Browsing by Author "Karanja, Njeri"

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    A Community-Based Intervention to Prevent Obesity Beginning at Birth among American Indian Children: Study Design and Rationale for the PTOTS study
    (2012) Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupomé, Gerardo; Ritenbaugh, Cheryl
    Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that American Indian (AI) children have higher rates of overweight and obesity than children of other races/ethnicities. The Prevention of Toddler Obesity and Teeth Health Study (PTOTS) is a community-partnered randomized controlled trial designed to prevent obesity beginning at birth in AI children. PTOTS was developed to test the effectiveness of a multi-component intervention designed to: promote breastfeeding, reduce sugar-sweetened beverage consumption, appropriately time the introduction of healthy solid foods, and counsel parents to reduce sedentary lifestyles in their children. A birth cohort of 577 children from five AI tribes is randomized by tribe to either the intervention (three tribes) or the comparison condition (two tribes). The strengths and weaknesses of PTOTS include a focus on a critical growth phase, placement in the community, and intervention at many levels, using a variety of approaches.
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    Knowledge, Attitudes and Beliefs That May Influence Infant Feeding Practices in American Indian Mothers
    (2014) Eckhardt, Cara L.; Lutz, Tam; Karanja, Njeri; Jobe, Jared B.; Maupomé, Gerardo; Ritenbaugh, Cheryl
    The promotion of healthy infant feeding is increasingly recognized as an important obesity prevention strategy. This is relevant for American Indian (AI) populations, who exhibit high levels of obesity and low compliance with infant feeding guidelines. The literature examining the knowledge, attitudes and beliefs (KAB) surrounding infant feeding within the AI population is sparse and focuses primarily on breastfeeding, with limited information on the introduction of solid foods and related practices that may be important in an obesity prevention context. This research presents descriptive findings from a baseline KAB questionnaire on infant feeding and related behaviors, administered to mothers (n=438) from five Northwest AI tribes that participated in the Prevention of Toddler Overweight and Teeth Health Study (PTOTS). Enrollment occurred during pregnancy or up to 6 months postpartum. The KAB questionnaire focused on themes of Breastfeeding/Formula Feeding and Introducing Solid Foods, with supplemental questions on Physical Activity. Knowledge questions were multiple-choice or true/false. Attitudes and beliefs were assessed on Likert scales. Descriptive statistics included frequencies and percents, and means and standard deviations. Most women knew basic breastfeeding recommendations and facts, but fewer recognized the broader health benefits of breastfeeding (e.g., reducing diabetes risk), or knew when to introduce solid foods. Women believed breastfeeding to be healthy and perceived their social networks to agree. Attitudes and beliefs about formula feeding and social support were more ambivalent. This work suggests opportunities to increase the perceived value of breastfeeding to include broader health benefits, increase knowledge about solid foods, and strengthen social support.