Using Baby Books to Promote Maternal and Child Health

• ClinicalTrials.gov Identifier: NCT02203617
• Recruitment Status: Completed
• First Posted: July 30, 2014
• Last Update Posted: April 14, 2017
• Sponsor: Vanderbilt University
• Collaborator: University of California, Irvine
• Information provided by (Responsible Party): Leonard Bickman, Vanderbilt University

Study Description

Brief Summary:

The Baby Books Project tests whether embedding educational information into baby books can improve the health and wellbeing of first-time mothers and their young children.

Condition or disease	Intervention/treatment	Phase
Condition 1 - Educational Condition (Educational Book Group); Condition 2 - Non-educational Condition (Non-educational Book Group); Condition 3 - Control Condition (No-book Group)	Behavioral: Educational Content/Pediatric Anticipatory Guidance; Behavioral: Book provision	Not Applicable

Detailed Description:

This study tests the efficacy of embedding educational information (i.e., pediatric anticipatory guidance) into baby books that first-time mothers read to their infants. This 3-group longitudinal study recruited first-time mothers in their third trimester of pregnancy, randomly assigned them to conditions, and followed them until the child was 18 months of age. One group received educational baby books, another group was given the same illustrated books with non-educational text, and the third group was not given any books. Thus, the effects of educational reading could be parsed from the effects of reading alone. The study aimed to test whether embedding pediatric anticipatory guidance in picture books is an effective method for increasing maternal knowledge of child development, parenting strategies, and safety practices, improving parenting beliefs and attitudes (e.g., parenting efficacy, importance of reading, use of corporal punishment), supporting optimal parenting practices (e.g., breastfeeding and nutrition, responsiveness, safety practices), improving maternal health (stress, depression), and supporting children's healthier development (injuries, illness, immunizations, and linguistic, social, and cognitive development).

Survey and observational data collection occurred in participants' homes during their third trimester of pregnancy and when their child was 2, 4, 6, 9, 12, and 18 months of age. Twelve phone call interviews were conducted between these home visits. When children were 18 months, a retrospective medical chart audit was conducted.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 198 participants
• Allocation: Randomized
• Intervention Model: Single Group Assignment
• Masking: Double (Care Provider, Outcomes Assessor)
• Primary Purpose: Prevention
• Official Title: Using Baby Books to Promote Maternal and Child Health
• Study Start Date: April 2005
• Actual Primary Completion Date: June 2009
• Actual Study Completion Date: July 2010

Arms and Interventions

Arm	Intervention/treatment
Experimental: educational baby books; books embedded with educational information (pediatric anticipatory guidance)	Behavioral: Educational Content/Pediatric Anticipatory Guidance; educational information from Bright Futures Guidelines for Health Supervision for birth to 18 months; Behavioral: Book provision; Given free books prenatally and at 2, 4, 6, 9, 12, and 18 months postpartum
Active Comparator: non-educational baby books; baby books given with same illustrations but no educational information	Behavioral: Book provision; Given free books prenatally and at 2, 4, 6, 9, 12, and 18 months postpartum
No Intervention: no books; not given any baby books

Outcome Measures

Primary Outcome Measures :

1. Change in knowledge of child development and parenting [ Time Frame: Change from Baseline (pregnancy) to 18 months postpartum ]
   Measured with Opinions about Babies questionnaire
2. Change in Reading Practices [ Time Frame: Change from 2 to 18 months postpartum ]
   Self-reported joint reading practices
3. Parenting Stress [ Time Frame: Change from 2 to 18 months post-partum ]
   Measured with the Parenting Stress Index
4. Costs [ Time Frame: Cumulative costs over study duration ]
   Maternal costs due to their own and their child's illness/injury, use of substances, and purchase of food was measured with the Incurred Cost Questionnaire.

Secondary Outcome Measures :

