Clinical trial NCT06773299: Enhancing Intergenerational Health in Nigeria: Peripartum as Critical Life Stage for Cardiovascular Health
Official title: ENhancing Intergenerational HeAlth in Nigeria: Peripartum as Critical Life StagE for CardioVascular Health
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Hypertension in Pregnancy
Hypertension
Obesity and Overweight
Maternal Morbidity and Mortality
Maternal and Child Health Outcomes
Keywords: Maternal Hypertension
Maternal and infant cardiovascular health
Hybrid Type 2 effectiveness-implementation
Obesity in pregnancy
Lead sponsor: Washington University School of Medicine
Sponsor class: OTHER
Collaborators: name: University of Abuja Teaching Hospital
name: New York University
name: Parents as Teachers
First posted: 2025-01-14
Enrollment: 1000
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of the ENHANCE-CVH study is to promote intergenerational cardiovascular health (CVH) of women and children in Abuja and the surrounding Federal Capital Territory of Nigeria. The study team plans to achieve this through an adaptation of an existing evidence based intervention - Parents as Teachers (PAT) curriculum + Healthy Eating Active Living Taught at Home (HEALTH) - among pregnant women with obesity and their children in Nigeria. The aim of the study is to evaluate the effectiveness and implementation of community health educator-led delivery of the PAT+HEALTH intervention via home visits to answer the following main questions:

* Will the women participating in the intervention have a greater change in weight from baseline to 18-month follow up compared to the women who do not?
* Will the women and children in the intervention group display better CVH promoting lifestyle behaviors compared to those in the control group?

Participants in the study will complete baseline surveys and have clinical data, lab data, and body measurements captured. Participants will also have these procedures repeated at birth and every 6 months up to 24 months post-delivery. Once randomized to the intervention group, participants will complete 40 biweekly PAT+HEALTH curriculum delivery sessions, each lasting approximately 60-90 minutes.


Eligibility criteria: Inclusion Criteria:

•≥18 years of age,

* Pregnant women under 14 weeks gestation,
* Singleton gestation,
* Body mass index \> 30 kg/m2
* Willing to participate in ENHANCE CVH for 2 years,
* Planning to receive prenatal care and deliver at either one of the participating primary healthcare, centers or University of Abuja Teaching Hospital, and
* Able to give informed consent for study participation, understanding she and her child will both be involved.

Exclusion Criteria:

* Current enrollment in a weight loss program,
* Inability to engage in a walking program,
* Active substance abuse
* Treatment with medications known to impact weight (e.g., corticosteroids, antipsychotics),
* Plan to relocate within the next 2 years, or
* Unwilling to provide informed consent.

Primary outcomes:
measure: Change in maternal body weight from baseline
timeFrame: Baseline to 18-month postnatal follow up
Secondary outcomes:
measure: Change in cardiovascular health score
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Tobacco Use/Exposure
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Diet
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Physical Activity
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - BMI
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Blood Pressure
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Cholesterol
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Blood Sugar
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in cardiovascular health score - Sleep
timeFrame: Baseline to 18-month postnatal follow up
measure: Change in Child CVH behaviors - Diet
timeFrame: Birth to 18 months
measure: Change in Child CVH behaviors - Physical Activity
timeFrame: Birth to 18 months
measure: Change in Child CVH behaviors - Sleep
timeFrame: Birth to 18 months
measure: Maternal Mortality
timeFrame: Baseline to 18-month postnatal follow up
measure: Maternal morbidity
timeFrame: Baseline to 18-month postnatal follow up
measure: Stillbirth or spontaneous abortion
timeFrame: Measured at Birth
measure: Neonatal, infant, and child mortality
timeFrame: Birth to 18 months
measure: Neonatal, infant, and child morbidity
timeFrame: Birth to 18 months
Other outcomes:
measure: Child Weight for length
timeFrame: Birth, 6 months, 18 months
measure: Child BMI
timeFrame: Birth, 6 months, 18 months
measure: Parental feeding behaviors
timeFrame: 6 months, 12 months, 18 months, 24 months
Locations:
Study officials:
affiliation: University of Abuja Teaching Hospital
name: Dike B Ojji, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1160-1203. doi: 10.1016/S0140-6736(20)30977-6.
