The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study

NCT ID: NCT01167270

Last Updated: 2024-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

316 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2023-12-31

Brief Summary

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This study will test an intervention program designed to provide developmentally appropriate guidance to parents of infants on responsive parenting and healthy lifestyle to see if that intervention will prevent rapid weight gain in infancy and overweight at age 3 years. Further, compared with control infants, intervention infants will have lower body mass index (BMI) percentiles at age 3. The investigators also hypothesize that control infants will gain weight more rapidly over time.

Detailed Description

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Principal Hypotheses: An intervention program designed to provide developmentally appropriate guidance to parents of infants on responsive parenting and healthy lifestyle will prevent rapid weight gain in infancy and overweight at age 3 years. Further, compared with control infants, intervention infants will have lower BMI percentiles at age 3. We also hypothesize that control infants will gain weight more rapidly over time, adjusting for trait-stable and time-varying covariates (e.g., maternal pre-pregnancy BMI, percent of feedings that are breast milk vs. formula, sleep duration, and feeding frequency).

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study, will test these hypotheses in a two arm randomized trial where participants in a program to prevent childhood obesity will be compared with those in a child safety control program. Nurses will deliver interventions to first-time parents and their infants in both study groups at four home visits in the first year after birth followed by annual clinical research center visits until age 3. Blood samples for genetic testing on appetite, growth, and temperament will be collected from mother, child, and father. The obesity prevention program focuses on messages of responsive parenting and healthy lifestyle, extending from infancy through age 3 years. The intervention will teach first-time parents to interact with their infants in a way that is prompt, emotionally supportive, contingent, and developmentally appropriate. This information is especially important during the first year after birth as infants make a dramatic dietary transition from the initial exclusive milk diet to one with many foods of the adult diet of their culture. During this transition, as foods are being introduced to children, there are numerous opportunities to address dietary content as well as parent feeding style. In addition to these messages, intervention parents will be given education on growth charts, the meaning of growth chart percentiles, and healthy growth patterns during early life. The intervention program is hypothesized to show efficacy in both breast and formula fed infants as measured by the primary outcome, body mass index (BMI) percentile at age 3 years. Additionally, participants will be followed to collect anthropometric measurements at 4,5,6,10,14,and 17 years of age to provide significant insight into long-term obesity risk.

The proposed research adds two major pieces by enrolling second born siblings and collecting genetic specimens from both siblings and their parents. Specifically, this translational research will a) prospectively evaluate obesity-related parenting similarities and differences as well as weight-related outcomes between first and second-born siblings, b) explore how genetic differences among siblings that are associated with appetite, temperament, and obesity susceptibility affect parent-child interactions, degree of responsive parenting, and weight status, and c) determine whether INSIGHT study intervention carryover effects occur among families participating in the observation-only second-born child evaluation.

Conditions

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Infant Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Parenting Insight

Educational program contains messages to provide developmentally appropriate guidance to parents of infants on responsive parenting and healthy lifestyle that will prevent rapid weight gain in infancy and overweight at age 3 years.

Group Type ACTIVE_COMPARATOR

Parenting Insights

Intervention Type BEHAVIORAL

Educational program contains messages to provide developmentally appropriate guidance to parents of infants on responsive parenting and healthy lifestyle that will prevent rapid weight gain in infancy and overweight at age 3 years.

Child Safety Insights

A child safety intervention with messages focused on the infant's environment and interactions with parents. They will be guided by the AAP guidelines and the Academy's guide for health supervision, Bright Futures

Group Type PLACEBO_COMPARATOR

Child Safety Insights

Intervention Type BEHAVIORAL

A child safety intervention with messages focused on the infant's environment and interactions with parents. They will be guided by the American Academy of Pediatrics as well as the Academy's guide for health supervision, Bright Futures.

Interventions

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Child Safety Insights

A child safety intervention with messages focused on the infant's environment and interactions with parents. They will be guided by the American Academy of Pediatrics as well as the Academy's guide for health supervision, Bright Futures.

