote responsive feeding practices among
low-income caregivers, by examining its impact on infant growth and exploring the
experiences of caregivers who participated in this intervention.
Methods
Using a difference-in-differences approach, we examined change in weight-for-length
among infants in GWCC before versus after implementation of the intervention compared
with infants in individual well-child care (IWCC) over the same time-period. In parallel,
we conducted semi-structured interviews in English and Spanish with caregivers who
participated in the intervention to explore their perspectives and analyzed transcripts
via the constant comparative method to identify salient themes.
Results
Using electronic health record data from 279 GWCC and 6134 IWCC participants, we found
no significant difference in first-year weight-for-length trajectory associated with
participation in the intervention. We reached thematic saturation after 19 interviews
with 22 caregivers and identified four major themes around feeding: 1) structural
barriers limit access to healthy foods through WIC, 2) conflicting sources of nutrition
advice challenge parental decision making, 3) exposure to novel foods facilitated
further experimentation with healthier foods, and 4) discussion of responsive feeding
facilitated awareness and adoption.
Conclusions
A primary care and WIC partnership to promote responsive feeding in the context of
GWCC was well received by caregivers but was not associated with improved weight-for-length
among infants. Structural barriers to implementing responsive feeding and healthy
eating practices may have impacted lack of measurable results from the intervention.
Keywords
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Article info
Publication history
Published online: January 01, 2023
Accepted:
December 27,
2022
Received:
August 23,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2023 by Academic Pediatric Association