citation: Tukur J, Lavin T, Adanikin A, Abdussalam M, Bankole K, Ekott MI, Godwin A, Ibrahim HA, Ikechukwu O, Kadas SA, Nwokeji-Onwe L, Nzeribe E, Ogunkunle TO, Oyeneyin L, Tunau KA, Bello M, Aminu I, Ezekwe B, Aboyeji P, Adesina OA, Chama C, Etuk S, Galadanci H, Ikechebelu J, Oladapo OT; Maternal and Perinatal Database for Quality, Equity and Dignity Network. Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals. EClinicalMedicine. 2022 Apr 28;47:101411. doi: 10.1016/j.eclinm.2022.101411. eCollection 2022 May.
citation: Abubakar I, Dalglish SL, Angell B, Sanuade O, Abimbola S, Adamu AL, Adetifa IMO, Colbourn T, Ogunlesi AO, Onwujekwe O, Owoaje ET, Okeke IN, Adeyemo A, Aliyu G, Aliyu MH, Aliyu SH, Ameh EA, Archibong B, Ezeh A, Gadanya MA, Ihekweazu C, Ihekweazu V, Iliyasu Z, Kwaku Chiroma A, Mabayoje DA, Nasir Sambo M, Obaro S, Yinka-Ogunleye A, Okonofua F, Oni T, Onyimadu O, Pate MA, Salako BL, Shuaib F, Tsiga-Ahmed F, Zanna FH. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet. 2022 Mar 19;399(10330):1155-1200. doi: 10.1016/S0140-6736(21)02488-0. Epub 2022 Mar 15. No abstract available.
citation: Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA, Gunderson EP, Stuart JJ, Vaidya D; American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council. Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association. Circulation. 2021 May 4;143(18):e902-e916. doi: 10.1161/CIR.0000000000000961. Epub 2021 Mar 29.
citation: Nigeria Federal Ministry of Health (2019). National Multi-Sectoral Action Plan for the Prevention and Control of Non-Communicable Diseases; Federal Capital Territory, Nigeria.
citation: Aifah A, Onakomaiya D, Iwelunmor J, Oladele D, Gbajabiamila T, Obiezu-Umeh C, Nwaozuru U, Musa AZ, Ezechi O, Ogedegbe G. Nurses' perceptions on implementing a task-shifting/sharing strategy for hypertension management in patients with HIV in Nigeria: a group concept mapping study. Implement Sci Commun. 2020 Jun 26;1:58. doi: 10.1186/s43058-020-00048-y. eCollection 2020.
citation: Wiltsey Stirman S, Baumann AA, Miller CJ. The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions. Implement Sci. 2019 Jun 6;14(1):58. doi: 10.1186/s13012-019-0898-y.
citation: Haire-Joshu D, Schwarz CD, Steger-May K, Lapka C, Schechtman K, Brownson RC, Tabak RG. A Randomized Trial of Weight Change in a National Home Visiting Program. Am J Prev Med. 2018 Mar;54(3):341-351. doi: 10.1016/j.amepre.2017.12.012.
citation: Haire-Joshu D, Cahill AG, Stein RI, Cade WT, Woolfolk CL, Moley K, Mathur A, Schwarz CD, Schechtman KB, Klein S. Randomized Controlled Trial of Home-Based Lifestyle Therapy on Postpartum Weight in Underserved Women with Overweight or Obesity. Obesity (Silver Spring). 2019 Apr;27(4):535-541. doi: 10.1002/oby.22413.
citation: Cahill AG, Haire-Joshu D, Cade WT, Stein RI, Woolfolk CL, Moley K, Mathur A, Schechtman K, Klein S. Weight Control Program and Gestational Weight Gain in Disadvantaged Women with Overweight or Obesity: A Randomized Clinical Trial. Obesity (Silver Spring). 2018 Mar;26(3):485-491. doi: 10.1002/oby.22070.