Intervention Type BEHAVIORAL

Parenting Insights

Educational program contains messages to provide developmentally appropriate guidance to parents of infants on responsive parenting and healthy lifestyle that will prevent rapid weight gain in infancy and overweight at age 3 years.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* full-term infant(\> 37 0/7 weeks gestational age)discharged from hospital without significant morbidity
* singleton infant
* nursery/NICU/maternity stay of 7 days or less
* primiparous mother
* English speaking mother

Exclusion Criteria

* presence of a congenital anomaly or neonatal condition that significantly affects a newborn's feeding (e.g. cleft lip, cleft palate, metabolic disease
* any major maternal morbidities and/or pre-existing condition that would affect postpartum care such as cancer, multiple sclerosis, lupus, etc.
* maternal age \<=20 years
* prenatal ultrasound presence of intrauterine growth retardation (IUGR)
* infant birth weight \<2500 grams plan for newborn to be adopted
* plan to move from Central Pennsylvania within 3 years
* inability to complete contact form with name, address, phone numbers, etc.
* Practicing pediatrician or pediatric resident
Minimum Eligible Age

1 Day

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Ian M. Paul, MD

OTHER

Sponsor Role lead

Responsible Party

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Ian M. Paul, MD

Professor of Pediatrics and Public Health Sciences

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Leann L Birch, PhD

Role: PRINCIPAL_INVESTIGATOR

Penn State University

Ian M Paul, MD, MSc

Role: PRINCIPAL_INVESTIGATOR

Penn State College of Medicine and Children's Hospital

Locations

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Penn State Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Penn State University

State College, Pennsylvania, United States

Site Status

Countries

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United States

References

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Paul IM, Williams JS, Anzman-Frasca S, Beiler JS, Makova KD, Marini ME, Hess LB, Rzucidlo SE, Verdiglione N, Mindell JA, Birch LL. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study. BMC Pediatr. 2014 Jul 18;14:184. doi: 10.1186/1471-2431-14-184.

Reference Type BACKGROUND
PMID: 25037579 (View on PubMed)

Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Mindell JA, Birch LL. INSIGHT Responsive Parenting Intervention and Infant Sleep. Pediatrics. 2016 Jul;138(1):e20160762. doi: 10.1542/peds.2016-0762.

Reference Type RESULT
PMID: 27354460 (View on PubMed)

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.

Reference Type RESULT
PMID: 27271455 (View on PubMed)

Paul IM, Hohman EE, Birch LL, Shelly A, Vallotton CD, Savage JS. Exploring infant signing to enhance responsive parenting: Findings from the INSIGHT study. Matern Child Nutr. 2019 Jul;15(3):e12800. doi: 10.1111/mcn.12800. Epub 2019 Mar 19.

Reference Type RESULT
PMID: 30810273 (View on PubMed)

Craig SJC, Blankenberg D, Parodi ACL, Paul IM, Birch LL, Savage JS, Marini ME, Stokes JL, Nekrutenko A, Reimherr M, Chiaromonte F, Makova KD. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Sci Rep. 2018 Sep 19;8(1):14030. doi: 10.1038/s41598-018-31866-9.

Reference Type RESULT
PMID: 30232389 (View on PubMed)

Eagleton SG, Hohman EE, Verdiglione N, Birch LL, Paul IM, Savage JS. INSIGHT Study Maternal Return to Work and Infant Weight Outcomes. Acad Pediatr. 2019 Jan-Feb;19(1):67-73. doi: 10.1016/j.acap.2018.08.008. Epub 2018 Aug 23.

Reference Type RESULT
PMID: 30145361 (View on PubMed)

Savage JS, Hohman EE, Marini ME, Shelly A, Paul IM, Birch LL. INSIGHT responsive parenting intervention and infant feeding practices: randomized clinical trial. Int J Behav Nutr Phys Act. 2018 Jul 9;15(1):64. doi: 10.1186/s12966-018-0700-6.

Reference Type RESULT
PMID: 29986721 (View on PubMed)

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.

Reference Type RESULT
PMID: 30088009 (View on PubMed)

Anzman-Frasca S, Paul IM, Moding KJ, Savage JS, Hohman EE, Birch LL. Effects of the INSIGHT Obesity Preventive Intervention on Reported and Observed Infant Temperament. J Dev Behav Pediatr. 2018 Dec;39(9):736-743. doi: 10.1097/DBP.0000000000000597.

Reference Type RESULT
PMID: 29927795 (View on PubMed)

Adams EL, Marini ME, Stokes J, Birch LL, Paul IM, Savage JS. INSIGHT responsive parenting intervention reduces infant's screen time and television exposure. Int J Behav Nutr Phys Act. 2018 Mar 15;15(1):24. doi: 10.1186/s12966-018-0657-5.

Reference Type RESULT
PMID: 29544506 (View on PubMed)

Hohman EE, Savage JS, Birch LL, Beiler JS, Paul IM. Pacifier Use and Early Life Weight Outcomes in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study. Child Obes. 2018 Jan;14(1):58-66. doi: 10.1089/chi.2017.0177. Epub 2017 Oct 4.