1. Safety Practices [ Time Frame: 2, 4, 6, 9, 12, and 18 months postpartum ]
   Measured with the Home Safety Assessment, an observational and self-report measure of safety practices in the home, car, and outside
2. Attitudes about Corporal punishment [ Time Frame: 2, 6, 12 and 18 months postpartum ]
   Adolescent-Adult Parenting Inventory
3. Maternal Depressive Symptoms [ Time Frame: Change from baseline (pregnancy) to 18 months postpartum ]
   Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale.
4. Beliefs about the Importance of Reading to Children [ Time Frame: Change from baseline (prenatal) to 18 months postpartum ]
   Maternal beliefs about the importance of reading was measured with the Modified Parent Reading Belief Inventory
5. Injuries and illnesses [ Time Frame: 16 months (from 2 to 18 months postpartum) ]
   Child illnesses injuries were measured with the Incurred Cost Questionnaire and through a retrospective medical chart audit.
6. Quality of Parent-Child Interaction [ Time Frame: Change from 2 to 18 months postpartum ]
   Video recording and in-vivo coding of mother-child dyads during play and reading.
7. Home environment and parenting [ Time Frame: Change from 2 to 18 months postpartum ]
   measured with the Home Observation for Measurement of Environment (HOME).
8. Receptive and Expressive language [ Time Frame: Change from 6 to 18 months postpartum ]
   Measured with the Preschool Language Scale - Fourth Edition (PLS4).
9. Cognitive and neurological development screening [ Time Frame: 4, 6, 9 months postpartum ]
   Measured with the Bayley Infant Neurodevelopmental Screener (BINS)
10. Infant nutrition [ Time Frame: 2, 4, 6, 9, 12, and 18 months postpartum ]
    Infant Nutrition Interview measured the introduction of news foods, types of foods, and serving portions at each time point.
11. Breastfeeding intentions and practices [ Time Frame: prenatal and postnatal every visit until no longer breastfeeding ]
    measured with the Breastfeeding Intentions and Practices Scale
12. Pregnancy uplifts and Hassles [ Time Frame: Baselines (pregnancy) ]
    measured with the Pregnancy Experience Scale
13. Parenting Satisfaction [ Time Frame: Change from 2 to 18 months postpartum ]
    measured with the Parenting Satisfaction Scale
14. Parenting Self-Efficacy [ Time Frame: Change from 2 to 18 months postpartum ]
    Measured with the Maternal Self-Efficacy Scale
15. Reading self-efficacy [ Time Frame: Change from 2 to 18 months postpartum ]
    measured with the Reading Self-Efficacy Scale
16. Cognitive Development [ Time Frame: 12 and 18 months postpartum ]
    measured with Exploratory Play Task
17. Immunizations, medical visits, and growth status [ Time Frame: 18 months postpartum ]
    measured through a retrospective medical chart audit.

Other Outcome Measures:

1. Community Conditions [ Time Frame: 4 months postpartum and following a move to a new residence ]
   measured with the observational Community Conditions Checklist and self-report Community Conditions Interview

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 50 Years (Adult)
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• Women who are pregnant with first child and able to read in English at a first grade reading level

Exclusion Criteria:

• Women with other children, men, those not able to read in English at a first grade level

Contacts and Locations

Locations

United States, California

University of California, Irvine

Irvine, California, United States, 92697

United States, Tennessee

Vanderbilt University

Nashville, Tennessee, United States, 37212

Sponsors and Collaborators

Vanderbilt University

University of California, Irvine

Investigators

• Study Director: Stephanie M Reich, PhD; University of California, Irvine
• Principal Investigator: Leonard Bickman, PhD; Vanderbilt University

More Information

Publications of Results:

Reich SM, Penner EK, Duncan GJ, Auger A. Using baby books to change new mothers' attitudes about corporal punishment. Child Abuse Negl. 2012 Feb;36(2):108-17. doi: 10.1016/j.chiabu.2011.09.017. Epub 2012 Mar 3.

Reich SM, Penner EK, Duncan GJ. Using baby books to increase new mothers' safety practices. Acad Pediatr. 2011 Jan-Feb;11(1):34-43. doi: 10.1016/j.acap.2010.12.006.

Reich SM, Bickman L, Saville BR, Alvarez J. The effectiveness of baby books for providing pediatric anticipatory guidance to new mothers. Pediatrics. 2010 May;125(5):997-1002. doi: 10.1542/peds.2009-2728. Epub 2010 Apr 12.

Other Publications:

Khalessi A, Reich SM. A Month of Breastfeeding Associated with Greater Adherence to Pediatric Nutrition Guidelines. J Reprod Infant Psychol. 2013 Jul 1;31(3):299-308.

• Responsible Party: Leonard Bickman, Professor, Vanderbilt University
• ClinicalTrials.gov Identifier: NCT02203617
• Other Study ID Numbers: R01HD447749
• First Posted: July 30, 2014
• Last Update Posted: April 14, 2017
• Last Verified: April 2017

Keywords provided by Leonard Bickman, Vanderbilt University:

anticipatory guidance; baby books; safety

Additional relevant MeSH terms:

Disease; Pathologic Processes