citation: Ojji DB, Baldridge AS, Orji IA, Shedul GL, Ojo TM, Ye J, Chopra A, Ale BM, Shedul G, Ugwuneji EN, Egenti NB, Aluka-Omitiran K, Okoli RCB, Eze H, Nwankwo A, Banigbe B, Tripathi P, Kandula NR, Hirschhorn LR, Huffman MD; Hypertension Treatment in Nigeria Program Investigators. Characteristics, treatment, and control of hypertension in public primary healthcare centers in Nigeria: baseline results from the Hypertension Treatment in Nigeria Program. J Hypertens. 2022 May 1;40(5):888-896. doi: 10.1097/HJH.0000000000003089. Epub 2022 Jan 15.
citation: Glasgow RE, Battaglia C, McCreight M, Ayele RA, Rabin BA. Making Implementation Science More Rapid: Use of the RE-AIM Framework for Mid-Course Adaptations Across Five Health Services Research Projects in the Veterans Health Administration. Front Public Health. 2020 May 27;8:194. doi: 10.3389/fpubh.2020.00194. eCollection 2020.
citation: Gemechu KS, Assefa N, Mengistie B. Prevalence of hypertensive disorders of pregnancy and pregnancy outcomes in Sub-Saharan Africa: A systematic review and meta-analysis. Womens Health (Lond). 2020 Jan-Dec;16:1745506520973105. doi: 10.1177/1745506520973105.
citation: Adeloye D, Ige-Elegbede JO, Ezejimofor M, Owolabi EO, Ezeigwe N, Omoyele C, Mpazanje RG, Dewan MT, Agogo E, Gadanya MA, Alemu W, Harhay MO, Auta A, Adebiyi AO. Estimating the prevalence of overweight and obesity in Nigeria in 2020: a systematic review and meta-analysis. Ann Med. 2021 Dec;53(1):495-507. doi: 10.1080/07853890.2021.1897665.
citation: Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press (US); 2009. Available from http://www.ncbi.nlm.nih.gov/books/NBK32813/
citation: Teede HJ, Bailey C, Moran LJ, Bahri Khomami M, Enticott J, Ranasinha S, Rogozinska E, Skouteris H, Boyle JA, Thangaratinam S, Harrison CL. Association of Antenatal Diet and Physical Activity-Based Interventions With Gestational Weight Gain and Pregnancy Outcomes: A Systematic Review and Meta-analysis. JAMA Intern Med. 2022 Feb 1;182(2):106-114. doi: 10.1001/jamainternmed.2021.6373.
citation: Mandy M, Nyirenda M. Developmental Origins of Health and Disease: the relevance to developing nations. Int Health. 2018 Mar 1;10(2):66-70. doi: 10.1093/inthealth/ihy006.
citation: Barker DJ. Fetal origins of coronary heart disease. BMJ. 1995 Jul 15;311(6998):171-4. doi: 10.1136/bmj.311.6998.171.
citation: Jebasingh F, Thomas N. Barker Hypothesis and Hypertension. Front Public Health. 2022 Jan 21;9:767545. doi: 10.3389/fpubh.2021.767545. eCollection 2021.
citation: Bhargava SK, Sachdev HS, Fall CH, Osmond C, Lakshmy R, Barker DJ, Biswas SK, Ramji S, Prabhakaran D, Reddy KS. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med. 2004 Feb 26;350(9):865-75. doi: 10.1056/NEJMoa035698.
citation: Haire-Joshu D, Tabak R. Preventing Obesity Across Generations: Evidence for Early Life Intervention. Annu Rev Public Health. 2016;37:253-71. doi: 10.1146/annurev-publhealth-032315-021859.
citation: Khalil A, Huffman MD, Prabhakaran D, Osmond C, Fall CH, Tandon N, Lakshmy R, Prabhakaran P, Biswas SK, Ramji S, Sachdev HS, Bhargava SK; New Delhi Birth Cohort. Predictors of carotid intima-media thickness and carotid plaque in young Indian adults: the New Delhi birth cohort. Int J Cardiol. 2013 Aug 20;167(4):1322-8. doi: 10.1016/j.ijcard.2012.03.180. Epub 2012 Apr 25.