Reference Type RESULT
PMID: 28976781 (View on PubMed)

Paul IM, Hohman EE, Loken E, Savage JS, Anzman-Frasca S, Carper P, Marini ME, Birch LL. Mother-Infant Room-Sharing and Sleep Outcomes in the INSIGHT Study. Pediatrics. 2017 Jul;140(1):e20170122. doi: 10.1542/peds.2017-0122. Epub 2017 Jun 5.

Reference Type RESULT
PMID: 28759407 (View on PubMed)

Carney MC, Tarasiuk A, DiAngelo SL, Silveyra P, Podany A, Birch LL, Paul IM, Kelleher S, Hicks SD. Metabolism-related microRNAs in maternal breast milk are influenced by premature delivery. Pediatr Res. 2017 Aug;82(2):226-236. doi: 10.1038/pr.2017.54. Epub 2017 May 24.

Reference Type RESULT
PMID: 28422941 (View on PubMed)

Hohman EE, Paul IM, Birch LL, Savage JS. INSIGHT responsive parenting intervention is associated with healthier patterns of dietary exposures in infants. Obesity (Silver Spring). 2017 Jan;25(1):185-191. doi: 10.1002/oby.21705.

Reference Type RESULT
PMID: 28008749 (View on PubMed)

Dadzie A, Master L, Hohman EE, Acton EH, Tauriello S, Paul IM, Savage JS, Anzman-Frasca S, Buxton OM. Associations Between Sleep Health and Child Behavior at Age 6 Years in the INSIGHT Study. J Dev Behav Pediatr. 2025 Jan-Feb 01;46(1):e56-e63. doi: 10.1097/DBP.0000000000001326. Epub 2024 Nov 8.

Reference Type DERIVED
PMID: 39514718 (View on PubMed)

Hernandez Acton E, Kubiniec E, Bhargava S, Tauriello S, Paul IM, Savage JS, Anzman-Frasca S. INSIGHT responsive parenting intervention effects on child self-regulation at ages 3 and 6 years. Dev Psychol. 2025 Aug;61(8):1413-1426. doi: 10.1037/dev0001839. Epub 2024 Sep 26.

Reference Type DERIVED
PMID: 39325391 (View on PubMed)

Tauriello S, Savage JS, Goldsmith J, Kubiniec E, Paul IM, Anzman-Frasca S. Effect of the INSIGHT Responsive Parenting Intervention on Parenting and Child Behavior at Ages 3 and 6 Years. J Pediatr. 2023 Apr;255:72-79. doi: 10.1016/j.jpeds.2022.10.025. Epub 2022 Oct 29.

Reference Type DERIVED
PMID: 37081779 (View on PubMed)

Hohman EE, Savage JS, Marini ME, Anzman-Frasca S, Buxton OM, Loken E, Paul IM. Effect of the INSIGHT Firstborn Parenting Intervention on Secondborn Sleep. Pediatrics. 2022 Jul 1;150(1):e2021055244. doi: 10.1542/peds.2021-055244.

Reference Type DERIVED
PMID: 35703026 (View on PubMed)

Hyczko AV, Ruggiero CF, Hohman EE, Anzman-Frasca S, Savage JS, Birch LL, Paul IM. Sex Differences in Maternal Restrictive Feeding Practices in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study. Acad Pediatr. 2021 Aug;21(6):1070-1076. doi: 10.1016/j.acap.2021.05.002. Epub 2021 May 19.

Reference Type DERIVED
PMID: 34020105 (View on PubMed)

Hohman EE, Savage JS, Birch LL, Paul IM. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Responsive Parenting Intervention for Firstborns Affects Dietary Intake of Secondborn Infants. J Nutr. 2020 Aug 1;150(8):2139-2146. doi: 10.1093/jn/nxaa135.

Reference Type DERIVED
PMID: 32412629 (View on PubMed)

Adams EL, Marini ME, Brick TR, Paul IM, Birch LL, Savage JS. Ecological momentary assessment of using food to soothe during infancy in the INSIGHT trial. Int J Behav Nutr Phys Act. 2019 Sep 5;16(1):79. doi: 10.1186/s12966-019-0837-y.

Reference Type DERIVED
PMID: 31488156 (View on PubMed)

Other Identifiers

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1R01DK088244-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

34493

Identifier Type: -

Identifier Source: org_study_id

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