citation: Huffman MD, Khalil A, Osmond C, Fall CH, Tandon N, Lakshmy R, Ramji S, Gera T, Prabhakaran P, Dey Biswas SK, Reddy KS, Bhargava SK, Sachdev HS, Prabhakaran D; New Delhi Birth Cohort. Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort. Indian J Med Res. 2015 Dec;142(6):690-8. doi: 10.4103/0971-5916.174559.
citation: Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Beiler JS, Hess LB, Loken E, Birch LL. Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial. JAMA. 2018 Aug 7;320(5):461-468. doi: 10.1001/jama.2018.9432.
citation: Phelan S, Clifton RG, Haire-Joshu D, Redman LM, Van Horn L, Evans M, Joshipura K, Couch KA, Arteaga SS, Cahill AG, Drews KL, Franks PW, Gallagher D, Josefson JL, Klein S, Knowler WC, Martin CK, Peaceman AM, Thom EA, Wing RR, Yanovski SZ, Pi-Sunyer X; LIFE-Moms Research Group. One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials. Int J Obes (Lond). 2020 Jan;44(1):57-68. doi: 10.1038/s41366-019-0410-4. Epub 2019 Jul 10.
citation: Leunissen RW, Kerkhof GF, Stijnen T, Hokken-Koelega A. Timing and tempo of first-year rapid growth in relation to cardiovascular and metabolic risk profile in early adulthood. JAMA. 2009 Jun 3;301(21):2234-42. doi: 10.1001/jama.2009.761.
citation: Ong KK, Ahmed ML, Emmett PM, Preece MA, Dunger DB. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ. 2000 Apr 8;320(7240):967-71. doi: 10.1136/bmj.320.7240.967.
citation: Sirard JR, Pate RR. Physical activity assessment in children and adolescents. Sports Med. 2001;31(6):439-54. doi: 10.2165/00007256-200131060-00004.
citation: Tabak RG, Morshed AB, Schwarz CD, Haire-Joshu D. Weight gain prevention content delivered to mothers: Lessons from an intervention embedded in a community organization. Obes Sci Pract. 2019 Nov 18;5(6):540-547. doi: 10.1002/osp4.369. eCollection 2019 Dec.
citation: Cole TJ, Power C, Moore GE. Intergenerational obesity involves both the father and the mother. Am J Clin Nutr. 2008 May;87(5):1535-6; author reply 1536-7. doi: 10.1093/ajcn/87.5.1535. No abstract available.
citation: Sutherland G, Brown S, Yelland J. Applying a social disparities lens to obesity in pregnancy to inform efforts to intervene. Midwifery. 2013 Apr;29(4):338-43. doi: 10.1016/j.midw.2012.01.016. Epub 2012 Nov 9.
citation: Wen LM, Baur LA, Simpson JM, Rissel C, Wardle K, Flood VM. Effectiveness of home based early intervention on children's BMI at age 2: randomised controlled trial. BMJ. 2012 Jun 26;344:e3732. doi: 10.1136/bmj.e3732.
citation: Savage JS, Birch LL, Marini M, Anzman-Frasca S, Paul IM. Effect of the INSIGHT Responsive Parenting Intervention on Rapid Infant Weight Gain and Overweight Status at Age 1 Year: A Randomized Clinical Trial. JAMA Pediatr. 2016 Aug 1;170(8):742-9. doi: 10.1001/jamapediatrics.2016.0445.
citation: Seidler AL, Hunter KE, Johnson BJ, Ekambareshwar M, Taki S, Mauch CE, Mihrshahi S, Askie L, Campbell KJ, Daniels L, Taylor RW, Wen LM, Byrne R, Lawrence J, Perlstein R, Wardle K, Golley RK. Understanding, comparing and learning from the four EPOCH early childhood obesity prevention interventions: A multi-methods study. Pediatr Obes. 2020 Nov;15(11):e12679. doi: 10.1111/ijpo.12679. Epub 2020 Jun 15.
citation: Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51 Suppl:S28-40. doi: 10.1177/0022146510383498.
citation: Solar O, Irwin A. (2010) A Conceptual Framework for Action on the Social Determinants of Health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva, Switzerland.
citation: National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey (NDHS) 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.
citation: Adepoju P. Nigeria's new law aims to provide health insurance to all. Lancet. 2022 Jun 4;399(10341):2092. doi: 10.1016/S0140-6736(22)01008-X. No abstract available.
citation: WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organization; 2016. Available from http://www.ncbi.nlm.nih.gov/books/NBK409108/
citation: Antenatal Care: An Orientation Package for Health Care Providers. (2017) Nigeria Federal Ministry of Health Guidelines. Federal Capital Territory, Nigeria.
citation: Ojji DB, Baldridge AS, Orji AI, Shedul LG, Ojji OI, Egenti NB, Nwankwo AM, Huffman MD. Feasibility and effect of community health worker support and home monitoring for blood pressure control in Nigeria: a randomised pilot trial. Cardiovasc J Afr. 2020 May-Jun;31(3):213-215. doi: 10.5830/CVJA-2019-066.
citation: Baldridge AS, Aluka-Omitiran K, Orji IA, Shedul GL, Ojo TM, Eze H, Shedul G, Ugwuneji EN, Egenti NB, Okoli RCB, Ale BM, Nwankwo A, Osagie S, Ye J, Chopra A, Sanuade OA, Tripathi P, Kandula NR, Hirschhorn LR, Huffman MD, Ojji DB. Hypertension Treatment in Nigeria (HTN) Program: rationale and design for a type 2 hybrid, effectiveness, and implementation interrupted time series trial. Implement Sci Commun. 2022 Aug 2;3(1):84. doi: 10.1186/s43058-022-00328-9.
citation: Ojji D, Aifah A, Dulli L, Iwelunmor J; MAP-IT Study Team. Early stakeholder engagement lessons from managing hypertension among people living with human-immunodeficiency virus: an integrated model (MAP-IT). Eur Heart J. 2022 Jul 1;43(25):2347-2349. doi: 10.1093/eurheartj/ehac159. No abstract available.
citation: Ojji D; Nigeria Sodium Study Team. Developing long-term strategies to reduce excess salt consumption in Nigeria. Eur Heart J. 2022 Mar 31;43(13):1277-1279. doi: 10.1093/eurheartj/ehac025. No abstract available.
citation: Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC. Available at: Https://Doi.Org/10.52570/DGAC2020.
citation: Holtrop JS, Rabin BA, Glasgow RE. Qualitative approaches to use of the RE-AIM framework: rationale and methods. BMC Health Serv Res. 2018 Mar 13;18(1):177. doi: 10.1186/s12913-018-2938-8.
citation: Shelton RC, Chambers DA, Glasgow RE. An Extension of RE-AIM to Enhance Sustainability: Addressing Dynamic Context and Promoting Health Equity Over Time. Front Public Health. 2020 May 12;8:134. doi: 10.3389/fpubh.2020.00134. eCollection 2020.
citation: Gale RC, Wu J, Erhardt T, Bounthavong M, Reardon CM, Damschroder LJ, Midboe AM. Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration. Implement Sci. 2019 Feb 1;14(1):11. doi: 10.1186/s13012-019-0853-y.
citation: Kirk MA, Moore JE, Wiltsey Stirman S, Birken SA. Towards a comprehensive model for understanding adaptations' impact: the model for adaptation design and impact (MADI). Implement Sci. 2020 Jul 20;15(1):56. doi: 10.1186/s13012-020-01021-y.
citation: Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Dec;19(6):349-57. doi: 10.1093/intqhc/mzm042. Epub 2007 Sep 14.
citation: Orji IA, Baldridge AS, Omitiran K, Guo M, Ajisegiri WS, Ojo TM, Shedul G, Kandula NR, Hirschhorn LR, Huffman MD, Ojji DB. Capacity and site readiness for hypertension control program implementation in the Federal Capital Territory of Nigeria: a cross-sectional study. BMC Health Serv Res. 2021 Apr 9;21(1):322. doi: 10.1186/s12913-021-06320-8.
citation: Huffman MD, Capewell S, Ning H, Shay CM, Ford ES, Lloyd-Jones DM. Cardiovascular health behavior and health factor changes (1988-2008) and projections to 2020: results from the National Health and Nutrition Examination Surveys. Circulation. 2012 May 29;125(21):2595-602. doi: 10.1161/CIRCULATIONAHA.111.070722. Epub 2012 Apr 30.
citation: Riley L, Guthold R, Cowan M, Savin S, Bhatti L, Armstrong T, Bonita R. The World Health Organization STEPwise Approach to Noncommunicable Disease Risk-Factor Surveillance: Methods, Challenges, and Opportunities. Am J Public Health. 2016 Jan;106(1):74-8. doi: 10.2105/AJPH.2015.302962.
citation: Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W; American Heart Association. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022 Aug 2;146(5):e18-e43. doi: 10.1161/CIR.0000000000001078. Epub 2022 Jun 29.
citation: American Academy of Pediatrics. Bright Futures: Prevention and Health Promotion for Infants, Children, Adolescents, and Their Families. 2021; Https://Brightfutures.Aap.Org/Pages/Default.Aspx. Accessed July 25, 2022.
citation: Kapp JM, Hall B, Kemner A. Collecting Early Childhood Obesity Measurements Through a Home Visiting Program: A Proof-of-Concept Study. Prev Chronic Dis. 2020 Dec 31;17:E169. doi: 10.5888/pcd17.200214.
citation: Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of Obesity and Severe Obesity in US Children, 1999-2016. Pediatrics. 2018 Mar;141(3):e20173459. doi: 10.1542/peds.2017-3459.
citation: O'Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for Obesity and Intervention for Weight Management in Children and Adolescents: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017 Jun 20;317(23):2427-2444. doi: 10.1001/jama.2017.0332.
citation: WHO Child Growth Standards. Int J Pediatrics. 2006; 95(S450): 1-106. doi: 10.1080/08035320500495373
citation: Ebrahim GJ. WHO Child Growth Standards. Growth velocity based on weight, length and head circumference: methods and development. J Trop Pediatrics. 2010;56(2):136-136. doi:10.1093/tropej/fmp086
citation: Hamilton CM, Strader LC, Pratt JG, Maiese D, Hendershot T, Kwok RK, Hammond JA, Huggins W, Jackman D, Pan H, Nettles DS, Beaty TH, Farrer LA, Kraft P, Marazita ML, Ordovas JM, Pato CN, Spitz MR, Wagener D, Williams M, Junkins HA, Harlan WR, Ramos EM, Haines J. The PhenX Toolkit: get the most from your measures. Am J Epidemiol. 2011 Aug 1;174(3):253-60. doi: 10.1093/aje/kwr193. Epub 2011 Jul 11.
citation: Thompson T, McQueen A, Croston M, Luke A, Caito N, Quinn K, Funaro J, Kreuter MW. Social Needs and Health-Related Outcomes Among Medicaid Beneficiaries. Health Educ Behav. 2019 Jun;46(3):436-444. doi: 10.1177/1090198118822724. Epub 2019 Jan 17.
citation: Sullivan SD, Mauskopf JA, Augustovski F, Jaime Caro J, Lee KM, Minchin M, Orlewska E, Penna P, Rodriguez Barrios JM, Shau WY. Budget impact analysis-principles of good practice: report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value Health. 2014 Jan-Feb;17(1):5-14. doi: 10.1016/j.jval.2013.08.2291. Epub 2013 Dec 13.
citation: Calhoun A, Mainor A, Moreland-Russell S, Maier RC, Brossart L, Luke DA. Using the Program Sustainability Assessment Tool to assess and plan for sustainability. Prev Chronic Dis. 2014 Jan 23;11:130185. doi: 10.5888/pcd11.130185.
citation: Luke DA, Calhoun A, Robichaux CB, Elliott MB, Moreland-Russell S. The Program Sustainability Assessment Tool: a new instrument for public health programs. Prev Chronic Dis. 2014 Jan 23;11:130184. doi: 10.5888/pcd11.130184.